71 research outputs found

    The Utility of Point-of-Care Ultrasound (POCUS) in the Emergency Department: A Systematic Review

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    Point-of-Care Ultrasonography (POCUS) has increasingly become a pivotal tool in emergency medicine, offering significant improvements in diagnostic accuracy and patient care. This systematic review aims to evaluate the utility of POCUS in emergency settings, focusing on its impact on diagnostic accuracy, patient management, and the implications of POCUS training for emergency medicine residents. Following PRISMA guidelines, a comprehensive search across major databases, primarily PubMed, was conducted in November 2023. The review included clinical trials, observational studies, and controlled clinical trials, focusing on the utility of POCUS in emergency departments. Out of 305 articles identified, 8 studies met the inclusion criteria and were analyzed. The review encompassed diverse studies with a total of 1203 participants, demonstrating the effectiveness of POCUS in various emergency scenarios. Key findings include the improvement of diagnostic accuracy for conditions like acute dyspnea and Acute Decompensated Heart Failure (ADHF), the utility of POCUS in pediatric emergency care, and its role in ocular emergencies. POCUS was also found to influence patient care decisions significantly, changing diagnostic impressions and management plans. Additionally, POCUS training for emergency medicine residents led to increased ultrasound usage and improved patient management efficiency. POCUS has emerged as a transformative tool in emergency medicine, enhancing diagnostic accuracy, guiding clinical decision-making, and improving patient care outcomes. Its applications range from general emergency scenarios to specialized pediatric and ocular emergencies. The integration of POCUS training in emergency medicine residency programs is crucial for harnessing its full potential. As technology advances, POCUS is poised to continue revolutionizing patient care in emergency settings, affirming its indispensable role in modern medical practice

    Genome-wide association mapping identifies a new arsenate reductase enzyme critical for limiting arsenic accumulation in plants

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    Inorganic arsenic is a carcinogen, and its ingestion through foods such as rice presents a significant risk to human health. Plants chemically reduce arsenate to arsenite. Using genome-wide association (GWA) mapping of loci controlling natural variation in arsenic accumulation in Arabidopsis thaliana allowed us to identify the arsenate reductase required for this reduction, which we named High Arsenic Content 1 (HAC1). Complementation verified the identity of HAC1, and expression in Escherichia coli lacking a functional arsenate reductase confirmed the arsenate reductase activity of HAC1. The HAC1 protein accumulates in the epidermis, the outer cell layer of the root, and also in the pericycle cells surrounding the central vascular tissue. Plants lacking HAC1 lose their ability to efflux arsenite from roots, leading to both increased transport of arsenic into the central vascular tissue and on into the shoot. HAC1 therefore functions to reduce arsenate to arsenite in the outer cell layer of the root, facilitating efflux of arsenic as arsenite back into the soil to limit both its accumulation in the root and transport to the shoot. Arsenate reduction by HAC1 in the pericycle may play a role in limiting arsenic loading into the xylem. Loss of HAC1-encoded arsenic reduction leads to a significant increase in arsenic accumulation in shoots, causing an increased sensitivity to arsenate toxicity. We also confirmed the previous observation that the ACR2 arsenate reductase in A. thaliana plays no detectable role in arsenic metabolism. Furthermore, ACR2 does not interact epistatically with HAC1, since arsenic metabolism in the acr2 hac1 double mutant is disrupted in an identical manner to that described for the hac1 single mutant. Our identification of HAC1 and its associated natural variation provides an important new resource for the development of low arsenic-containing food such as rice
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