An Echocardiography Training Program for Improving the Left Ventricular Function Interpretation in Emergency Department; a Brief Report

Introduction: Focused training in transthoracic echocardiography enables emergency physicians (EPs) to accurately estimate the left ventricular function. This study aimed to evaluate the efficacy of a brief training program utilizing standardized echocardiography video clips in this regard. Methods: A before and after design was used to determine the efficacy of a 1 hour echocardiography training program using PowerPoint presentation and standardized echocardiography video clips illustrating normal and abnormal left ventricular ejection fraction (LVEF) as well as video clips emphasizing the measurement of mitral valve E-point septal separation (EPSS). Pre- and post-test evaluation used unique video clips and asked trainees to estimate LVEF and EPSS based on the viewed video clips. Results: 21 EPs with no prior experience with the echocardiographic technical methods completed this study. The EPs had very limited prior echocardiographic training. The mean score on the categorization of LVEF estimation improved from 4.9 (95% CI: 4.1-5.6) to 7.6 (95%CI: 7-8.3) out of a possible 10 score (

A cruise ship emergency medical evacuation triggered by handheld ultrasound findings and directed by tele-ultrasound

Cruise ships travel far from shoreside medical care and present a unique austere medical environment. For the cruise ship physician, decisions regarding emergency medical evacuation can be challenging. In the event that a passenger or crew member becomes seriously ill or is injured, the use of point-of-care ultrasound may assist in clarifying the diagnosis and stratifying the risk of a delayed care, and at times expedite an emergent medical evacuation. In this report we present the first case reported in the literaturę of an emergency medical evacuation from a cruise ship triggered by handheld ultrasound. A point-of-care ultrasound performed by a trained cruise ship physician, reviewed by a remote telemedical consultant with experience in point-of-care ultrasound, identified an ectopic pregnancy with intraabdominal free fluid in a young female patient with abdominal pain and expedited emergent helicopter evacuation from a cruise ship to a shoreside facility, where she immediately underwent successful surgery. The case highlights a medical evacuation that was accurately triggered by utilising a handheld ultrasound and successfully directed via a tele-ultrasound consultation. American College of Emergency Physicians (ACEP) health care guidelines for cruise ship medical facilities should be updated to include guidelines for point-of-care ultrasound, including training and telemedical support

Ultrasound and Perforated Viscus; Dirty Fluid, Dirty Shadows, and Peritoneal Enhancement.

Early detection of free air in the peritoneal cavity is vital in diagnosis of life-threatening emergencies, and can play a significant role in expediting treatment. We present a series of cases in which bedside ultrasound (US) in the emergency department accurately identified evidence of free intra-peritoneal air and echogenic (dirty) free fluid consistent with a surgical final diagnosis of a perforated hollow viscus. In all patients with suspected perforated viscus, clinicians were able to accurately identify the signs of pneumoperitoneum including enhanced peritoneal stripe sign (EPSS), peritoneal stripe reverberations, and focal air collections associated with dirty shadowing or distal multiple reflections as ring down artifacts. In all cases, hollow viscus perforation was confirmed surgically. It seems that, performing US in patients with suspected perforated viscus can accurately identify presence of intra-peritoneal echogenic or dirty free fluid as well as evidence of free air, and may expedite patient management

Degradation of phenol using US/periodate/nZVI system from aqueous solutions

In the present work, the degradation of phenol from aqueous solutions was investigated using periodate/zero valent iron nanoparticle (nZVI) in the presence of ultrasound at a batch reactor. The Experimental tests were carried out using pre-designated concentrations of nZVI, periodate, and pH ranging from 1-7 mM, 0.5-5 mM, 3-11 respectively. During the all experimental tests the ultrasonic reactor was operated at a fix frequency (40 kHz), temperature (33±1) and power (350 W). The results of nZVI/periodate/ultrasound system on degradation of phenol showed that the removal efficiency was indeed affected by the amount of free radicals produced to initiate the oxidative decomposition of phenol. also, by increasing the nZVI loading to 3 mM and periodate concentration to 3 mM, the efficiency of phenol removal was increased. Besides, the acidic pH (pH = 3) was found to be more effective than neutral and alkaline pH in degradation of phenol. © 2019 Global NEST Printed in Greece. All rights reserved

Effect of long-chain inulin and modified starch on the physicochemical and rheological properties of doogh (Iranian yogurt drink)

In this research, simultaneous contribution of long-chain inulin (0–2.34%) and modified starch (0–0.58%) on the physical stability and rheological properties of doogh within 30 days of production was studied. Increased concentration of both hydrocolloids redounded to improvements in physical stability, apparent viscosity, flow behaviour, and viscoelastic properties compared to the control sample. Fitting the data to Herschel—Bulkley model showed a decrease in flow behaviour index, while consistency coefficient (k) increased. Furthermore, for samples containing inulin and starch, G′ was greater than G″, unlike control sample. Indeed, contribution of long-chain inulin at concentrations above 1.18% and modified starch at above 0.3% promote the formation of gel network structure. The expected viscosity increases in the continuous phase in the presence of starch, and also the interactions established between inulin and yoghurt casein aggregates seem to be responsible in the improvement observed in physical characteristics of the product. Among the concentrations studied here, two samples, containing 2% inulin and 0.5% modified starch and 1.18% inulin and 0.58% modified starch, respectively, were recognized as functional doogh samples presenting premier physicochemical and rheological properties

