A nationwide analysis of emergency medicine residents' CT interpretation in trauma: The Tract-EM study.

OBJECTIVE: To evaluate the accuracy and determine the factors influencing trauma CT interpretation proficiency among emergency medicine (EM) residents in Turkey through the TraCT-EM study (Interpretation of Trauma CT by EMergency Physicians). METHODS: This nationwide, multicenter, cross-sectional study was conducted in 29 academic emergency departments (EDs) from April 2023 to March 2024. A total of 401 senior EM residents participated in the study, each interpreting a standardized set of 42 trauma CT series (cranial, maxillofacial, and cervical) derived from seven patients. Interpretation accuracy was assessed, and factors predicting interpretation failure were analyzed using univariate and multivariate regression models. RESULTS: The median accuracy rate of residents was 64.9 %, with higher accuracy in normal CT findings. Using the Angoff method, 14 % of residents scored below the passing threshold. Factors associated with interpretation failure included shorter interpretation times (OR, 0.97; 95 % CI, 0.95-0.99), lower self-confidence in detecting serious pathologies (OR, 2.50; 95 % CI, 1.42-4.42), reliance on in-hospital radiology department reports (OR, 3.45; 95 % CI, 1.47-8.05), and receiving final radiology reports for CT scans (OR, 3.30; 95 % CI, 1.67-6.52), and lack of in-department training programs (OR, 2.51; 95 % CI, 1.34-4.70). CONCLUSION: The TraCT-EM study highlighted a 65 % accuracy rate for senior EM residents in trauma CT interpretation, with specific predictors of failure identified. These findings suggest a need for tailored radiology education strategies to enhance training and competency in trauma CT interpretation for EM residents. Further optimization of educational programs could address these gaps, ultimately improving patient outcomes in trauma care.

Flexible switch matrix addressable electrode arrays with organic electrochemical transistor and pn diode technology.

Due to their effective ionic-to-electronic signal conversion and mechanical flexibility, organic neural implants hold considerable promise for biocompatible neural interfaces. Current approaches are, however, primarily limited to passive electrodes due to a lack of circuit components to realize complex active circuits at the front-end. Here, we introduce a p-n organic electrochemical diode using complementary p- and n-type conducting polymer films embedded in a 15-µm -diameter vertical stack. Leveraging the efficient motion of encapsulated cations inside this polymer stack and the opposite doping mechanisms of the constituent polymers, we demonstrate high current rectification ratios ([Formula: see text]) and fast switching speeds (230 µs). We integrate p-n organic electrochemical diodes with organic electrochemical transistors in the front-end pixel of a recording array. This configuration facilitates the access of organic electrochemical transistor output currents within a large network operating in the same electrolyte, while minimizing crosstalk from neighboring elements due to minimized reverse-biased leakage. Furthermore, we use these devices to fabricate time-division-multiplexed amplifier arrays. Lastly, we show that, when fabricated in a shank format, this technology enables the multiplexing of amplified local field potentials directly in the active recording pixel (26-µm diameter) in a minimally invasive form factor with shank cross-sectional dimensions of only 50×8 [Formula: see text].

Which is the most appropriate anterior glenohumeral dislocation reduction technique among three different techniques? A prospective, randomized clinical trial.

