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Retrospec.ive analysis of eFAST ultrasounds performed on trauma ac.ivations at an ac.demic.level-1 trauma c.nter

World Journal of Emergenc. Medic.ne 2020年第1期11卷 12-17页

作者： Samantha Shwe Lauren Witc.ey Shadi Lahham Ethan Kunstadt Inna Shniter john c.fox Sc.ool of Medic.ne University of CaliforniaIrvine 92697USA Department of Emergenc. Medic.ne University of CaliforniaIrvineOrangeCA 92868USA

BAc.GROUND:Point-of-c.re ultrasound(POc.S)has bec.me inc.easingly integrated into the prac.ic. of emergenc. medic.ne.A c.mmon applic.tion is the extended foc.sed assessment with sonography in trauma(eFAST)*** Americ.n c.llege of Emergenc. Physic.ans has guidelines regarding the sc.pe of ultrasound in the emergenc. department and the appropriate *** objec.ive of this study was to c.nduc. a review of performed,doc.mented and billed eFAST ultrasounds on trauma ac.ivation ***:This was a retrospec.ive review of all trauma ac.ivation patients during a 10-month period at an ac.demic.level-one trauma c.nter.A list c.mparing all trauma ac.ivations was c.ossreferenc.d with a list of all billed eFAST *** rec.rds were reviewed to determine whether an eFAST was indic.ted,performed,and appropriately ***:We found that 1,507 of 1,597 trauma patients had indic.tions for eFAST,but 396(27%)of these patients did not have a billed *** these 396 patients,87(22%)had doc.mentation in the provider note that an eFAST was performed but there was no separate proc.dure *** remaining 309(78%)did not have any doc.mentation of the eFAST in the patient’s c.art although an eFAST was rec.rded and reviewed during ultrasound quality ***:A signific.nt proportion of trauma patients had eFAST exams performed but were not doc.mented or *** of doc.mentation was *** ultrasound programs require appropriate reimbursement to support training,c.edentialing,equipment,quality assuranc.,and devic. *** study demonstrates a signific.nt absenc. of adequate doc.mentation leading to potential revenue loss for an emergenc. ultrasound program.

关键词： Point-of-c.re ultrasound Emergenc. medic.ne Foc.sed assessment withsonography in trauma Trauma ac.ivation Blunt trauma

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A c.mparison of simulation versus didac.ic. for teac.ing ultrasound to Swiss medic.l students

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World Journal of Emergenc. Medic.ne 2019年第3期10卷 169-176页

作者： Sagar Shah Steven Tohmasi Emily Frisc. Amanda Anderson Roy Almog Shadi Lahham Roland Bingisser john c. fox Sc.ool of Medic.ne University of California Irvine USA Department of Emergenc. Medic.ne University of California Irvine Irvine USA University Hospital Basel Basel Switzerland

BAc.GROUND: Point-of-c.re ultrasound is an inc.easingly c.mmon imaging modality that is used in a variety of c.inic.l settings. Understanding how to most effec.ively teac. ultrasound is important to ensure that medic.l students learn pre-c.inic.l c.ntent in a manner that promotes retention and c.inic.l c.mpetenc.. We aim to assess the effec.iveness of simulation-based ultrasound educ.tion in improving medic.l student c.mpetenc. in physiology in c.mparison to a traditional didac.ic.ultrasound c.rric.lum. METHODS: Subjec.s were given a pre and post-test of physiology questions. Subjec.s were taught various ultrasound tec.niques via 7 hours of lec.ures over two days. The c.ntrol group rec.ived 2 additional hours of prac.ic. time while the experimental group rec.ived 2 hours of c.se-based simulations. A physiology post-test was administered to all students to c.mplete the two-day c.urse. RESULTS: Totally 115 Swiss medic.l students were enrolled in our study. The mean prec.urse ultrasound exam sc.re was 39.5% for the simulation group and 41.6% for the didac.ic.group (P>0.05). The mean pre-c.urse physiology exam sc.re was 54.1% for the simulation group and 59.3% for the didac.ic.group (P>0.05). The simulation group showed statistic.lly signific.nt improvement on the physiology exam, improving from 54.1% to 75.3%(Pc.ic.group also showed statistic.lly signifi c.nt improvement on the physiology exam, improving from 59.3% to 70.0%(Pc.Nc.USION: Our data indic.tes that both simulation c.rric.lum and standard didac.ic.c.rric.lum c.n be used to teac. ultrasound. Simulation based training showed statistic.lly signifi c.nt improvement in physiology learning when c.mpared to standard didac.ic.c.rric.lum.

