Impact of Quantitative Feedback via High-Fidelity Airway Management Training on Success Rate in Endotracheal Intubation in Undergraduate Medical Students—A Prospective Single-Center Study

Endotracheal intubation is still the gold standard in airway management. For medical students and young professionals, it is often difficult to train personal skills. We tested a high-fidelity simulator with an additional quantitative feedback integration to elucidate if competence acquisition for airway management is increased by using this feedback method. In the prospective trial, all participants (n = 299; 4th-year medical students) were randomized into two groups—One had been trained on the simulator with additional quantitative feedback (n = 149) and one without (n = 150). Three simulator measurements were considered as quality criteria—The pressure on the upper front row of teeth, the correct pressure point of the laryngoscope spatula and the correct depth for the fixation of the tube. There were a total of three measurement time points—One after initial training (with additional capture of cognitive load), one during the exam, and a final during the follow-up, approximately 20 weeks after the initial training. Regarding the three quality criteria, there was only one significant difference, with an advantage for the control group with respect to the correct pressure point of the laryngoscope spatula at the time of the follow-up (p = 0.011). After the training session, the cognitive load was significantly higher in the intervention group (p = 0.008) and increased in both groups over time. The additional quantitative feedback of the airway management trainer brings no measurable advantage in training for endotracheal intubation. Due to the increased cognitive load during the training, simple airway management task training may be more efficient for the primary acquisition of essential procedural steps

Einsatz interaktiver Lernzirkelstationen zur Förderung der Variablenkontrollstrategie

Die Verwendung der Variablenkontrollstrategie (VKS) ist eine experimentelle Arbeitsweise, um kausale Zusammenhänge in der Wissenschaft systematisch zu untersuchen. Schülerinnen und Schülern der Sekundarstufe I bereitet diese Methodik jedoch in vielerlei Hinsicht Probleme, da sie beim Experimentieren häufig eigene Strategien verwenden und dabei unsystematisch vorgehen. Um dieser Problematik entgegenzuwirken, kann die Anwendung der VKS mit den Lernenden experimentell geübt werden, indem konfundierte und variablenkontrollierte Settings behandelt werden. Ohne einen zusätzlichen externen Impuls werden allerdings bei den Lernenden häufig nicht die Denkprozesse angestoßen, um ein konfundiertes Experiment zu erkennen. Auf dem Poster werden verschiedene Ansätze zur Förderung der VKS in Form von Lernzirkelstationen vorgestellt, wobei neben klassischen experimentellen Stationen mit Arbeitsblatt auch interaktive, teilweise videobasierte Lernzirkelstationen mit direktem Feedback entwickelt wurden. Dabei wurden im Rahmen einer kleinen Stichprobe die unterschiedlichen medialen Formate mit Schülerinnen und Schülern der Mittelstufe erprobt, um die Vor- und Nachteile bewerten zu können

Einsatz interaktiver Lernzirkelstationen zur Förderung der Variablenkontrollstrategie

Die Verwendung der Variablenkontrollstrategie (VKS) ist eine experimentelle Arbeitsweise, um kausale Zusammenhänge in der Wissenschaft systematisch zu untersuchen. Schülerinnen und Schülern der Sekundarstufe I bereitet diese Methodik jedoch in vielerlei Hinsicht Probleme, da sie beim Experimentieren häufig eigene Strategien verwenden und dabei unsystematisch vorgehen. Um dieser Problematik entgegenzuwirken, kann die Anwendung der VKS mit den Lernenden experimentell geübt werden, indem konfundierte und variablenkontrollierte Settings behandelt werden. Ohne einen zusätzlichen externen Impuls werden allerdings bei den Lernenden häufig nicht die Denkprozesse angestoßen, um ein konfundiertes Experiment zu erkennen. Auf dem Poster werden verschiedene Ansätze zur Förderung der VKS in Form von Lernzirkelstationen vorgestellt, wobei neben klassischen experimentellen Stationen mit Arbeitsblatt auch interaktive, teilweise videobasierte Lernzirkelstationen mit direktem Feedback entwickelt wurden. Dabei wurden im Rahmen einer kleinen Stichprobe die unterschiedlichen medialen Formate mit Schülerinnen und Schülern der Mittelstufe erprobt, um die Vor- und Nachteile bewerten zu können

Simulating the effect of tillage practices with the global ecosystem model LPJmL (version 5.0-tillage)

