Ultrasound interest group: a novel method of expanding ultrasound education in medical school

Abstract Purpose Ultrasound technology and clinical applications are advancing across many medical specialties and there exists an increasing need for ultrasound education in medical school. Few institutions, however, have incorporated this into the 4-year curriculum and barriers to curricular change remain. The Ultrasound Interest Group (USIG) is an alternative, extracurricular way for future operators to gain ultrasound exposure throughout all four years of medical school and develop the skill sets necessary to emerge as leaders in sonography. Methods The USIG was designed using a student organization infrastructure. The mission is to promote ultrasound education and student leadership across the medical school, outside the required curriculum. Participation is voluntary and open to all medical students. Leadership consists of defined positions held by junior and senior medical students. The USIG holds four meetings per year, organizes clinical and scanning opportunities for students, sponsors ultrasound events, and distributes a newsletter. Results The USIG has been an active student interest group for three academic years and had three sets of student leaders. Participants in USIG activities included first through fourth-year medical students each year. To date, the USIG had 12 meetings including 2 national and 4 local guest speakers. The USIG has organized scanning opportunities for students, sponsored events, and established a vertical model of structured mentorship. Conclusion The USIG is a feasible method of promoting ultrasound education and student leadership among medical students. This model may be implemented at other medical schools as a centralized, organizing body for extracurricular ultrasound education

Advanced Topics in Emergency Medicine: Curriculum Development and Initial Evaluation

<p>Background: Emergency medicine (EM) is a young specialty and only recently has a recommended medical student curriculum been developed. Currently, many schools do not require students to complete a mandatory clerkship in EM, and if one is required, it is typically an overview of the specialty.</p> <p>Objectives: We developed a 10-month longitudinal elective to teach subject matter and skills in EM to fourth-year medical students interested in the specialty. Our goal was producing EM residents with the knowledge and skills to excel at the onset of their residency. We hoped to prove that students participating in this rigorous 10-month longitudinal EM elective would feel well prepared for residency.</p> <p>Methods: We studied the program with an end-of-the-year, Internet-based, comprehensive course evaluation completed by each participant of the first 2 years of the course. Graduates rated each of the course components by using a 5-point Likert format from ‘‘strongly disagree’’ to ‘‘strongly agree,’’ either in terms of whether the component was beneficial to them or whether the course expectations were appropriate, or their perceptions related to the course.</p> <p>Results: Graduates of this elective have reported feeling well prepared to start residency. The resident-led teaching shifts, Advanced Pediatric Life Support certification, Grand Rounds presentations, Advanced Cardiovascular Life Support proficiency testing, and ultrasound component, were found to be beneficial by all students.</p> <p>Conclusions: Our faculty believes that participating students will be better prepared for an EM residency than those students just completing a 1-month clerkship. Our data, although limited, lead us to believe that a longitudinal, immersion-type experience assists fourth-year medical students in preparation for residency. [West J Emerg Med. 2011;12(4):543–550.]</p

Pediatric Emergency Medicine Physicians’ Use of Point‐of‐care Ultrasound and Barriers to Implementation: A Regional Pilot Study

