Does Telemedical Support of First Responders Improve Guideline Adherence in an Offshore Emergency Scenario? A Simulator-Based Prospective Study

OBJECTIVE: To investigate, in a simulator-based prospective study, whether telemedical support improves quality of emergency first response (performance) by medical non-professionals to being non-inferior to medical professionals. SETTING: In a simulated offshore wind power plant, duos (teams) of offshore engineers and teams of paramedics conducted the primary survey of a simulated patient. PARTICIPANTS: 38 offshore engineers and 34 paramedics were recruited by the general email invitation. INTERVENTION: Teams (randomised by lot) were supported by transmission technology and a remote emergency physician in Berlin. OUTCOME MEASURES: From video recordings, performance (17 item checklist) and required time (up to 15 min) were quantified by expert rating for analysis. Differences were analysed using two-sided exact Mann-Whitney U tests for independent measures, non-inferiority was analysed using Schuirmann one-sided test. The significance level of 5 % was Holm-Bonferroni adjusted in each family of pairwise comparisons. RESULTS: Nine teams of engineers with, nine without, nine teams of paramedics with and eight without support completed the task. Two experts quantified endpoints, insights into rater dependence were gained. Supported engineers outperformed unsupported engineers (p<0.01), insufficient evidence was found for paramedics (p=0.11). Without support, paramedics outperformed engineers (p<0.01). Supported engineers' performance was non-inferior (at one item margin) to that by unsupported paramedics (p=0.03). Supported groups were slower than unsupported groups (p<0.01). CONCLUSIONS: First response to medical emergencies in offshore wind farms with substantially delayed professional care may be improved by telemedical support. Future work should test our result during additional scenarios and explore interdisciplinary and ecosystem aspects of this support. TRIAL REGISTRATION NUMBER: DRKS0001437

Neural basis of somatosensory target detection independent of uncertainty, relevance, and reports

Research on somatosensory awareness has yielded highly diverse findings with putative neural correlates ranging from activity within somatosensory cortex to activation of widely distributed frontoparietal networks. Divergent results from previous studies may reside in cognitive processes that often coincide with stimulus awareness in experimental settings. To scrutinise the specific relevance of regions implied in the target detection network, we used functional magnetic resonance imaging (n = 27) on a novel somatosensory detection task that explicitly controls for stimulus uncertainty, behavioural relevance, overt reports, and motor responses. Using Bayesian Model Selection, we show that responses reflecting target detection are restricted to secondary somatosensory cortex, whereas activity in insular, cingulate, and motor regions is best explained in terms of stimulus uncertainty and overt reports. Our results emphasise the role of sensory-specific cortex for the emergence of perceptual awareness and dissect the contribution of the frontoparietal network to classical detection tasks

Designing with nature:Advancing three-dimensional green spaces in architecture through frameworks for biophilic design and sustainability

In the transition to a more sustainable built environment over the last two decades, the “greening” of architecture as a popular approach has received widespread attention. However, there are still many open questions and contradictions regarding how to design with “nature” and contribute to sustainability. In addition, explorations of built examples are rare, and three-dimensional (3D) green spaces in buildings are often overlooked. Therefore, we introduce “green pockets” (3D green spaces) as a typology distinct from two-dimensional green roofs and walls/facades. We draw on a mixed-method approach to study two cases (Erasmus MC and Hotel Jakarta), comprising 12 semi-structured interviews with different stakeholders, design document analysis, and site observation. We develop a critical reflection (a framework) on the impacts of “green architecture” on sustainability from unpacked benefits and adopt a biophilic design framework to analyse designing with “nature” in architectural practice. These findings demonstrate that green pockets contribute to integrating multiple experiences of “nature” into buildings and developing sustainable architecture. Designing green pockets with visibility, accessibility, and spatial characteristics (e.g., prospect and refuge, organised complexity, peril, and mystery) of “nature” improves building quality. Furthermore, we provide design recommendations to advance green pocket designs and make suggestions for future research

Biophilic Design in Architecture and Its Contributions to Health, Well-being, and Sustainability:A Critical Review