Automatic alignment of surgical videos using kinematic data

Over the past one hundred years, the classic teaching methodology of "see one, do one, teach one" has governed the surgical education systems worldwide. With the advent of Operation Room 2.0, recording video, kinematic and many other types of data during the surgery became an easy task, thus allowing artificial intelligence systems to be deployed and used in surgical and medical practice. Recently, surgical videos has been shown to provide a structure for peer coaching enabling novice trainees to learn from experienced surgeons by replaying those videos. However, the high inter-operator variability in surgical gesture duration and execution renders learning from comparing novice to expert surgical videos a very difficult task. In this paper, we propose a novel technique to align multiple videos based on the alignment of their corresponding kinematic multivariate time series data. By leveraging the Dynamic Time Warping measure, our algorithm synchronizes a set of videos in order to show the same gesture being performed at different speed. We believe that the proposed approach is a valuable addition to the existing learning tools for surgery.Comment: Accepted at AIME 201

Removal of bisphenol, using antimony nanoparticle multi-walled carbon nanotubes composite from aqueous solutions

This study focuses on preparing Antimony Nanoparticle Multi-walled Carbon (ANMWC) composite as an effective adsorbent and then the effect of produced composite in BPA removal from aqueous solutions was studied. ANMWC were prepared using chemical method and characterized with X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR) and Brunauer-Emmett-Teller (BET). Moreover, the removal efficiency of prepared AMWCNT and Nanoparticle Multi-walled Carbon (MWCNT) in removal of Bisphenol A was investigated. Results revealed that the BPA removal efficiency by AMWCNT increased from 80 to 93 with the increase of contact time 5 to 60 min. The maximum removal efficiency for the both adsorbents was seen at pH 7, which was 85 for MWCNT and 95 for ANMWC composite. According to the results obtained, pHzpc for both adsorbents was 7. Results showed that the adsorption process followed the pseudo-first order model with a high correlation value and BPA adsorption on MWCNT followed the Langmuir isotherm model

Pattern of contributing behaviors and their determinants among people living with HIV in Iran: A 30-year nationwide study

Introduction: A major shift in the routes of HIV transmission seams to be taking place in Iran. Our study aimed to investigate the 30-year trend of major HIV related behaviors in Iran. Methods: The national HIV/AIDS registry database (from September 1986 to July 2016 with data on 32,168 people newly diagnosed with HIV) was used to study the 30 years trend and demographic determinants of major HIV related behaviors. Results: The highest rate of drug injection (DI) among people living with HIV (PLHIV) was reported during 1996 to 1999 (p-for trend < 0.001) while the highest rate of sexual activity by minorities or hard to reach groups was during 2004 to 2011 (p-for trend < 0.001). Among males, drug injection was directly associated with being single (ORsingle/married = 1.34), being unemployed (ORunemployed/employed = 1.94) and having lower level of education (OR<highschool/≥highschool = 2.21). Regarding females, drug injection was associated with being housewife (ORhousewife/employed = 1.35) and lower level of education (OR<highschool/≥highschool = 1.85). In females, condomless sexual contact was more common among those younger (OR20−29/<20 = 6.15), and married (ORmarried/single = 7.76). However, among males those being single (ORmarried/single = 0.82), being more educated (OR≥highschool/<highschool = 1.24), and being unemployed (ORunemployed/employed = 1.53) reported more sexual activity by minoritised or hard to reach groups. Discussion: The pattern of major HIV related behaviors among Iranian males and females have been rapidly changing and people living with HIV (PLHIV) are being diagnosed at a younger age. Health education to younger individuals is an essential HIV controlling strategy among Iranian population. Implementation of surveys in hidden and hard-to-reach populations is also recommended. Copyright © 2023 Gheibi, Fararouei, Afrashteh, Akbari, Afsar Kazerooni and Shokoohi

High-risk behaviors among regular and casual female sexworkers in Iran: A report fromwestern Asia

Background: Female Sex workers are at risk of obtaining sexually transmitted infections, particularly human immunodeficiency virus. Objectives: This study aimed at comparing the high-risk behaviours between regular and casual sex workers. Methods: This was a cross-sectional study conducted on sex workers from February to December, 2015, in a city of northern Iran. The research recruited 184 sex workers, who had the inclusion criteria. Three sampling methods were used to recruit the subjects. The test was conducted at an error level of 5 using the SPSS software. Results: The average age of the casual sex workers (32.53±7.39) was older than that of regular sex workers, with a significant difference (P value > 0.05). A significant association was found between the 2 groups on the inconsistent use of condoms and working in brothels (P value > 0.05). The comparison of drug use before sex was not significantly different (P value < 0.05) between the 2 groups. Conclusions: It is very essential to organize peer groups for outreach services for sex workers, which could be more appropriate and consequently decrease the relevant damage in these groups. ©2018, Iranian Journal of Psychiatry and Behavioral Sciences

Recurrent Auto-Encoder Model for Large-Scale Industrial Sensor Signal Analysis

Recurrent auto-encoder model summarises sequential data through an encoder structure into a fixed-length vector and then reconstructs the original sequence through the decoder structure. The summarised vector can be used to represent time series features. In this paper, we propose relaxing the dimensionality of the decoder output so that it performs partial reconstruction. The fixed-length vector therefore represents features in the selected dimensions only. In addition, we propose using rolling fixed window approach to generate training samples from unbounded time series data. The change of time series features over time can be summarised as a smooth trajectory path. The fixed-length vectors are further analysed using additional visualisation and unsupervised clustering techniques. The proposed method can be applied in large-scale industrial processes for sensors signal analysis purpose, where clusters of the vector representations can reflect the operating states of the industrial system.Comment: Accepted paper at the 19th International Conference on Engineering Applications of Neural Networks (EANN 2018