OBJECTIVES: This study aims to compare three glenohumeral dislocation (GHD) reduction techniques in terms of pain and reduction time and to offer clinicians an idea of the selection of the most appropriate technique. PATIENTS AND METHODS: This multi-center, prospective, randomized clinical study included a total of 90 patients (55 males, 35 females; median age: 29 years; range, 22 to 41 years) who had isolated anterior GHD without complication between December 2019 and December 2021. The patients were divided into three equal groups (traction-countertraction [TCT], external rotation [ExR], and Cunningham) using the block randomization method, and reductions were performed. Pre-reduction, intra-reduction, and post-reduction Visual Analog Scale (VAS) scores, reduction times, success rates, and complication rates were analyzed. RESULTS: There was no statistically significant difference among the groups in terms of age (p=0.414), sex (p=0.954), pre-reduction VAS (p=0.175), and post-reduction VAS (p=0.204). The median intra-reduction VAS values in the TCT, the external rotation, and the Cunningham groups were 8 (range, 7 to 9), 5 (range, 4 to 7), and 4 (range, 2.75 to 5), respectively (p<0.001). The median reduction time and IQR were 105 (range, 82.5 to 120) sec for TCT, 270 (range, 232.5 to 300) sec for ExR, and 630 (range, 540 to 780) sec for Cunningham (p=0.001). CONCLUSION: The fastest, but most painful technique is TCT, while the longest and the least painful technique is Cunningham. An inverse relationship is found between time and pain. Based on these findings, it seems to be reasonable to leave the choice of the ideal reduction technique to the clinician. The clinician should choose the technique to be used according to the conditions in the emergency department.

Flexible ultrasound transceiver array for non-invasive surface-conformable imaging enabled by geometric phase correction.

Ultrasound imaging provides the means for non-invasive real-time diagnostics of the internal structure of soft tissue in living organisms. However, the majority of commercially available ultrasonic transducers have rigid interfaces which cannot conform to highly-curved surfaces. These geometric limitations can introduce a signal-quenching air gap for certain topographies, rendering accurate imaging difficult or impractical. Here, we demonstrate a 256-element flexible two-dimensional (2D) ultrasound piezoelectric transducer array with geometric phase correction. We show surface-conformable real-time B-mode imaging, down to an extreme radius of curvature of 1.5 cm, while maintaining desirable performance metrics such as high signal-to-noise ratio (SNR) and minimal elemental cross-talk at all stages of bending. We benchmark the array capabilities by resolving reflectors buried at known locations in a medical-grade tissue phantom, and demonstrate how phase correction can improve image reconstruction on curved surfaces. With the current array design, we achieve an axial resolution of ≈ 2 mm at clinically-relevant depths in tissue, while operating the array at 1.4 MHz with a bandwidth of ≈ 41%. We use our prototype to image the surface of the human humerus at different positions along the arm, demonstrating proof-of-concept applicability for real-time diagnostics using phase-corrected flexible ultrasound probes.

Comparison of the Effects of Aspergillus niger and Aspergillus ficuum on the Removal of Impurities in Feldspar by Bio-beneficiation.

Depending on its purity, feldspar has a wide application in industry. Fungi play an important role in the feldspar purification. A bacterial leaching study of feldspar sample from Aydin, Turkey, was conducted to obtain a suitable raw material for industrial applications. XRD analyses indicated that albite (NaAlSi3O8) with minor amounts of orthoclase (KAlSi3O8), quartz (SiO2), muscovite (KAl2(Si3AlO10)(OH)2), rutile (TiO2), and small quantities of weathered clay minerals. This study evaluates bacterial leaching treatment to iron removal from feldspar using Aspergillus niger and Aspergillus ficuum to attain a product suitable for industrial uses. These funguses were tested for organic acid (oxalic and citric acid) production and leaching capabilities of feldspar. The leaching performances of two funguses were compared. Bacterial leaching experiments were performed in 500-mL Erlenmeyer flask at 30 ± 2 °C and 180 rpm agitation under aseptic conditions. In bacterial leaching experiments using A. niger and A. ficuum, 70.13% and 85.09% of the total iron oxides in the feldspar were removed, respectively. As a result, the final iron oxide concentrations in bacterial leaching experiments using A. niger and A. ficuum were 0.095% and 0.047%, respectively (at 5% w/v pulp density, temperature 30 ± 2 °C, A. niger 3 × 107 spores, A. ficuum 5 × 107 spores, and particle size < 63 µm). The use of fungi to remove iron from feldspar has the potential to be an effective method for upgrading the content and the commercial value of the feldspar. The experimental results of this study have provided significant opportunity to use biotechnological approach for producing the feldspar as a feed material for the high-quality ceramic industry.

