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Background: This scoping review was conducted to provide an overview of the evidence of point-of-care lung ultrasound (LUS) in emergency medicine. By emphasizing clinical topics, time trends, study designs, and the scope of the primary outcomes, a map is provided for physicians and researchers to guide their future initiatives., Research Question: Which study designs and primary outcomes are reported in published studies of LUS in emergency medicine?, Study Design and Methods: We performed a systematic search in the PubMed/MEDLINE, Embase, Web of Science, Scopus, and Cochrane Library databases for LUS studies published prior to May 13, 2023. Study characteristics were synthesized quantitatively. The primary outcomes in all papers were categorized into the hierarchical Fryback and Thornbury levels., Results: A total of 4,076 papers were screened and, following selection and handsearching, 406 papers were included. The number of publications doubled from January 2020 to May 2023 (204 to 406 papers). The study designs were primarily observational (n = 375 [92%]), followed by randomized (n = 18 [4%]) and case series (n = 13 [3%]). The primary outcome measure concerned diagnostic accuracy in 319 papers (79%), diagnostic thinking in 32 (8%), therapeutic changes in 4 (1%), and patient outcomes in 14 (3%). No increase in the proportions of randomized controlled trials or the scope of primary outcome measures was observed with time. A freely available interactive database was created to enable readers to search for any given interest (https://public.tableau.com/app/profile/blinded/viz/LUSinEM_240216/INFO)., Interpretation: Observational diagnostic studies have been produced in abundance, leaving a paucity of research exploring clinical utility. Notably, research exploring whether LUS causes changes to clinical decisions is imperative prior to any further research being made into patient benefits., Competing Interests: Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: S. H. O. reports a relationship with Danish Society for Ultrasound in General Practice that includes travel reimbursement, and a relationship with USabcd that includes speaking and lecture fees. M. D. A. reports relationships with the Danish Society for Ultrasound in General Practice and the Danish Emergency Medical Conference 10 (DEMC10) that include travel reimbursement. J. W. reports a relationship with DEMC10 that includes travel reimbursement. I. W. Y. M. reports a relationship with Research Chair, the John A. Buchanan Chair in General Internal Medicine, University of Calgary that includes funding grants, relationships with the 3rd Vice President of the American Institute of Ultrasound in Medicine and with the Governor, Alberta Chapter, American College of Physicians that include board membership, and relationships with American College of Physicians, the American Institute of Ultrasound in Medicine, Cornell University, University of Alberta, Sonography Canada, the Canadian Society of Internal Medicine, the Canadian Thoracic Society, American Society of Regional Anesthesia and Pain Medicine, the International Pediatric Nephrology Association, and the Canadian Rheumatology Ultrasound Society that include: speaking and lecture fees. None declared (A. H. C., H. K., B. L., R. A., M. H. L., A. H. K., M. B. C., C. F., L. T., A. R., R. L., J. D.)., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Quantifying the spatial variability of factors affecting natural attenuation of hydrocarbons in the unsaturated zone is important to (i) performing a reliable risk assessment and (ii) evaluating the possibility for bioremediation of petroleum-polluted sites. Most studies to date have focused on the shallow unsaturated zone. Based on a data set comprising analysis of about 100 soil samples taken in a 16 m-deep unsaturated zone polluted with volatile petroleum compounds, we statistically and geostatistically analysed values of essential soil properties. The subsurface of the site was highly layered, resulting in an accumulation of pollution within coarse sandy lenses. Air-filled porosity, readily available phosphorous, and the first-order rate constant (k(1)) of benzene obtained from slurry biodegradation experiments were found to depend on geologic sample characterization (P<0.05), while inorganic nitrogen was homogenously distributed across the soil stratigraphy. Semivariogram analysis showed a spatial continuity of 4-8.6 m in the vertical direction, while it was 2-5 times greater in the horizontal direction. Values of k(1) displayed strong spatial autocorrelation. Even so, the soil potential for biodegradation was highly variable, which from autoregressive state-space modeling was partly explained by changes in soil air-filled porosity and gravimetric water content. The results suggest considering biological heterogeneity when evaluating the fate of contaminants in the subsurface., (2010 Elsevier B.V. All rights reserved.)

Modeling gas-phase diffusion of volatile contaminants in the unsaturated zone relies on soil-gas diffusivity models often developed for repacked and structureless soil columns. These suffer from the flaw of not reflecting preferential diffusion through voids and fractures in the soil, thus possibly causing an underestimation of vapor migration towards building foundations and vapor intrusion to indoor environments. We measured the ratio of the gas diffusion coefficient in soil and in free air (D(p)/D(0)) for 42 variously structured, intact, and unsaturated soil cores taken from 6 Danish sites. Whilst the results from structureless fine sand were adequately described using previously proposed models, results that were obtained from glacial clay till and limestone exhibited a dual-porosity behavior. Instead, these data were successfully described using a dual-porosity model for gas-phase diffusivity, considering a presence of drained fractures surrounded by a lower diffusivity matrix. Based on individual model fits, the tortuosity of fractures in till and limestone was found to be highest in samples with a total porosity <40%, suggesting soil compaction to affect the geometry of the fractures. In summary, this study highlights a potential order of magnitude underestimation associated in the use of classical models for prediction of subsurface gas-phase diffusion coefficients in heterogeneous and fractured soils., (2010 Elsevier B.V. All rights reserved.)