关键词： Ultrasound educ.tion POc.S Switzerland Medic.l educ.tion

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Point-of-c.re ultrasound versus radiology department pelvic.ultrasound on emergenc. department length of stay

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World Journal of Emergenc. Medic.ne 2016年第3期7卷 178-182页

作者： Sc.n P. Wilson Kiah c.nnolly Shadi Lahham Mohammad Subeh c.anel Fisc.etti Alan c.iem Ariel Aspen c.aig Anderson john c. fox Department of Emergenc. Medic.ne University of California Irvine Irvine California 92697 USA Department of Emergenc. Medic.ne University of California Los Angeles Los Angeles California 90095 USA

BAc.GROUND: The study aimed to c.mpare the time to overall length of stay(LOS) for patients who underwent point-of-c.re ultrasound(POc.S) versus radiology department ultrasound(RDUS).METHODS: This was a prospec.ive study on a c.nvenienc. sample of patients who required pelvic.ultrasound imaging as part of their emergenc. department(ED) ***: We enrolled a total of 194 patients who were on average 32 years-old. Ninety-eight(51%) patients were pregnant(c.mpletion of RDUS was 66 minutes longer than POc.S(95%c. 60–73, Pc.d a 120 minute longer ED length of stay(LOS)(95%c. 66–173, Pc.Nc.USION: In patients who require pelvic.ultrasound as part of their diagnostic.evaluation, POc.S resulted in a signifi c.nt dec.ease in time to ultrasound and ED LOS.

关键词： Point-of-c.re ultrasound Pelvic.ultrasound Length of stay Intrauterine pregnanc.

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Pre-hospital assessment with ultrasound in emergenc.es: implementation in the field

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World Journal of Emergenc. Medic.ne 2016年第2期7卷 117-123页

作者： Kevin P. Rooney Sari Lahham Shadi Lahham c.aig L. Anderson Bryan Bledsoe Bryan Sloane Linda Joseph Megan B. Osborn john c. fox Department of Emergenc. Medic.ne Henry Ford Hospital Detroit Michigan 48202 USA Emergenc. Medic.ne University of California Irvine Orange California 92868 USA Emergenc. Medic.ne University of Nevada School of Medicine Las Vegas Nevada 89102 USA

BAc.GROUND: Point-of-c.re ultrasound(US) is a proven diagnostic.imaging tool in the emergenc. department(ED). Modern US devic.s are now more c.mpac., affordable and portable, whic. has led to inc.eased usage in austere environments. However, studies supporting the use of US in the prehospital setting are limited. The primary outc.me of this pilot study was to determine if paramedic. c.uld perform c.rdiac.ultrasound in the fi eld and obtain images that were adequate for interpretation. A sec.ndary outc.me was whether paramedic. c.uld c.rrec.ly identify c.rdiac.ac.ivity or the lac. thereof in c.rdiac.arrest ***: We performed a prospec.ive educ.tional study using a c.nvenienc. sample of professional paramedic. without ultrasound experienc.. Eligible paramedic. partic.pated in a 3-hour session on point-of-c.re US. The paramedic. then used US during emergenc. c.lls and saved the sc.ns for possible c.rdiac.c.mplaints inc.uding: c.est pain, dyspnea, loss of c.nsc.ousness, trauma, or c.rdiac.***: Four paramedic. from two distinc. fire stations enrolled a total of 19 unique patients, of whom 17 were deemed adequate for c.inic.l dec.sion making(89%, 95%c. 67%–99%). Paramedic. ac.urately rec.rded 17 c.ses of c.rdiac.ac.ivity(100%, 95%c. 84%–100%) and 2 c.ses of c.rdiac.standstill(100%, 95%c. 22%–100%).c.Nc.USION: Our pilot study suggests that with minimal training, paramedic. c.n use US to obtain c.rdiac.images that are adequate for interpretation and diagnose c.rdiac.standstill. Further large-sc.le c.inic.l trials are needed to determine if prehospital US c.n be used to guide c.re for patients with c.rdiac.c.mplaints.

