Prefrontal cortex activation and young driver behaviour: a fNIRS study

Road traffic accidents consistently show a significant over-representation for young, novice and particularly male drivers. This research examines the prefrontal cortex activation of young drivers and the changes in activation associated with manipulations of mental workload and inhibitory control. It also considers the explanation that a lack of prefrontal cortex maturation is a contributing factor to the higher accident risk in this young driver population. The prefrontal cortex is associated with a number of factors including mental workload and inhibitory control, both of which are also related to road traffic accidents. This experiment used functional near infrared spectroscopy to measure prefrontal cortex activity during five simulated driving tasks: one following task and four overtaking tasks at varying traffic densities which aimed to dissociate workload and inhibitory control. Age, experience and gender were controlled for throughout the experiment. The results showed that younger drivers had reduced prefrontal cortex activity compared to older drivers. When both mental workload and inhibitory control increased prefrontal cortex activity also increased, however when inhibitory control alone increased there were no changes in activity. Along with an increase in activity during overtaking manoeuvres, these results suggest that prefrontal cortex activation is more indicative of workload in the current task. There were no differences in the number of overtakes completed by younger and older drivers but males overtook significantly more than females. We conclude that prefrontal cortex activity is associated with the mental workload required for overtaking. We additionally suggest that the reduced activation in younger drivers may be related to a lack of prefrontal maturation which could contribute to the increased crash risk seen in this population

Publications by university Departments of Anaesthesiology from Germany, Austria and Switzerland in 2011-2015. Scientific publications by university hospitals in D-A-CH

BackgroundThis study presents acount of publications and citations for all articles published by university Departments of Anaesthesiology in Germany, Austria and Switzerland between 2011 and 2015. The results were compared with former analyses of these countries from 2001-2010 as well as similar international studies.MethodsWe performed aPubMed search based on PERL-scripts for all publications originating from university Departments of Anaesthesiology in Germany, Austria and Switzerland between 2011 and 2015. According to their author's affiliation, articles were assigned to their affiliated university department. Publications were considered an original article if the category of publication was classified as original research in PubMed. Predatory journals were omitted by using PubMed-listed journals only. Data of citations was retrieved from Thomson Reuter's ISI Web of Knowledge. The following indicators were reported: the number of publications and original articles (counting each author and first authors only) and the share of original articles out of all publications. With regard to citations, we reported the overall number, the percentage of publications, which were cited at least once and the median of citations per publication and per original article as well as the calculated h-index.ResultsThe 47university Departments of Anaesthesiology published 4.697 articles between 2011 and 2015, which make up 89% of all anaesthesiology research originating from Germany, Austria and Switzerland (overall 5.284 publications). Of these, 1.037 (22%) were classified as original articles. Considering only articles with first authors, equalizing a change of PubMed's affiliation field policy in 2012 to compare the numbers with previous periods, 3.709 publications and 821 original articles were published. 90% of all publications and 96% of original articles, respectively, were cited at least once. Publications were cited six times, while original articles were cited nine times. The university department of Anaesthesiology in Zurich published most (n=245), while most original articles were published in Vienna (n=77). The highest share of original articles was achieved by Vienna (37%). Publications from Berlin - Benjamin Franklin and Jena (11citations per publication) and original articles from Essen (23,5 citations per original article) achieved the highest citation rates.DiscussionIn contrast to the worldwide increasing trend, the number of publications of the university Departments of Anaesthesiology in Germany, Austria and Switzerland stagnated. The share of original articles out of all publications continues to decline in comparison to 2001-2010 (-6%). Despite this, original articles were cited more frequently and thus had a higher value for the scientific community. The reasons of the decrease in the number of original articles remain unclear and require further investigation to reverse this negative trend.ConclusionStrategies to foster academic work in anaesthesiology in Germany, Austria and Switzerland are required

Oxygenation laryngoscope vs. nasal standard and nasal high flow oxygenation in a technical simulation of apnoeic oxygenation

Background Failed airway management is the major contributor for anaesthesia-related morbidity and mortality. Cannot-intubate-cannot-ventilate scenarios are the most critical emergency in airway management, and belong to the worst imaginable scenarios in an anaesthetist's life. In such situations, apnoeic oxygenation might be useful to avoid hypoxaemia. Anaesthesia guidelines recommend careful preoxygenation and application of high flow oxygen in difficult intubation scenarios to prevent episodes of deoxygenation. In this study, we evaluated the decrease in oxygen concentration in a model when using different strategies of oxygenation: using a special oxygenation laryngoscope, nasal oxygen, nasal high flow oxygen, and control. Methods In this experimental study we compared no oxygen application as a control, standard pure oxygen application of 10 l center dot min(- 1) via nasal cannula, high flow 90% oxygen application at 20 l center dot min(- 1) using a special nasal high flow device, and pure oxygen application via our oxygenation laryngoscope at 10 l center dot min(- 1). We preoxygenated a simulation lung to 97% oxygen concentration and connected this to the trachea of a manikin model simulating apnoeic oxygenation. Decrease in oxygen concentration in the simulation lung was measured continuously for 20 min. Results Oxygen concentration in the simulation lung dropped from 97 +/- 1% at baseline to 40 +/- 1% in the no oxygen group, to 80 +/- 1% in the standard nasal oxygen group, and to 73 +/- 2% in the high flow nasal oxygenation group. However, it remained at 96 +/- 0% in the oxygenation laryngoscope group (p < 0.001 between all groups). Conclusions In this technical simulation, oxygenation via oxygenation laryngoscope was more effective than standard oxygen insufflation via nasal cannula, which was more effective than nasal high flow insufflation of 90% oxygen