Abstract Background Despite the increasing integration of ultrasound training into medical education, there is an inadequate body of research demonstrating the benefits and practicality of medical ...student–performed point-of-care ultrasound (SP-POCUS) in the clinical setting. Objectives The primary purpose of this study was to evaluate the effects that SP-POCUS can have on physician diagnosis and management of patients in the emergency department, with a secondary purpose of evaluating the diagnostic accuracy of SP-POCUS. Methods SP-POCUS examinations were performed in the emergency department by medical students who completed year one of a 4-year medical school curriculum with integrated ultrasound training. Scans were evaluated by an emergency physician who then completed a survey to record any changes in diagnosis and management. Results A total of 641 scans were performed on the 482 patients enrolled in this study. SP-POCUS resulted in a change in management in 17.3% of scans performed. For 12.4% of scans, SP-POCUS discovered a new diagnosis. SP-POCUS reduced time to disposition 33.5% of the time. Because of SP-POCUS, physicians avoided ordering an additional imaging study for 53.0% of the scans performed. There was 94.7% physician agreement with SP-POCUS diagnosis. Conclusions This study showed that SP-POCUS is feasible and may potentially have a meaningful impact on physician diagnosis and management of patients in the emergency department. In addition, the implementation of SP-POCUS could serve as an ideal method of developing ultrasound skills in medical school while positively impacting patient care.
The subject of high-energy-density (HED) states in matter is of considerable importance to numerous branches of basic as well as applied physics. Intense heavy-ion beams are an excellent tool to ...create large samples of HED matter in the laboratory with fairly uniform physical conditions. Gesellschaft für Schwerionenforschung, Darmstadt, is a unique worldwide laboratory that has a heavy-ion synchrotron, SIS18, that delivers intense beams of energetic heavy ions. Construction of a much more powerful synchrotron, SIS100, at the future international facility for antiprotons and ion research (FAIR) at Darmstadt will lead to an increase in beam intensity by 3 orders of magnitude compared to what is currently available. The purpose of this Letter is to investigate with the help of two-dimensional numerical simulations, the potential of the FAIR to carry out research in the field of HED states in matter.
Intense heavy ion beams from the Gesellschaft für
Schwerionenforschung (GSI, Darmstadt, Germany) accelerator facilities,
together with two high energy laser systems: petawatt high energy laser
for ...ion experiments (PHELIX) and nanosecond high energy laser for ion
experiments (NHELIX) are a unique combination to facilitate pioneering
beam-plasma interaction experiments, to generate and probe
high-energy-density (HED) matter and to address basic physics issues
associated with heavy ion driven inertial confinement fusion. In one class
of experiments, the laser will be used to generate plasma and the ion beam
will be used to study the energy loss of energetic ions in ionized matter,
and to probe the physical state of the laser-generated plasma. In another
class of experiments, the intense heavy ion beam will be employed to
create a sample of HED matter and the laser beam, together with other
diagnostic tools, will be used to explore the properties of these exotic
states of matter. The existing heavy ion synchrotron facility, SIS18,
deliver an intense uranium beam that deposit about 1 kJ/g specific
energy in solid matter. Using this beam, experiments have recently been
performed where solid lead foils had been heated and a brightness
temperature on the order of 5000 K was measured, using a fast
multi-channel pyrometer that has been developed jointly by GSI and IPCP
Chernogolovka. It is expected that the future heavy ion facility, facility
for antiprotons and ion research (FAIR) will provide compressed beam
pulses with an intensity that exceeds the current beam intensities by
three orders of magnitude. This will open up the possibility to explore
the thermophysical and transport properties of HED matter in a regime that
is very difficult to access using the traditional methods of shock
compression. Beam plasma interaction experiments using dense plasmas with
a Γ-parameter between 0.5 and 1.5 have also been carried out. This
dense Ar-plasma was generated by explosively driven shockwaves and showed
enhanced energy loss for Xe and Ar ions in the energy range between 5.9 to
11.4 MeV.
•Development of two non-invasive beam profile monitors.•Key features of both profile monitors.•Experimental results for the beam profile measurements using helium, nitrogen and neon gases.•Density ...measurements for the gas jet.•Ongoing development of Quantum gas jet system and for optimization of gas jet density.
A beam profile monitor based on a supersonic gas-curtain is currently under development for transverse profile diagnostics of electron and proton beams in the High Luminosity LHC. This monitor uses a thin supersonic gas curtain that crosses the primary beam to be characterized under an angle of 45 degrees. The fluorescence caused by the interaction between the beam and gas-curtain is detected using a specially designed imaging system to determine the 2D transverse profile of the primary beam. Another prototype monitor based on beam induced ionization is installed at The Cockcroft Institute. This paper presents the design features of both the monitors, the gas-jet curtain formation and various experimental tests, including profile measurements of an electron beam, using helium, nitrogen and neon as gases. Such a non-invasive online beam profile monitor would be highly desirable also for medical LINAC’s and storage rings as it can characterize the beam without stopping machine operation. The paper discusses opportunities for simplifying the monitor design for integration into a medical accelerator and expected monitor performance.
This paper describes a fast multi-channel radiation pyrometer that was developed for warm dense-matter experiments with intense heavy ion beams at the Gesellschaft für Schwerionenforschung mbH (GSI). ...The pyrometer is capable of measuring brightness temperatures from 2000 K to 50,000 K, at six wavelengths in the visible and near-infrared parts of the spectrum, with 5 ns temporal resolution, and several micrometers spatial resolution. The pyrometer's spectral discrimination technique is based on interference filters, which also act as mirrors to allow for simultaneous spectral discrimination of the same ray at multiple wavelengths.
The utility of point of care ultrasound training during medical school is becoming more and more evident. At the Loma Linda University School of Medicine, we have formally integrated ultrasound ...education into the curriculum of all four years. Exposure begins in the first few months of Year 1 and takes form in a variety of educational mediums through Year 4. Whether students receive training through mandatory sessions during physical diagnosis courses or extracurricular workshops provided through the Ultrasound Interest Group–-the experience equips learners of at all different skill levels with the confidence to apply what they have learned to patient care. The successful integration of ultrasound training into the medical curriculum can be attributed to progressive administration, devoted faculty and eager students. The perspective of medical students during the integration process is described in this paper.
Four quadrupole lenses based on permanent magnets of the NdFeB material (PMQ) were developed for the imaging section for forming images of the ion-optical system of the PRIOR proton microscope ...prototype: the effective length of two of them is 144 mm, and the other two are 288 mm long. The field induction at the radius of the lens aperture is 1.77 Т, and the aperture is 30 mm in size. The modular design of the PMQ makes it possible to vary the length of the lenses, compensate for the offset of the magnetic axis from the ion optical axis of the microscope channel, and decrease the variation of the angular position of the magnetic medians. The PMQ magnetic field was adjusted, scanned, and its main characteristics were determined. The 3D mathematical models of the magnetic-field distribution that are obtained as a result of PMQ measurements are intended for the use in calculations of the beam dynamics during adjustment of the ion-optical system of the proton microscope and for attaining the highest spatial resolution. The developed lenses were used in the first experiments on the PRIOR facility.
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