Developing Emergency Medicine Leaders: The AACEM/SAEM Chair Development Program at 5 Years

The Association of Academic Chairs of Emergency Medicine Chair Development Program (CDP) was started in 2014 to provide emergency medicine (EM) chairs and leaders who aspired to become academic chairs with EM‐specific leadership training. Each class participated in a 1‐year program, with five sessions taught primarily by EM leaders. Data from the first 5 years of the CDP are provided. A total of 81 participants completed the program (16% women). Twenty participants who were not chairs at entry have become EM chairs. Ratings of the CDP based on a survey of participants with a 94% response rate were very favorable. The CDP has been a popular and successful vehicle to increase leadership skills and prepare EM leaders for academic chair positions.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154449/1/acem13896_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154449/2/acem13896.pd

Optimierung von Saatgutbehandlungsmitteln mit Wirkung gegen Flugbrand an Gerste und Weizen (Ustilago nuda, U. tritici) unter Nutzung verbesserter Verfahren zum Nachweis der Erreger

Ziel des Projektes war die Entwicklung von Saatgutbehandlungsmitteln zur Flugbrandbekämpfung im Ökolandbau und von Techniken die geeignet sind, die Entwicklung solcher Saatgutbehandlungsmittel zu beschleunigen. In Inokulationsversuchen konnte im Feldversuch durch Ausstäuben von Sporen Saatgut mit 2-5% Flugbrandbefall erzeugt werden. Nach Einzelblüteninokulation lag der Befall oft über 60%. Anders als bei Weizen waren bei Gerste die Keimfähigkeit und das Tausendkorngewicht von solchem Saatgut deutlich reduziert. Von ca. 30 geprüften Pflanzenextrakten führten neun nach Inkorporation in PDA zu einer vollständigen Hemmung der Brandsporenkeimung. In Hemmtesten mit Mikroorganismen betrug der Anteil wirksamer Isolate bei den Trichoderma-Isolaten 43%, bei den Actinomyceten 30% und bei den übrigen Bakterien 11%. In mehrjährig durchgeführten Kleinparzellenversuchen mit flugbrandinfizierter Gerste und Weizen wurden mit einigen Behandlungsvarianten Bekämpfungserfolge erzielt. Die Effekte waren aber zu gering für die praktische Anwendung und nur bedingt reproduzierbar. Topfversuche im Gewächshaus mit hochinfizierten Saatgutchargen erbrachten ähnliche Ergebnisse. Die Wirksamkeit gegen Haferflugbrand wurde nur einmal überprüft. Wie im Falle von Gersten- und Weizenflugbrand war der Bekämpfungserfolg auch beim Haferflugbrand unbefriedigend. Eine Ausnahme bildete die Saatgutbehandlung mit Ethanol (70%). Mit ihr wurde bei Hafer eine Flugbrandwirksamkeit von ca. 80% erzielt. Nach Anfärbung mit dem Fluoreszenzfarbstoff Blankophor wurde beobachtet, dass der Pilz schon wenige Tage nach Beginn der Keimung in das Apikalmeristem und die Blattprimordien eindrang. Im 1-Knotenstadium waren die Ährenanlagen meist völlig besiedelt. Ein Protokoll für einen immunologischen (ELISA) und für einen molekularbiologischen (real-time PCR) Nachweis wurde entwickelt und zur Quantifizierung des Pilzes in Jungpflanzen angewendet. Die mit beiden Methoden erhaltenen Daten stimmten gut überein. In weiteren Versuchen konnte die Anwendbarkeit des mikroskopischen Nachweises und des ELISA für die Entwicklung von Saatgutbehandlungsmitteln und –verfahren exemplarisch gezeigt werden

Guidelines for the Management of Severe Head Injury: Are Emergency Physicians Following Them?

The Brain Trauma Foundation published “Guidelines for the Management of Severe Head Injury” in 1995. These evidence-based clinical guidelines (CGs) recommended against prophylactic hyperventilation and glucocorticoid use and advocated for aggressive blood pressure (BP) resuscitation, and the careful use of mannitol. Objective: To survey Michigan emergency physicians (MEPs) to test their adherence to these guidelines. Methods: An anonymous mail survey was sent to all 566 MEPs who are members of the American College of Emergency Physicians. Three clinical scenarios involving severe head injury were presented, all with Glasgow Coma Scale (GCS) scores of 8 or less. The physicians were asked to choose from 15 diagnostic and treatment options, which included: intubation and hyperventilation, BP resuscitation, intravenous (IV) mannitol administration, and IV glucocorticoid administration. Results: Three hundred nineteen (56%) surveys were returned. Forty-six percent [95% confidence interval (95% CI) = 40% to 51%] of the MEPs elected to use prophylactic hyperventilation; very few administered IV glucocorticoids. Seventy-eight percent (95% CI = 75% to 81%) corrected hypotension with systolic BP < 90 mm Hg; 83% (95% CI = 80% to 86%) also administered mannitol appropriately. Conclusions: A majority of MEPs are managing severe head injury patients in accordance with the “Guidelines for the Management of Severe Head Injury,” with the exception of avoiding prophylactic hyperventilation. More education and/or exposure to the evidence regarding prophylactic hyperventilation of severely head injured patients may improve adherence to the guidelines.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74731/1/aemj.9.8.806.pd