In the last ten years, ‘nature’ and biophilic design have received widespread attention in architecture, especially in response to growing environmental challenges. However, open questions and controversies remain regarding conceptualizing and addressing ‘nature’ in practice and research. This study conducts a literature review to discuss biophilic design as a theoretical framework to interpret ‘nature’ in architecture. The following questions are answered: (1) How has the concept of biophilic design emerged, and how can it be defined? (2) In what ways can biophilic design contribute to the goals of sustainable architecture? (3) What are the key design strategies in biophilic design? This review identifies and compares the key frameworks of biophilic design and explains their major elements. We then analyse the benefits (e.g. enhance health, well-being, productivity, biodiversity, and circularity) of biophilic design in achieving sustainability, as framed through the UN Sustainable Development Goals. The results indicate that biophilic design is more complex and richer than the mere application of vegetation in buildings; it broadens the variety through encompassing different types of nature from physical, sensory, metaphorical, morphological, material to spiritual. Moreover, knowledge gaps are identified to motivate future research and critical reflections on biophilic design practices

Die Zukunft des Bildungssystems: Lernen auf Abruf - eigenverantwortlich und lebenslänglich! Oder: die langfristige Entwicklung und politische Implementierung eines postindustriellen Bidlungsparadigma

The German educational system passes through a lasting conversion under the aegis of terms like "market", "competition", and "personal responsibility". As a result the rapport of corporate and individual responsibility will be reversed: education solely becomes a resource of individual competitiveness in deregulated markets. The article deciphers the conversion as an example for the long lasting strategy of neoliberal politics. Thereby a special focus lies on a certain kind of "sub-politics" carried out by advocacy think tanks, which are acting in the threshold of science, media and politics

Not Guilty on Every Count: The “Non‐Innocent” Nitrosyl Ligand in the Framework of IUPAC′s Oxidation‐State Formalism

Nitrosyl–metal bonding relies on the two interactions between the pair of N–O‐π* and two of the metal's d orbitals. These (back)bonds are largely covalent, which makes their allocation in the course of an oxidation‐state determination ambiguous. However, apart from M‐N‐O‐angle or net‐charge considerations, IUPAC′s “ionic approximation” is a useful tool to reliably classify nitrosyl metal complexes in an orbital‐centered approach

Bimodal mesoporous titanium dioxide anatase films templated by a block polymer and an ionic liquid: influence of the porosity on the permeability

In the present paper, we report the synthesis of bimodal mesoporous anatase TiO2 films by the EISA (Evaporation-Induced Self-Assembly) method using sol-gel chemistry combining two porogen agents, a low molecular weight ionic template and a neutral block copolymer. The surfactant template (C(16)mimCl) generates non-oriented worm-like pores (8 to 10 nm) which connect the regularly packed ellipsoidal mesopores (15 to 20 nm diameter) formed by an amphiphilic block copolymer of the type poly(isobutylene)-b-poly(ethylene oxide) (PIB-PEO). The surfactant template can also significantly influence the size and packing of the ellipsoidal mesopores. The mesostructural organization and mesoporosity of the films are studied by Environmental Ellipsometry-Porosimetry (EEP), Grazing-Incidence Small-Angle X-ray Scattering (GISAXS) and electron microscopy techniques. Electrochemical characterization is performed to study the permeability of the films to liquid solutions, using two types of probe moieties (K3FeIII(CN)(6) and Ru(bpy)(3)(2+)) by the wall-jet technique. An optimum ratio of C(16)mimCl/PIB-PEO provides anatase films with a continuous bimodal mesopore structure, possessing a permeability up to two times higher than that of the mesoporous films templated by PIB-PEO only (with partially isolated mesopores). When C(16)mimCl is used in large quantities, up to 20% weight vs. PIB-PEO, large overall porous volume and surface area are obtained, but the mesostructure is increasingly disrupted, leading to a severe loss of permeability of the bimodal films. A dye-sensitized solar cell set-up is used with anatase films as the photoelectrode. The photosensitizer loading and the total energy conversion efficiency of the solar cells using the mesoporous films templated by an optimal ratio of the two porogen agents C(16)mimCl and PIB-PEO can be substantially increased in comparison with the solar cells using mesoporous films templated by PIB-PEO only.DFG/SM 199/6-1DFG/OE 420/5-1BMBF/SOHyb/03X3525