Optimization of target grouping in distributive stereotactic radiosurgery using the excel evolutionary solver.

Purpose: Distributive stereotactic radiosurgery (dSRS) is a form of fractionation where groups of metastases are treated with a full single-fraction dose on different days. The challenge with dSRS is determining optimal target groupings to maximize the distance between targets treated in the same fraction. This study aimed to develop and validate an accessible optimization technique for distributing brain metastases into optimal treatment fractions using a genetic algorithm.

Point-of-care ultrasound diagnosis of acute valvular emergencies.

Introduction: Acute valvular emergencies, a time-sensitive diagnosis, are nearly impossible to diagnose without ultrasound, and missing the diagnosis can significantly impact patient outcomes. Many emergency physicians lack access to echo technicians and may be uncomfortable performing the ultrasound themselves. Approaching the paucity of review articles, none of which are focused for the emergency physician, can be quite daunting, even for those with extensive ultrasound training.

Predictors of household drinking water E. coli contamination: Population-based results from rural areas of Ghana, Malawi, Mozambique, Niger, Rwanda, Uganda, and Zambia.

Background: In sub-Saharan Africa, rural areas have lower rates of access to safe drinking water compared to urban areas. We investigated predictors of Escherichia coli contamination in drinking water of rural households in Ghana, Malawi, Mozambique, Niger, Rwanda, Uganda, and Zambia.

Methods: We used a population-based, cluster randomized sampling design to select rural households in each country.

Ultrasound-Guided Nerve Blocks for Flexor Tenosynovitis.

Performing an ultrasound-guided nerve block (UGNB) is now common practice in many emergency departments (EDs) and is considered a core skill according to the American College of Emergency Physicians (ACEP). Nerve blocks are mostly utilized for fractures and laceration repairs, however, these blocks have many other applications. We present a case of utilizing an ulnar UGNB in a patient with flexor tenosynovitis and a history of intravenous drug use (IVDU) when parental opiates proved to be ineffective.