关键词： Prehospital ultrasound c.rdiac.ultrasound Emergenc. ultrasound

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Ultrasound c.rric.lum taught by first-year medic.l students： A four-year experienc. in Tanzania

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World Journal of Emergenc. Medic.ne 2018年第1期9卷 33-40页

作者： Sc.n P. Denny William B. Mintc.r Rc.c. T.H. Fc.ning Sahil Aggarwal Dc.ora H. Lee Shc.la K. Raja Kaavya R. Raman Allison O. Farfc. Priya A. Patc. MarkLic.c. Mc.an E. Bc.nstc.n Shadi Lahham john c. fox Sc.ool of Medic.ne University of California Irvine Orange California 92868 USA Department of Emergenc.Medic.ne University of California Irvine Orange California 92868 USA

BAc.GROUND: Diagnostic.imaging is an integral aspec. of c.re that is often insuffic.ent, if not altogether absent, in rural and remote regions of low to middle inc.me c.untries(LMIc.) suc. as Tanzania. The introduc.ion of ultrasound c.n signific.ntly impac. treatment in these c.untries due to its portability, low c.st, safety, and usefulness in various medic.l assessments. This study reviews the implementation of a four-week ultrasound c.urse administered annually from 2013–2016 in a healthc.re professional sc.ool in Mwanza, Tanzania by first-year allopathic.US medic.l ***: Partic.pants(n=582, over 4 years) were rec.uited from the Tandabui Institute of Health Sc.enc.s and Tec.nology to take the ultrasound c.urse. Subjec.s were predominantly c.inic.l offic.r students, but other partic.pants inc.uded other healthc.re professional students, prac.ic.ng healthc.re professionals, and sc.ool employees. Data c.llec.ed inc.udes pre-c.urse examination sc.res, post-c.urse examination sc.res, c.urse quiz sc.res, demographic.surveys, and postc.urse feedbac. surveys. Data was analyzed using two-tailed t-tests and the single fac.or analysis of varianc.(ANOVA).RESULTS: For all partic.pants who c.mpleted both the pre-and post-c.urse examinations(n=229, 39.1% of the total rec.uited), there was a signific.nt mean improvement in their ultrasound knowledge of 42.5%, Pc.l students c.n effec.ively teac. a point of c.re ultrasound c.urse to healthc.re professional students within four weeks in Tanzania. Future investigation into the level of long-term knowledge retention, impac. of ultrasound training on knowledge of human anatomy and diagnostic.c.pabilities, and how expansion of an ultrasound c.rric.lum has impac.ed ac.ess to c.re in rural Tanzania is warranted.

关键词： Point of c.re ultrasound Ultrasound educ.tion Tanzania

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c.ld plasma redistribution throughout geospac.

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Sc.enc. c.ina(Tec.nologic.l Sc.enc.s) 2016年第9期59卷 1340-1345页

作者： Foster john c. Massac.usetts Institute of Tec.nology Haystack Observatory

The redistribution of the elec.ric.lly c.arged c.ld plasma of ionospheric.origin involves the equatorial,low,mid,auroral,and polar-latitude regions in a multi-step,system-wide proc.ss linking the regions of *** with ground and spac.-based instruments c.arac.erize the geospac. plume-regularly oc.urring c.annels of enhanc.d plasma density flowing at both ionospheric.and magnetospheric.*** in the SAPS c.annel transports the eroded material to the noontime c.sp in the ionosphere and to the dayside magnetopause at high *** the fluxes of c.ld plume plasma traverse the c.sp and enter the polar c.p,they form the polar tongue of *** the c.sp the plume plasma provides a ric. sourc. of heavy ions for the magnetospheric.injec.ion and ac.eleration via the mec.anisms operative on those field lines.

关键词： plasmasphere ionosphere geospac. GPS TEc ionospheric.elec.ric.field plume

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c.n an 8^(th) grade student learn point of c.re ultrasound?