ObjectivesPoint‐of‐care ultrasound (POCUS) has been identified as a critical skill for pediatric emergency medicine (PEM) physicians. The purpose of this study was to profile the current status of PEM POCUS in pediatric emergency departments (EDs).MethodsAn electronic survey was distributed to PEM fellows and attending physicians at four major pediatric academic health centers. The 24‐item questionnaire covered professional demographics, POCUS experience and proficiency, and barriers to the use of POCUS in pediatric EDs. We used descriptive and inferential statistics to profile respondent’s PEM POCUS experience and proficiency and Rasch analysis to evaluate barriers to implementation.ResultsOur return rate was 92.8% (128/138). Respondents were attending physicians (68%) and fellows (28%). Most completed pediatric residencies prior to PEM fellowship (83.6%). Almost all had some form of ultrasound education (113/128, 88.3%). Approximately half (46.9%) completed a formal ultrasound curriculum. More than half (53.2%) said their ultrasound education was pediatric‐specific. Most participants (67%) rated their POCUS proficiency low (Levels 1–2), while rating proficiency in other professional competencies (procedures 52%, emergency stabilization 70%) high (Levels 4–5). There were statistically significant differences in POCUS proficiency between those with formal versus informal ultrasound education (p < 0.001) and those from pediatric versus emergency medicine residencies (p < 0.05). Participants identified both personal barriers discomfort with POCUS skills (76.7%), insufficient educational time to learn POCUS (65%), and negative impact of POCUS on efficiency (58.5%)—and institutional barriers to the use of ultrasound‐consultants will not use ultrasound findings from the ED (60%); insufficient mentoring (64.7%), and POCUS not being a departmental priority (57%).ConclusionsWhile POCUS utilization continues to grow in PEM, significant barriers to full implementation still persist. One significant barrier relates to the need for dedicated time to learn and practice POCUS to achieve sufficient levels of proficiency for use in practice.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138938/1/aet210049_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138938/2/aet210049-sup-0001-SupInfo.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138938/3/aet210049.pd

A National Point‐of‐Care Ultrasound Competition for Medical Students

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146850/1/jum14670_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146850/2/jum14670.pd

Allelic Exclusion and Peripheral Reconstitution by TCR Transgenic T Cells Arising From Transduced Human Hematopoietic Stem/Progenitor Cells

Transduction and transplantation of human hematopoietic stem/progenitor cells (HSPC) with the genes for a T-cell receptor (TCR) that recognizes a tumor-associated antigen may lead to sustained long-term production of T cells expressing the TCR and confer specific antitumor activity. We evaluated this using a lentiviral vector (CCLc-MND-F5) carrying cDNA for a human TCR specific for an HLA-A*0201-restricted peptide of Melanoma Antigen Recognized by T cells (MART-1). CD34+ HSPC were transduced with the F5 TCR lentiviral vector or mock transduced and transplanted into neonatal NSG mice or NSG mice transgenic for human HLA-A*0201 (NSG-A2). Human CD8+ and CD4+ T cells expressing the human F5 TCR were present in the thymus, spleen, and peripheral blood after 4–5 months. Expression of human HLA-A*0201 in NSG-A2 recipient mice led to significantly increased numbers of human CD8+ and CD4+ T cells expressing the F5 TCR, compared with control NSG recipients. Transduction of the human CD34+ HSPC by the F5 TCR transgene caused a high degree of allelic exclusion, potently suppressing rearrangement of endogenous human TCR-β genes during thymopoiesis. In summary, we demonstrated the feasibility of engineering human HSPC to express a tumor-specific TCR to serve as a long-term source of tumor-targeted mature T cells for immunotherapy of melanoma

Combination of searches for heavy spin-1 resonances using 139 fb−1 of proton-proton collision data at s = 13 TeV with the ATLAS detector

A combination of searches for new heavy spin-1 resonances decaying into different pairings of W, Z, or Higgs bosons, as well as directly into leptons or quarks, is presented. The data sample used corresponds to 139 fb−1 of proton-proton collisions at = 13 TeV collected during 2015–2018 with the ATLAS detector at the CERN Large Hadron Collider. Analyses selecting quark pairs (qq, bb, , and tb) or third-generation leptons (τν and ττ) are included in this kind of combination for the first time. A simplified model predicting a spin-1 heavy vector-boson triplet is used. Cross-section limits are set at the 95% confidence level and are compared with predictions for the benchmark model. These limits are also expressed in terms of constraints on couplings of the heavy vector-boson triplet to quarks, leptons, and the Higgs boson. The complementarity of the various analyses increases the sensitivity to new physics, and the resulting constraints are stronger than those from any individual analysis considered. The data exclude a heavy vector-boson triplet with mass below 5.8 TeV in a weakly coupled scenario, below 4.4 TeV in a strongly coupled scenario, and up to 1.5 TeV in the case of production via vector-boson fusion