The effects of tillage on soil properties, crop productivity, and global greenhouse gas emissions have been discussed in the last decades. Global ecosystem models have limited capacity to simulate the various effects of tillage. With respect to the decomposition of soil organic matter, they either assume a constant increase due to tillage or they ignore the effects of tillage. Hence, they do not allow for analysing the effects of tillage and cannot evaluate, for example, reduced tillage or no tillage (referred to here as “no-till”) practises as mitigation practices for climate change. In this paper, we describe the implementation of tillage-related practices in the global ecosystem model LPJmL. The extended model is evaluated against reported differences between tillage and no-till management on several soil properties. To this end, simulation results are compared with published meta-analyses on tillage effects. In general, the model is able to reproduce observed tillage effects on global, as well as regional, patterns of carbon and water fluxes. However, modelled N fluxes deviate from the literature values and need further study. The addition of the tillage module to LPJmL5 opens up opportunities to assess the impact of agricultural soil management practices under different scenarios with implications for agricultural productivity, carbon sequestration, greenhouse gas emissions, and other environmental indicators

Termination of atrial flutter by directed transesophageal atrial pacing during transesophageal echocardiography: Terminierung von Vorhofflattern mit gerichteter transösophagealer Vorhofstimulation bei transösophagealer Echokardiographie

Introduction: The purpose of this study was to evaluate termination of atrial flutter (AFL) by directed rapid transesophageal atrial pacing (TAP) with and without simultaneous transesophageal echocardiography (TEE) performed using a novel TEE tube electrode. Materials and methods, and Results: A total of 16 AFL patients (age 63"12 years; 13 males) with mean AFL cycle length of 224"24 ms (ns12) and mean ventricular cycle length of 448"47 ms (ns12) were analyzed using either an esophageal TO electrode (ns10) or a novel TEE tube electrode consisting of a tube with four hemispherical electrodes that is pulled over the echo probe (ns6). AFL could be terminated by directed rapid TAP using an esophageal TO electrode, leading to induction of atrial fibrillation (AF) (ns6), induction of AF and spontaneous conversion to sinus rhythm (SR) (ns3), and with conversion to SR (ns1). AFL could also be terminated by directed rapid TAP using the TEE tube electrode, with induction of AF (ns3) or induction of AF and pontaneous conversion to SR (ns3). Conclusion: AFL can be terminated by directed rapid TAP with hemispherical electrodes with and without simultaneous TEE. TAP with the directed TEE tube electrode is a safe, simple, and useful method for terminating AFL

The wealth of information from transient guest profiles

The application of interference microscopy (IFM) and infrared microscopy (IRM) to monitor the evolution of the concentration of guest molecules in nanoporous host materials opens a new field of diffusion research in condensed matter. It combines the methodical virtues of the profiling methods of solid-state diffusion studies with the benefit of the mobility enhancement in fluids. We are going to illustrate the rich options of diffusion studies provided by this novel experimental approach

Tree mortality submodels drive simulated long-term forest dynamics: assessing 15 models from the stand to global scale

Models are pivotal for assessing future forest dynamics under the impacts of changing climate and management practices, incorporating representations of tree growth, mortality, and regeneration. Quantitative studies on the importance of mortality submodels are scarce. We evaluated 15 dynamic vegetation models (DVMs) regarding their sensitivity to different formulations of tree mortality under different degrees of climate change. The set of models comprised eight DVMs at the stand scale, three at the landscape scale, and four typically applied at the continental to global scale. Some incorporate empirically derived mortality models, and others are based on experimental data, whereas still others are based on theoretical reasoning. Each DVM was run with at least two alternative mortality submodels. Model behavior was evaluated against empirical time series data, and then, the models were subjected to different scenarios of climate change. Most DVMs matched empirical data quite well, irrespective of the mortality submodel that was used. However, mortality submodels that performed in a very similar manner against past data often led to sharply different trajectories of forest dynamics under future climate change. Most DVMs featured high sensitivity to the mortality submodel, with deviations of basal area and stem numbers on the order of 10–40% per century under current climate and 20–170% under climate change. The sensitivity of a given DVM to scenarios of climate change, however, was typically lower by a factor of two to three. We conclude that (1) mortality is one of the most uncertain processes when it comes to assessing forest response to climate change, and (2) more data and a better process understanding of tree mortality are needed to improve the robustness of simulated future forest dynamics. Our study highlights that comparing several alternative mortality formulations in DVMs provides valuable insights into the effects of process uncertainties on simulated future forest dynamics

Developing a research strategy to better understand, observe, and simulate urban atmospheric processes at kilometer to subkilometer scales

A Met Office/Natural Environment Research Council Joint Weather and Climate Research Programme workshop brought together 50 key international scientists from the UK and international community to formulate the key requirements for an Urban Meteorological Research strategy. The workshop was jointly organised by University of Reading and the Met Office