Emergency medicine physicians' perspectives on subspecialty training: A national survey.

BACKGROUND: Subspecialty training (sST) is an accepted educational model for the branches that have completed the maturation period. At the end of a rapid growth and reaching its limits, we wanted to determine the emergency medicine (EM) physicians' thoughts about subspecialty training in EM in Turkey. METHOD: This is a national cross-sectional survey study conducted in November 2017. Participants were physicians who were receiving or who had completed emergency medicine education. RESULTS: The response rate was 32% (n = 607) in the study. The rate of attending physicians was 45.1%, resident physicians were 40.2%, and academic staff were 14.7%. Among all the EM physicians, 85.2% noted the need for sST, 9.6% were uncertain about the need, and 5.3% found the need unnecessary. The most frequently requested trainings were toxicology (72.5%), traumatology (71.3%), and critical care (67.4%). After sST, 48.9% of EM physicians requested to work both in the emergency department and in the other relevant department, 36.1% requested to work full-time in the emergency department, and 14.9% requested to work full-time in the other relevant department. CONCLUSION: The great majority of EM physicians believed in the need for sST in Turkey. There were two primary reasons for wanting to apply for sST: first, and most frequently, was the contribution to advanced training, and second, was avoiding problems in the daily practice of EM.

Use of Aspergillus niger in the bioleaching of colemanite for the production of boric acid

Colemanite is one of the most important underground riches of Turkey, having approximately 60 percent of the world boron deposits, and it has a large portion in the deposits. In this study, chemical leaching and biological leaching methods were used for production of boric acid from colemanite (2CaO · 3B3O3 · 5H2O) (Emet-Kütahya, Turkey). Oxalic acid concentration, temperature, stirring time and solid-to-liquid ratio were taken as parameters in the chemical leaching process. It was found that the dissolution rate increases with increasing oxalic acid concentration and temperature but it decreases at higher solid-to-liquid ratios in the chemical leaching process. Using optimum conditions (d100 = 0.075 mm; 5 percent solids by weight; 0.55 M oxalic acid; 80 +/- 2 ºC leaching temperature; 150 rpm stirring speed; 90 min leaching time) for colemanite sample (28.05 percent B2O3) on chemical leaching with oxalic acid experiments, the calculated boric acid extraction efficiency from colemanite ore was 97.89 percent. Optimum conditions on bioleaching of Emet-Kütahya, Turkey colemanite ores using the fungus Aspergillus niger were found to be as follows: reaction temperature 25 +/- 2ºC; solid-to-liquid ratio 5 percent solids by weight; d100 = 0.075 mm; stirring speed 150 rpm; initial the fungus populations in the inocula about 3 x 10(7) cells/ml and reaction time 21 days. The calculated boric acid extraction efficiency from colemanite ore was 90.18 percent under the optimum conditions. Bioleachate contained 12.95 g/l B2O3, 6.60 g/l Ca and 0.087 g/l Mg. Compared with chemical leaching at 5 percent pulp density, the fungus was less efficient in the extraction of B2O3 from colemanite but the difference in the extraction yields between the two processes was less than 10 percent. Although bioleaching generally requires a longer period of operation compared to chemical leaching, these results suggest that bioleaching by A...

Bioleaching of zinc and iron from steel plant waste using Acidithiobacillus ferrooxidans.

The bacterial leaching of zinc and iron from solid wastes at the Isdemir iron and steel plant has been investigated using Acidithiobacillus ferrooxidans as the bacterial agent. The effects of a range of operational parameters, including particle size, solids concentration and pH, on the efficiency of the bioleaching process were investigated. In each test, several variables were determined to assess the efficiency of leaching, including slurry pH and redox potential, temperature, bacteria population and concentrations of zinc and iron in solution. Experimental results demonstrated that pulp solids concentration, slurry pH and solids particle size were all important parameters in the bacterial leaching process. Maximum extraction was achieved at pH values around 1.3 and a solids concentration of 1% w/v, with 35% of the Zn content and 37% of the Fe being dissolved.