Give me a break! Unavoidable fatigue effects in cognitive pupillometry

Issue Online: 08 June 2023Pupillometry has a rich history in the study of perception and cognition. One perennial challenge is that the magnitude of the task-evoked pupil response diminishes over the course of an experiment, a phenomenon we refer to as a fatigue effect. Reducing fatigue effects may improve sensitivity to task effects and reduce the likelihood of confounds due to systematic physiological changes over time. In this paper, we investigated the degree to which fatigue effects could be ameliorated by experimenter intervention. In Experiment 1, we assigned participants to one of three groups—no breaks, kinetic breaks (playing with toys, but no social interaction), or chatting with a research assistant—and compared the pupil response across conditions. In Experiment 2, we additionally tested the effect of researcher observation. Only breaks including social interaction significantly reduced the fatigue of the pupil response across trials. However, in all conditions we found robust evidence for fatigue effects: that is, regardless of protocol, the task-evoked pupil response was substantially diminished (at least 60%) over the duration of the experiment. We account for the variance of fatigue effects in our pupillometry data using multiple common statistical modeling approaches (e.g., linear mixed-effects models of peak, mean, and baseline pupil diameters, as well as growth curve models of time-course data). We conclude that pupil attenuation is a predictable phenomenon that should be accommodated in our experimental designs and statistical models.Agencia Estatal de Investigación, Grant/Award Number: CEX2020-001010- S; Eusko Jaurlaritza; National Institutes of Health, Grant/ Award Number: R01 DC014281 and R01 DC019507; National Science Foundation, Grant/Award Number: DGE-174503

Inhomogeneous nucleation in quark hadron phase transition

The effect of subcritical hadron bubbles on a first-order quark-hadron phase transition is studied. These subcritical hadron bubbles are created due to thermal fluctuations, and can introduce a finite amount of phase mixing (quark phase mixed with hadron phase) even at and above the critical temperature. For reasonable choices of surface tension and correlation length, as obtained from the lattice QCD calculations, we show that the amount of phase mixing at the critical temperature remains below the percolation threshold. Thus, as the system cools below the critical temperature, the transition proceeds through the nucleation of critical-size hadron bubbles from a metastable quark-gluon phase (QGP), within an inhomogeneous background populated by an equilibrium distribution of subcritical hadron bubbles. The inhomogeneity of the medium results in a substantial reduction of the nucleation barrier for critical bubbles. Using the corrected nucleation barrier, we estimate the amount of supercooling for different parameters controlling the phase transition, and briefly discuss its implications to cosmology and heavy-ion collisions.Comment: LaTeX, 14 pages with 8 Postscript figures. Discussion added in introduction and conclusion, Fig. 8 added, few more references added, Typographical errors corrected. Version to appear in Phys. Rev.

Electrochemical investigation of the kinetics of chloride substitution upon reduction of [Ru(porphyrin)(NO)Cl] complexes in THF.

The electrochemistry of several ruthenium porphyrin nitrosyl chloride complexes [Ru(por)(NO)Cl] have been examined in tetrahydrofuran. The complexes undergo 1-electron irreversible reductions which result in the diffusion-limited substitutions of the chloride ligands for THF. This chloride metathesis is reversible in the presence of added NBu4Cl, and equilibrium constants and rate constants for chloride loss have been estimated. These parameters correlate with the NO stretching frequencies of the parent complexes, with more electron-donating porphyrin ligands favouring chloride loss from the reduced complexes. The [Ru(por)(NO)(THF)] products of the reductions can be detected by IR, EPR and visible spectroscopies. These species undergo three further reductions, with good reversibility at scan rates \u3e0.40 V s-1. The [Ru(por)(NO)(THF)]+/0 couples have also been determined, and the rate constants and equilibrium constants for recombination with chloride have been estimated. One-electron reductions of the [Ru(por)(NO)Cl] complexes result in ~1018 enhancement of the rates of chloride loss

Circle talks as situated experiential learning: Context, identity, and knowledgeability in \u27learning from reflection\u27

This article presents research that used ethnographic and sociolinguistic methods to study ways participants learn through reflection when carried out as a “circle talk.” The data indicate that participants in the event (a) invoked different contextual frames that (b) implicated them in various identity positions, which (c) affected how they could express their knowledge. These features worked together to generate socially shared meanings that enabled participants to jointly achieve conceptualization—the ideational role “reflection” is presumed to play in the experiential learning process. The analysis supports the claim that participants generate new knowledge in reflection, but challenges individualistic and cognitive assumptions regarding how this occurs. The article builds on situated views of experiential learning by showing how knowledge can be understood as socially shared and how learning and identity formation are mutually entailing processes

Enhancement of the electronic contribution to the low temperature specific heat of Fe/Cr magnetic multilayer

We measured the low temperature specific heat of a sputtered $(Fe_{23\AA}/Cr_{12\AA})_{33}$ magnetic multilayer, as well as separate $1000\AA$ thick Fe and Cr films. Magnetoresistance and magnetization measurements on the multilayer demonstrated antiparallel coupling between the Fe layers. Using microcalorimeters made in our group, we measured the specific heat for $4<T<30 K$ and in magnetic fields up to $8 T$ for the multilayer. The low temperature electronic specific heat coefficient of the multilayer in the temperature range $4<T<14 K$ is $\gamma_{ML}=8.4 mJ/K^{2}g-at$. This is significantly larger than that measured for the Fe or Cr films (5.4 and $3.5 mJ/K^{2}mol$ respectively). No magnetic field dependence of $\gamma_{ML}$ was observed up to $8 T$. These results can be explained by a softening of the phonon modes observed in the same data and the presence of an Fe-Cr alloy phase at the interfaces.Comment: 20 pages, 5 figure