Barreralinnet6033

Point-of-care ultrasound (POCUS) has become increasingly integrated into medical education given the growing role of evaluative and procedural techniques in practice today. Tele-ultrasound is a new and promising venture that aims to expand medical knowledge and education to previously unreached or underserved areas. This study aimed to determine the non-inferiority of teaching ultrasound remotely using tele-ultrasound via the Philips Lumify (Philips Medical Systems, Bothell, WA) system, which utilizes video conferencing technology and real-time imaging that can be viewed by the operator and educator simultaneously.

Three commonly used ultrasound exams were taught and evaluated in 56 ultrasound-naive medical participants Focused Assessment with Sonography in Trauma (FAST), Lower Extremity Deep Venous Thrombosis (LEDVT) screening, and ultrasound-guided vascular access. The participants were randomized into either in-person traditional learning or tele-ultrasound learning with the Philips Lumify (Philips Medical Systems, Bothell, WA) units. The primary outcome of interest was the ability to perform certain tasks for each exam RESULTS Competency on each exam was tested across all exams and no inferiority was found between in-person and remote learning (p < 0.05).

Our findings support the use of tele-ultrasound in beginner ultrasound education.

Our findings support the use of tele-ultrasound in beginner ultrasound education.This study proposes a bibliometric measure to visualize and analyze the research status and development trend of carbon offset based on 1,581 articles over the period 1900-2019. The main findings include (1) carbon offset research turned into a rapid growth after 2009; (2) environmental studies, environmental science, economics, and energy fuels are the top four research domains in publication; (3) Energy Policy, Ecological Economics and Science are the top three journals in terms of citation impact; (4) climate change, impact, emission, CO2 emission, and policy are shown to be the most frequently used keywords; (5) the top 10 cited articles cover the following five essential aspects individual carbon offset behavior; forest and land carbon offset; transportation carbon offset; international trade carbon offset; and eco-system service-related carbon offset; (6) eight research hotspots were identified including forest carbon sequestration program, understanding carbon and uncertainty market, policy design, biomass development, Chinese province, increasing adoption, and ecosystem service commodification. These findings suggest that the carbon offset research has been evolved from the theoretical exploration at the early stage to a more diversified conversion of research outputs at the practical level in recent years. Interdisciplinary research towards individual and organizational carbon offset behaviors in a broader context of socio-economic development and cooperation among various agents is the emphasis and direction for future study.The regional climate has significantly warmed with erratically declining annual rainfall and intensified downpour within a narrower span of monsoon months, which led to an increased trophic state (≈algae) in most inland waters. Freshwater clupeids vitally control the aquatic food chain by grazing on algae. Despite increasing food availability, IUCN Red List® revealed 16 freshwater clupeids with a decreasing population trend. We investigated one such species' reproductive dependencies, Gudusia chapra (Indian river shad), in the lower Gangetic drainage (India) under a mixed context of climate change and overfishing. Monthly rainfall (≥ 60-100 mm) and water temperature (≥ 31-32 °C) are key breeding cues for females. The regional climate seems inclined to fulfill these through the significant part of the breeding season, and indeed the species has maintained consistent breeding phenology over 20 years. Other breeding thresholds relevant to fishing include size at first maturity (≥ 6.8 cm; reduced by ~ 25-36%) and pre-spawning girth (Girthspawn50 ≥ 7 cm; first record). Girthspawn50 is a proxy of the minimum mesh size requirement of fishing nets to allow safe passage of "gravid" females (+ 22% bulged abdomen) and breed. The operational fishing nets (3-10 cm mesh) probably have been indulged in indiscriminative fishing of gravid females for generations. Under a favorably changing climate and food availability, existing evidence suggests a fishery-induced evolution in regional females (to circumvent such mesh sizes) through earlier maturation/puberty at smaller sizes. It could be an early warning sign of population collapse (smaller females → lessening fecundity → fewer offspring). Overfishing seemed to be a bigger threat than climate change.Arsenic (As) bioremediation has been an economical and sustainable approach, being practiced widely under several As-contaminated environments. Bioremediation of As involves the use of bacteria, fungi, yeast, plants, and genetically modified organisms for detoxification/removal of As from the contaminated site. The understanding of multi-factorial biological components involved in these approaches is complex and more and more efforts are on their way to make As bioremediation economical and efficient. In this regard, we systematically reviewed the recent literature (n=200) from the last two decades regarding As bioremediation potential of conventional and recent technologies including genetically modified plants for phytoremediation and integrated approaches. Also, the responsible mechanisms behind different approaches have been identified. From the literature, it was found that As bioremediation through biosorption, bioaccumulation, phytoextraction, and volatilization involving As-resistant microbes has proved a very successful technology. However, there