Duration to Establish an Emergency Vascular Access and How to Accelerate It: A Simulation-Based Study Performed in Real-Life Neonatal Resuscitation Rooms

Objectives: To compare the duration to establish an umbilical venous catheter and an intraosseous access in real hospital delivery rooms and as a secondary aim to assess delaying factors during establishment and to provide recommendations to accelerate vascular access in neonatal resuscitation. Design: Retrospective analysis of audio-video recorded neonatal simulation training. Settings: Simulation training events in exact replications of actual delivery/resuscitation rooms of 16 hospitals with different levels of care (Austria and Germany). Equipment was prepared the same way as for real clinical events. Subjects: Medical teams of four to five persons with birth-related background (midwives, nurses, neonatologists, and anesthesiologists) in a realistic team composition. Interventions: Audio-video recorded mannequin-based simulated resuscitation of an asphyxiated newborn including the establishment of either umbilical venous catheter or intraosseous access. Measurements and Main Results: The duration of access establishment (time from decision to first flush/aspiration), preparation (decision to start of procedure), and the procedure itself (start to first flush/aspiration) was significantly longer for umbilical venous catheter than for intraosseous access (overall duration 199 vs 86 s). Delaying factors for umbilical venous catheter establishment were mainly due to the complex approach itself, the multitude of equipment required, and uncertainties about necessary hygiene standards. Challenges in intraosseous access establishment were handling of the unfamiliar material and absence of an intraosseous access kit in the resuscitation room. There was no significant difference between the required duration for access establishment between large centers and small hospitals, but a trend was observed that duration for umbilical venous catheter was longer in small hospitals than in centers. Duration for intraosseous access was similar in both hospital types. Conclusions: Vascular access establishment in neonatal resuscitation could be accelerated by infrastructural improvements and specific training of medical teams. In simulated in situ neonatal resuscitation, intraosseous access is faster to establish than umbilical venous catheter. Future studies are required to assess efficacy and safety of both approaches in real resuscitation settings

Measuring a photonic qubit without destroying it

Measuring the polarisation of a single photon typically results in its destruction. We propose, demonstrate, and completely characterise a \emph{quantum non-demolition} (QND) scheme for realising such a measurement non-destructively. This scheme uses only linear optics and photo-detection of ancillary modes to induce a strong non-linearity at the single photon level, non-deterministically. We vary this QND measurement continuously into the weak regime, and use it to perform a non-destructive test of complementarity in quantum mechanics. Our scheme realises the most advanced general measurement of a qubit: it is non-destructive, can be made in any basis, and with arbitrary strength.Comment: 4 pages, 3 figure

Effects of Training on Social Work, Nursing and Medical Trainees' Knowledge, Attitudes and Beliefs Related to Screening and Brief Intervention for Alcohol Use

Indiana University's Schools of Social Work, Nursing and Medicine formed a consortium to advance education for Screening Brief Intervention and Referral to Treatment (SBIRT). Trainees participated in SBIRT training and completed data collection before, immediately after, and 30 days after a face-to-face training. The study explored participants' perceptions about the training and the likelihood of implementing SBI in practice, including attitudes and beliefs that may be predictive of SBIRT utilization in clinical practice. Results show the training targeting SBI and MI behaviors may improve participants' self-reported competence with SBI. This improvement was consistent and strong in all programs. The study results also provided a preliminary indication that the training affected participants' perception of time utilization and compensation for performing SBI

Versorgung und Reanimation des reifen Neugeborenen nach der Geburt : Basierend auf der aktuellen Leitlinie des European Resuscitation Council 2021

