High-fidelity simulation increases obstetric self-assurance and skills in undergraduate medical students

Objective: Teaching intrapartum care is one of the most challenging tasks in undergraduate medical education. High-fidelity obstetric simulators might support students' learning experience. The specific educational impact of these simulators compared with traditional methods of model-based obstetric teaching has not yet been determined. Study design: We randomly assigned 46 undergraduate medical students to be taught using either a high-fidelity simulator or a scale wood-and-leather phantom. Their self-assessments were evaluated using a validated questionnaire. We assessed obstetric skills and asked students to solve obstetric paper cases. Main outcome measures: Assessment of fidelity-specific teaching impact on procedural knowledge, motivation, and interest in obstetrics as well as obstetric skills using high- and low-fidelity training models. Results: High-fidelity simulation specifically improved students' feeling that they understood both the physiology of parturition and the obstetric procedures. Students in the simulation group also felt better prepared for obstetric house jobs and performed better in obstetric skills evaluations. However, the two groups made equivalent obstetric decisions. Conclusion: This study provides first data on the impact of high-fidelity simulation in an undergraduate setting

Flowcytometric assessment of fetomaternal hemorrhage during external cephalic version at term

External cephalic version (ECV) at term is a safe procedure and reduces the incidence of cesarean sections for breech presentation. One of the known complications, however, is an ECV-related disruption of the placental barrier and a subsequent transfusion of fetal blood into maternal circulation. While the incidence of ECV-related fetomaternal hemorrhage (FMH) has been determined recently in a large trial using a manual Kleihauer-Betke test (KBT), questions remain on the amount of ECV-related FMH. KBT, which detects fetal red blood cells (RBC) on the basis of acidic resistance of fetal hemoglobin (HbF), is known to be a sensitive test, yet prone to procedural errors limiting its accuracy in quantifying FMH. In this study we investigated 50 patients for FMH before and after ECV, using a dual-color flow cytometric test kit with a lower limit of quantification of 0.05% fetal RBC in maternal peripheral blood. Three patients had a quantifiable increase of fetal RBC detected after ECV (0.06%; 0.08%; 0.1%). None of these subtle increments was predictable by ECV-related clinical parameters or translated into fetal compromise. Using a sensitive and accurate flow cytometric test method, our data provide further assurance to mothers on the safety of ECV at term

前川 良博教授 略歴

Ist das Gewissen am Ende? - In: Geprüfter Glaube / hrsg. von Johannes Ries. - Stuttgart : Kathol. Bibelwerk, 1973. - S. 109-11

Continuous Variable Quantum Key Distribution: Finite-Key Analysis of Composable Security against Coherent Attacks

We provide a security analysis for continuous variable quantum key distribution protocols based on the transmission of squeezed vacuum states measured via homodyne detection. We employ a version of the entropic uncertainty relation for smooth entropies to give a lower bound on the number of secret bits which can be extracted from a finite number of runs of the protocol. This bound is valid under general coherent attacks, and gives rise to keys which are composably secure. For comparison, we also give a lower bound valid under the assumption of collective attacks. For both scenarios, we find positive key rates using experimental parameters reachable today.Comment: v2: new author, technical inaccuracy corrected, new plots, v3: substantially improved key rates against coherent attacks (due to correction of an error in the numerical computation

Erratum: Continuous Variable Quantum Key Distribution: Finite-Key Analysis of Composable Security Against Coherent Attacks [Phys. Rev. Lett. 109, 100502 (2012)]

no abstract availabl

Epsilon Indi Ba, Bb: a detailed study of the nearest known brown dwarfs

The discovery of epsilon Indi Ba, Bb, a binary brown dwarf system very close to the Sun, makes possible a concerted campaign to characterise the physical parameters of two T dwarfs. Recent observations suggest substellar atmospheric and evolutionary models may be inconsistent with observations, but there have been few conclusive tests to date. We therefore aim to characterise these benchmark brown dwarfs to place constraints on such models. We have obtained high angular resolution optical, near-infrared, and thermal-infrared imaging and medium-resolution (up to R~5000) spectroscopy of epsilon Indi Ba, Bb with the ESO VLT and present VRIzJHKL'M' broad-band photometry and 0.63--5.1 micron spectroscopy of the individual components. Furthermore, we use deep AO-imaging to place upper limits on the (model-dependent) mass of any further system members. We derive luminosities of log L/L_sun = -4.699+/-0.017 and -5.232+/-0.020 for epsilon Indi Ba, Bb, respectively, and using the dynamical system mass and COND03 evolutionary models predict a system age of 3.7--4.3 Gyr, in excess of previous estimates and recent predictions from observations of these brown dwarfs. Moreover, the effective temperatures of 1352--1385 K and 976--1011 K predicted from the COND03 evolutionary models, for epsilon Indi Ba and Bb respectively, are in disagreement with those derived from the comparison of our data with the BT-Settl atmospheric models where we find effective temperatures of 1300--1340 K and 880--940 K, for epsilon Indi Ba and Bb respectively, with surface gravities of log g=5.25 and 5.50. Finally, we show that spectroscopically determined effective temperatures and surface gravities for ultra-cool dwarfs can lead to underestimated masses even where precise luminosity constraints are available.Comment: 27 pages, 30 figures, 9 tables, accepted for publication in Astronomy and Astrophysic

Formation conditions and 40Ar/39Ar age of the Gem-Bearing Boqueir?o Granitic Pegmatite, Parelhas, Rio Grande do Norte, Brazil.