are various pathways of As tolerance of which the mechanisms have not been fully understood. Recently, phytosuction separation technology has been introduced and needs further exploration. Also, integrated approaches like phytobial, constructed wetlands using As-resistant bacteria with plant growth-promoting activities have not been extensively studied. It is speculated that the integrated bioremediation approaches with practical applicability and reliability would prove most promising for As remediation. Further technological advancements would help explore the identified research gaps in different approaches and lead us toward sustainability and perfection in As bioremediation.Worldwide, black shales and shale waste are known to be a potential source of metals to the environment. This project demonstrates ongoing weathering and evaluates leaching processes at a 100-m-high shale waste deposit closed in the 1960s. Some deep parts of the deposit are still burning with temperatures exceeding 500 °C. To demonstrate ongoing weathering and leaching, analyses of groundwater and solid samples of shale and shale waste have been undertaken. Largest impact on groundwater quality was observed downstream the deposit, where elevated temperatures also indicate a direct impact from the burning waste deposit. Groundwater quality is largely controlled by pH and redox conditions (e.g., for arsenic, nickel, molybdenum, uranium and vanadium), and the mixture of different waste materials, including pyrite (acidic leachates) and carbonates (neutralizing and buffering pH). Analyses of shale waste from the deposit confirm the expected pyrite weathering with high concentrations of iron, nickel and uranium in the leachates. No general time trends could be distinguished for the groundwater quality from the monitoring in 2004-2019. This study has shown that black shale waste deposits can have a complex long-term impact on the surrounding environment.Mercury is a very toxic metal that persists and accumulates in the living organisms present in the aquatic systems and its elimination is an urgent need. Two green (Ulva intestinalis and Ulva lactuca), brown (Fucus spiralis and Fucus vesiculosus), and red (Gracilaria sp. and Osmundea pinnatifida) marine macroalgae were tested for mercury removal from saline waters. The ability of each species was evaluated to the initial mercury concentrations of 50, 200, and 500 μg dm-3 along 72 h. In general, all species exhibited good performances, removing 80.9-99.9% from solutions with 50 μg dm-3, 79.3-98.6% from solutions with 200 μg dm-3, and 69.8-97.7% from solutions containing 500 μg dm-3 of mercury. Among the macroalgae, Ulva intestinalis showed the highest affinity to mercury and it presented an uptake ability up to 1888 μg g-1 of Hg(II) and bioconcentration factors up to 3823, which proved its promising potential on Hg removal.This study evaluated protective effects of synbiotic on meat quality and oxidative status of breast muscle in heat-stressed broilers. IACS-13909 Twenty 2-day-old broilers were allocated in a 2×2 factorial design, and the main factors consisted of synbiotic level (0 (basal diet) or 1.5 g/kg synbiotic) and temperature (thermoneutral or high temperature), resulting in 4 treatments. From 22 to 42 days, chickens were raised at thermoneutral temperature (22 °C) or subjected to cyclic high temperature (heat stress, HS) by keeping them at 32-33 °C for 8 h and 22 °C for rest 16 h daily. Cyclic HS decreased relative weight, redness (45 min), and pH values (45 min and 24 h) but increased contents of moisture and ether extract, lightness (45 min and 24 h), drip loss (24 h and 48 h), and cooking loss in breast muscle of broilers compared with those under thermoneutral temperature. It also increased malondialdehyde content and mRNA abundances of heat shock protein 70 (HSP70) and HSP90 but decreased glutathione (GSH) concentration and activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), as well as mRNA abundances of nuclear factor (erythroid 2)-like 2 (Nrf2), NAD(P)H quinone dehydrogenase 1 (NQO1), GSH-Px, and copper and zinc superoxide dismutase in breast muscle in broilers. Dietary synbiotic supplementation was effective in increasing weight and reducing lightness (45 min), drip loss (24 h and 48 h) and cooking loss of breast muscle in heat-stressed broilers compared with those fed the basal diet. It also reduced malondialdehyde content and HSP70 mRNA abundance and increased GSH-Px activity, GSH content, and mRNA abundances of Nrf2, NQO1 and GSH-Px in breast muscle of heat-stressed broilers. These results suggested that synbiotic supplementation at a level of 1.5 g/kg could ameliorate compromised meat quality and oxidative status in broilers under cyclic HS.Bangladesh is well on course to become one of the leading emerging market economies in the world. Hence, it can be expected that the economic growth of Bangladesh would substantially increase over the next decade. This, in turn, is likely to boost the energy consumption levels of the nation whereby meeting the surge in the energy demand would be a crucial agenda of the government. Therefore, it is important to understand the factors that influence the nation's energy demand. Against this backdrop, this paper aims to evaluate the macroeconomic determinants of total, renewable, and non-renewable energy demands in Bangladesh between 1980 and 2014. Besides, the analysis is conducted for both primary energy and electricity consumption levels. The econometric methods used in this study controlled for the structural break issues in the data. The key findings, in a nutshell, show that economic growth and household consumption expenditure positively influence the overall primary energy and electricity demands in Bangladesh while income inequality exerts opposite effects.