Zusammenfassung Die volle Reanimation eines Neugeborenen mit Beatmungen, Thoraxkompressionen und der Gabe von Medikamenten ist ein äußerst seltenes Ereignis, das selbst neonatologische Teams immer wieder vor Herausforderungen stellt. Gerade in diesen seltenen und häufig dramatischen Situationen ist schnelles und umsichtiges Handeln im Team gefragt. Dabei ist die effektivste und meist einzig notwendige Maßnahme für die erfolgreiche Versorgung eines nicht spontan atmenden Neugeborenen eine suffiziente Maskenbeatmung. Wird diese effektiv durchgeführt, sind beim Neugeborenen in den seltensten Fällen tatsächlich Thoraxkompressionen notwendig. Im März 2021 wurde vom European Resuscitation Council (ERC) die neue Leitlinie zur Reanimation von Neugeborenen publiziert. Auf Basis dieser Leitlinie beschreibt der vorliegende Beitrag detailliert den im Algorithmus der Versorgung und Reanimation von reifen Neugeborenen dargestellten Handlungsablauf. Er richtet sich damit einerseits insbesondere an NichtneonatologInnen, die für die Versorgung v. a. von reifen Neugeborenen nach der Geburt verantwortlich sind. Andererseits soll er auch jenen zur Unterstützung dienen, die medizinisches Personal in der Versorgung von lebensbedrohten Neugeborenen trainieren und den Algorithmus der Neugeborenenreanimation als didaktisches Konzept vermitteln. Abstract The resuscitation of a neonate with the need for ventilation, chest compressions and the administration of drugs is an extremely rare event that repeatedly challenges even neonatal teams. It is precisely in these rare and often dramatic situations that rapid and prudent team action is required. The most effective and usually the only necessary measure for the successful resuscitation of a neonate who is not breathing spontaneously is sufficient mask ventilation. If ventilation is performed effectively, chest compressions are rarely necessary in the neonate. In March 2021, the European Resuscitation Council (ERC) published the new guidelines for neonatal resuscitation. Based on these guidelines, this article describes in detail the course of action outlined in the algorithm for the stabilisation and resuscitation of term neonates. On the one hand, it is aimed at non-neonatologists who are responsible for the care of term neonates after birth. On the other hand, it is also intended to support those who train medical personnel in the care of life-threatened neonates and teach the algorithm of neonatal resuscitation as a didactic concept

On the unique possibility to increase significantly the contrast of dark resonances on D1 line of 87^{87}Rb

We propose and study, theoretically and experimentally, a new scheme of excitation of a coherent population trapping resonance for D1 line of alakli atoms with nuclear spin $I=3/2$ by bichromatic linearly polarized light ({\em lin}$||${\em lin} field) at the conditions of spectral resolution of the excited state. The unique properties of this scheme result in a high contrast of dark resonance for D1 line of $^{87}$Rb.Comment: 9 pages, 7 figures. This material has been partially presented on ICONO-2005, 14 May 2005, St. Petersburg, Russia. v2 references added; text is changed a bi

A Minimal Length from the Cutoff Modes in Asymptotically Safe Quantum Gravity

Within asymptotically safe Quantum Einstein Gravity (QEG), the quantum 4-sphere is discussed as a specific example of a fractal spacetime manifold. The relation between the infrared cutoff built into the effective average action and the corresponding coarse graining scale is investigated. Analyzing the properties of the pertinent cutoff modes, the possibility that QEG generates a minimal length scale dynamically is explored. While there exists no minimal proper length, the QEG sphere appears to be "fuzzy" in the sense that there is a minimal angular separation below which two points cannot be resolved by the cutoff modes.Comment: 26 pages, 1 figur

Guiding neutral atoms around curves with lithographically patterned current-carrying wires

Laser-cooled neutral atoms from a low-velocity atomic source are guided via a magnetic field generated between two parallel wires on a glass substrate. The atoms bend around three curves, each with a 15-cm radius of curvature, while traveling along a 10-cm-long track. A maximum flux of 2*10^6 atoms/sec is achieved with a current density of 3*10^4 A/cm^2 in the 100x100-micrometer-cross-section wires. The kinetic energy of the guided atoms in one transverse dimension is measured to be 42 microKelvin.Comment: 9 page

Brane-bulk matter relation for a purely conical codimension-2 brane world

We study gravity on an infinitely thin codimension-2 brane world, with purely conical singularities and in the presence of an induced gravity term on the brane. We show that in this approximation, the energy momentum tensor of the bulk is strongly related to the energy momentum tensor of the brane and thus the gravity dynamics on the brane are induced by the bulk content. This is in contrast with the gravity dynamics on a codimension-1 brane. We show how this strong result is relaxed after including a Gauss-Bonnet term in the bulk.Comment: 12 pages, mistake corrected, references adde

Observation of off-diagonal geometric phase in polarized neutron interferometer experiments

Off-diagonal geometric phases acquired in the evolution of a spin-1/2 system have been investigated by means of a polarized neutron interferometer. Final counts with and without polarization analysis enable us to observe simultaneously the off-diagonal and diagonal geometric phases in two detectors. We have quantitatively measured the off-diagonal geometric phase for noncyclic evolutions, confirming the theoretical predictions. We discuss the significance of our experiment in terms of geometric phases (both diagonal and off-diagonal) and in terms of the quantum erasing phenomenon.Comment: pdf, 22 pages + 8 figures (included in the pdf). In print on Phys. Rev.