Combination of searches for heavy spin-1 resonances using 139 fb−1 of proton-proton collision data at √s = 13 TeV with the ATLAS detector

A combination of searches for new heavy spin-1 resonances decaying into diferent pairings of W, Z, or Higgs bosons, as well as directly into leptons or quarks, is presented. The data sample used corresponds to 139 fb−1 of proton-proton collisions at √s = 13 TeV collected during 2015–2018 with the ATLAS detector at the CERN Large Hadron Collider. Analyses selecting quark pairs (qq, bb, tt¯, and tb) or third-generation leptons (τν and τ τ ) are included in this kind of combination for the frst time. A simplifed model predicting a spin-1 heavy vector-boson triplet is used. Cross-section limits are set at the 95% confdence level and are compared with predictions for the benchmark model. These limits are also expressed in terms of constraints on couplings of the heavy vector-boson triplet to quarks, leptons, and the Higgs boson. The complementarity of the various analyses increases the sensitivity to new physics, and the resulting constraints are stronger than those from any individual analysis considered. The data exclude a heavy vector-boson triplet with mass below 5.8 TeV in a weakly coupled scenario, below 4.4 TeV in a strongly coupled scenario, and up to 1.5 TeV in the case of production via vector-boson fusion

Measurement of the tt¯ cross section and its ratio to the Z production cross section using pp collisions at √s = 13.6 TeV with the ATLAS detector

The inclusive top-quark-pair production cross section σtt¯ and its ratio to the Z-boson production cross section have been measured in proton–proton collisions at √s = 13.6 TeV, using 29 fb−1 of data collected in 2022 with the ATLAS experiment at the Large Hadron Collider. Using events with an opposite-charge electron-muon pair and b-tagged jets, and assuming Standard Model decays, the top-quark-pair production cross section is measured to be σtt¯=850±3(stat.)±18(syst.)±20(lumi.) pb. The ratio of the tt¯ and the Z-boson production cross sections is also measured, where the Z-boson contribution is determined for inclusive e+e− and μ+μ− events in a fiducial phase space. The relative uncertainty on the ratio is reduced compared to the tt¯ cross section, thanks to the cancellation of several systematic uncertainties. The result for the ratio, Rtt¯/Z=1.145±0.003(stat.)±0.021(syst.)±0.002(lumi.) is consistent with the Standard Model prediction using the PDF4LHC21 PDF set

Search for new phenomena with top-quark pairs and large missing transverse momentum using 140 fb−1 of pp collision data at √s = 13 TeV with the ATLAS detector

A search is conducted for new phenomena in events with a top quark pair and large missing transverse momentum, where the top quark pair is reconstructed in final states with one isolated electron or muon and multiple jets. The search is performed using the Large Hadron Collider proton-proton collision data sample at a centre-of-mass energy of √s = 13 TeV recorded by the ATLAS detector that corresponds to an integrated luminosity of 140 fb−1. An analysis based on neural network classifiers is optimised to search for directly produced pairs of supersymmetric partners of the top quark (stop), and to search for spin-0 mediators, produced in association with a pair of top quarks, that decay into dark-matter particles. In the stop search, the analysis is designed to target models in which the mass difference between the stop and the neutralino from the stop decay is close to the top quark mass. This new search is combined with previously published searches in final states with different lepton multiplicities. No significant excess above the Standard Model background is observed, and limits at 95% confidence level are set. Models with neutralinos with masses up to 570 GeV are excluded, while for small neutralino masses models are excluded for stop masses up to 1230 GeV. Scalar (pseudoscalar) dark matter mediator masses as large as 350 (370) GeV are excluded when the coupling strengths of the mediator to Standard Model and dark-matter particles are both set to one. At lower mediator masses, models with production cross-sections as small as 0.15 (0.16) times the nominal predictions are excluded. Results of this search are also used to set constraints on effective four-fermion contact interactions between top quarks and neutrinos