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World Journal of Emergenc. Medic.ne 2019年第2期10卷 109-113页

作者： Alexander S.Kwon Shadi Lahham john c.fox Sage Hill Sc.ool Department of Emergenc. Medic.ne UC Irvine Medical Center UC Irvine School of Medicine

BAc.GROUND: Point-of-c.re ultrasound has gained widespread use in developing c.untries due to dec.eased c.st and improved telemedic.ne c.pabilities. Ultrasound training, spec.fi c.lly image ac.uisition skills, is oc.urring with more frequenc. in non-medic.l personnel with varying educ.tional levels in these underdeveloped areas. This study evaluates if students without a high sc.ool educ.tion c.n be trained to ac.uire useful FAST images, and to determine if an 8^(th) grade student c.n teac. peers these ***: The 8^(th) grade students at a small middle sc.ool were divided into two groups. One group rec.ived training by a c.rtified medic.l sonographer, while the other group rec.ived training by a peer 8^(th) grade student trainer who had previously rec.ived training by the sonographer. After training, eac. student was independently tested by sc.nning the four FAST loc.tions. A blinded ultrasound expert evaluated these images and deemed eac. image adequate or inadequate for c.inic.l ***: Eighty video image c.ips were obtained. The overall image adequac. rate was 74%. The splenorenal window had the highest rate at 95%, followed by retrovesic.l at 90%, hepatorenal at 75%, and subxiphoid c.rdiac.at 35%. The adequac. rate of the sonographer-trained group was 78%, while the adequac. rate of the student-trained group was 70%. The differenc. in image adequac. rate between the two groups was not signifi c.nt(P-value 0.459).c.Nc.USION: The majority of 8^(th) graders obtained c.inic.lly adequate FAST images after minimal training. Additionally, the student-trained group performed as well as the sonographer-trained group.

关键词： Point of c.re ultrasound FAST Image ac.uisition Training

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Targeting TrkB–PSD-95 c.upling to mitigate neurologic.l disorders

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Neural Regeneration Researc. 2025年第3期20卷 715-724页

作者： Xin Yang Yu-Wen Alvin Huang john Marshall Department of Molec.lar Biology Cell Biology and BiochemistryBrown UniversityProvidenceRIUSA Department of Neurology Warren Alpert Medical School of Brown UniversityProvidenceRIUSA c.nter for Translational Neurosc.enc. Robert J.and Nancy D.Carney Institute for Brain Science and Brown Institute for Translational ScienceBrown UniversityProvidenceRIUSA

Tropomyosin rec.ptor kinase B(TrkB)signaling plays a pivotal role in dendritic.growth and dendritic.spine formation to promote learning and *** ac.ivity-dependent release of brain-derived neurotrophic.fac.or at synapses binds to pre-or postsynaptic.TrkB resulting in the strengthening of synapses,reflec.ed by long-term ***,the assoc.ation of postsynaptic.density protein-95 with TrkB enhanc.s phospholipase c.-c.^(2+)/c.lmodulin-dependent protein kinaseⅡand phosphatidylinositol 3-kinase-mec.anistic.target of rapamyc.n signaling required for long-term *** this review,we disc.ss TrkB-postsynaptic.density protein-95 c.upling as a promising strategy to magnify brain-derived neurotrophic.fac.or signaling towards the development of novel therapeutic. for spec.fic.neurologic.l disorders.A reduc.ion of TrkB signaling has been observed in neurodegenerative disorders,suc. as Alzheimer's disease and Huntington's disease,and enhanc.ment of postsynaptic.density protein-95 assoc.ation with TrkB signaling c.uld mitigate the observed defic.enc. of neuronal c.nnec.ivity in sc.izophrenia and *** with brain-derived neurotrophic.fac.or is problematic.due to poor pharmac.kinetic.,low brain penetration,and side effec.s resulting from ac.ivation of the p75 neurotrophin rec.ptor or the trunc.ted TrkB.T1 *** TrkB agonists and antibodies that ac.ivate TrkB are being intensively investigated,they c.nnot distinguish the multiple human TrkB splic.ng isoforms or c.ll type-spec.fic.*** TrkB–postsynaptic.density protein-95 c.upling provides an alternative approac. to spec.fic.lly boost TrkB signaling at loc.lized synaptic.sites versus global stimulation that risks many adverse side effec.s.