The Boqueir?o granitic pegmatite, alias Alto da Cabe?a pegmatite, is situated in Borborema Pegmatitic Province (BPP) in Northeast Brazil. This pegmatitic province hosts globally important reserves of tantalum and beryllium, as well as significant quantities of gemstones, including aquamarine, morganite, and the high-quality turquoise-blue ?Para?ba Elbaite?. The studied lithium-cesium-tantalum Boqueir?o granitic pegmatite intruded meta-conglomerates of the Equador Formation during the late Cambrian (502.1 ? 5.8 Ma; 40Ar/39Ar plateau age of muscovite). The pegmatite exhibits a typical zonal mineral pattern with four defined zones (Zone I: muscovite, tourmaline, albite, and quartz; Zone II: K-feldspar (microcline), quartz, and albite; Zone III: perthite crystals (blocky feldspar zone); Zone IV: massive quartz). Huge individual beryl, spodumene, tantalite, and cassiterite crystals are common as well. Microscopic examinations revealed that melt inclusions were entrapped simultaneously with fluid inclusions, suggesting the magmatic?hydrothermal transition. The magmatic?hydrothermal transition affected the evolution of the pegmatite, segregating volatile compounds (H2O, CO2, N2) and elements that preferentially partition into a fluid phase from the viscous silicate melt. Fluid inclusion studies on microcline and associated quartz combined with microthermometry and Raman spectroscopy gave an insight into the P-T-X characteristics of entrapped fluids. The presence of spodumene without other LiAl(SiO3)2 polymorphs and constructed fluid inclusion isochores limited the magmatic?hydrothermal transition at the gem-bearing Boqueir?o granitic pegmatite to the temperature range between 300 and 415 ?C at a pressure from 1.8 to 3 kbar. View Full-Tex

A long-period massive planet around HD106515A

We have performed RV monitoring of the components of the binary system HD 106515 over about 11 years using the high resolution spectrograph SARG at TNG. The primary shows long-period radial velocity variations that indicate the presence of a low mass companion whose projected mass is in the planetary regime (m sin i = 9.33 Mjup). The 9.8 years orbit results quite eccentric (e=0.57), as typical for massive giant planets. Our results confirm the preliminary announcement of the planet included in Mayor et al. (2011). The secondary instead does not show significant RV variations. The two components do not differ significantly in chemical composition, as found for other pairs for which one component hosts giant planets. Adaptive optics images obtained with AdOpt@TNG do not reveal additional stellar companions. From the analysis of the relative astrometry of the components of the wide pair we put an upper limit on the mass of the newly detected companion of about 0.25 Msun. State of art or near future instrumentation can provide true mass determination, thanks to the availability of the wide companion HD106515B as reference. Therefore, HD106515Ab will allow deeper insight in the transition region between planets and brown dwarfs.Comment: A&A, accepted, 8 pages, 10 figure

Large ESR forging ingots and their quality in production

ESR is known as an alternative step on the continuous improvement in single ingot production for heavyforgings. In the recent past a new state of the art ESR remelting system was installed with the possibility toproduce ingots in diameter from 1000mm for 45tons till 2000mm for 145tons. Consumable electrodes fromtraditional fabrication processes which consist of melting with electrical arc furnace, refining, degassingof the steel and bottom pouring will be used to produce one single heavy ingot with best cleanness withthe help of electrode exchange technique. This paper tells about the furnace characteristics and the efforts tobe made to ensure high quality level in material and furnace preparation as well as save automatic productionperformances during remelting and electrode exchange. Finally the results of ingots characterized by anelevated level of chemical homogeneity and internal quality such as to ensure the absence of defectgreater than 0.5mm AVG during the final inspection of the forged part from the ESR production will bepresented. The ESR process serves for the reproducible quality in heavy ingot making and tightens the limits inspecifications together with high material yield

Heavy ions and X-rays in brain tumor treatment : a comparison of their biological effects on tissue slice cultures

Background: In this interdisciplinary project, the biological effects of heavy ions are compared to those of X-rays using tissue slice culture preparations from rodents and humans. Advantages of this biological model are the conservation of an organotypic environment and the independency from genetic immortalization strategies used to generate cell lines. Its open access allows easy treatment and observation via live-imaging microscopy. Materials and methods: Rat brains and human brain tumor tissue are cut into 300 micro m thick tissue slices. These slices are cultivated using a membrane-based culture system and kept in an incubator at 37°C until treatment. The slices are treated with X-rays at the radiation facility of the University Hospital in Frankfurt at doses of up to 40 Gy. The heavy ion irradiations were performed at the UNILAC facility at GSI with different ions of 11.4 A MeV and fluences ranging from 0.5–10 x 106 particles/cm². Using 3D-confocal microscopy, cell-death and immune cell activation of the irradiated slices are analyzed. Planning of the irradiation experiments is done with simulation programs developed at GSI and FIAS. Results: After receiving a single application of either X-rays or heavy ions, slices were kept in culture for up to 9d post irradiation. DNA damage was visualized using gamma H2AXstaining. Here, a dose-dependent increase and time-dependent decrease could clearly be observed for the X-ray irradiation. Slices irradiated with heavy ions showed less gamma H2AX-positive cells distributed evenly throughout the slice, even though particles were calculated to penetrate only 90–100 micro m into the slice. Conclusions: Single irradiations of brain tissue, even at high doses of 40 Gy, will result neither in tissue damage visible on a macroscopic level nor necrosis. This is in line with the view that the brain is highly radio-resistant. However, DNA damage can be detected very well in tissue slices using gamma H2AX-immuno staining. Thus, slice cultures are an excellent tool to study radiation-induced damage and repair mechanisms in living tissues