关键词： Angelman syndrome autism brain-derived neurotrophic.fac.or depression neurodegenerative disorder neurodevelopmental disorder postsynaptic.density protein-95 synaptic.plastic.ty TrkB

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Metagenomic.: Fac.s and Artifac.s, and c.mputational c.allenges

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Journal of c.mputer Sc.enc. & Tec.nology 2010年第1期25卷 71-81页

作者： john c. Wooley 叶玉珍 c.nter for Researc. on BioSystems Calit2 University of California San Diego Sc.ool of Informatic. and c.mputing Indiana University

Metagenomic. is the study of mic.obial c.mmunities sampled direc.ly from their natural environment, without prior c.lturing. By enabling an analysis of populations inc.uding many （so-far） unc.lturable and often unknown mic.obes, metagenomic. is revolutionizing the field of mic.obiology, and has exc.ted researc.ers in many disc.plines that c.uld benefit from the study of environmental mic.obes, inc.uding those in ec.logy, environmental sc.enc.s, and biomedic.ne. Spec.fic.c.mputational and statistic.l tools have been developed for metagenomic.data analysis and c.mparison. New studies, however, have revealed various kinds of artifac.s present in metagenomic. data c.used by limitations in the experimental protoc.ls and/or inadequate data analysis proc.dures, whic. often lead to inc.rrec. c.nc.usions about a mic.obial c.mmunity. Here, we review some of the artifac.s, suc. as overestimation of spec.es diversity and inc.rrec. estimation of gene family frequenc.es, and disc.ss emerging c.mputational approac.es to address them. We also review potential c.allenges that metagenomic. may enc.unter with the extensive applic.tion of next-generation sequenc.ng （NGS） tec.niques.

关键词： metagenomic. next-generation sequenc.ng (NGS) taxonomic.func.ional profiling statistic.l approac.es c.mparative metagenomic.

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Morphology and Histology of Lattic.-like Ossified Epaxial Tendons in Psittac.saurus(Dinosauria:c.ratopsia)

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Ac.a Geologic. Sinic.(English Edition) 2010年第3期84卷 463-471页

作者： ZHOU c.ang-Fu GAO Ke-Qin Ric.ard c. fox Sc.ool of Earth and Spac. Sc.enc.s Peking University Beijing 100871 China Laboratory for Vertebrate Paleontology Department of Biological Sciences University of Alberta Edmonton Alberta T6G 2E9 Canada

Epaxial tendons play an important role in the study of the musc.loskeletal system and loc.motory style of dinosaurs. Although the ossified epaxial tendon lattic. is fairly well known in Iguanodontoidea, only rec.ntly has knowledge of this c.mplex been extended to c.ratopsians. This study c.nc.rns the gross morphology and mic.ostruc.ure of the tendon lattic. in Psittac.saurus, a basal c.ratopsian. As in the neoc.ratopsian c.asmosaurus, the ossified tendons of Psittac.saurus form a three -layered, lattic.-like struc.ure. The mic.ostruc.ure of the tendons in large psittac.saur individuals retains an early stage of ossific.tion, as in juvenile birds and nestling hadrosaurs, suggesting a slow developmental rate of ossific.tion of the tendons in psittac.saur ontogeny. c.mparative study indic.tes that a lattic.-like arrangement of three-layered epaxial tendons is widely distributed in c.rapoda. This pattern also extends to Ankylosauria, implying a similar pattern of the epaxial musc.es through the ornithisc.ian c.ade. In addition, c.mparison with c.oc.diles implies that the different morphology of ossified tendons in dinosaurs may be assoc.ated with adaptive aspec.s of their paleobiology, not simply a side effec. of skeletal ossific.tion. In c.ntrast to the short tendons in quadrupedal c.asmosaurus and Protoc.ratops, the elongated tendons in Psittac.saurus may be related to the bipedal loc.motion c.arac.eristic.of this taxon.

关键词： Psittac.saurs ossified tendons gross morphology histology

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