Hands-on Distance Simulation of Technical Skills: A Systematic Review.

Distance simulation in health care has advanced rapidly, offering potential to reduce geographical barriers, costs, and carbon emissions while increasing global access to medical education. This systematic review evaluated hands-on technical skills training via distance simulation compared to traditional on-site training. Following PRISMA guidelines, 104 studies were analyzed.

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Fentanyl is an opioid used for acute pain relief, but its slow elimination may lead to prolonged respiratory depression and sedation. As fatty tissue serves as fentanyl storage and prolongs its elimination, fentanyl should be dosed based on estimated ideal body weight. High-risk patients include those who are overweight, have lung disease and are exposed to other sedative drugs.

Training esophagogastroduodenoscopy skills: a randomized multicenter trial comparing simulation-based training versus clinical training.

The quality of esophagogastroduodenoscopy (EGD) performed by trainees depends on their competency level and training. This study assessed whether the addition of simulation-based training (SBT) reduces the number of supervised clinical procedures needed to achieve independent procedural completion compared with conventional clinically based training (CBT) alone.EGD novices were randomized (1 : 1) to either SBT followed by CBT or CBT alone in a randomized controlled trial.

Assessment of Basic Orthopedic Surgical Skills in a Low-Cost Simulation-Based Setting: A Validation Study.

Introduction: Basic orthopedic surgery skills (BOSS) have been identified as critical in resident surgeons' training. Costs and limited evidence hinder integrating simulation training into resident surgeons' curricula. This study aimed to gather validity evidence for a low-cost simulation-based test to assess BOSS.

Prevalence and characteristics of tramadol-induced seizures in young adult emergency admissions.

Introduction: Tramadol is an opioid analgesic used to treat moderately severe pain. Overuse and recreational use of tramadol may cause seizures, but the extent of this problem remains unclear. This study evaluates admissions with tramadol-induced seizures (TIS) among young adults admitted to the emergency department (ED).

Should Anaesthesiologists Be Taught to Perform Ultrasound-Assisted Neuraxial Access in Spinal Anaesthesia?-Protocol of a Randomised Controlled Study.

Background: Neuraxial blockade, typically guided by manual palpation, can be challenging in certain patient populations. Ultrasound-assisted neuraxial access has the potential to improve success rates, particularly for novice anaesthesiologists, though structured training programs in this technique are limited.

Methods: This multicentre, randomised controlled trial will evaluate the use of ultrasound-assisted neuraxial block, following a simulation-based training programme based on the mastery-learning approach.

Continuous structure modification of metal-organic framework glasses via halide salts.

Melting and glass formation of metal-organic frameworks (MOFs) allow them to be processed into bulk materials. However, two major challenges remain: only a small fraction of MOF crystals undergo melting and glass-formation, and no well-established strategies exist for tuning MOF glass structures and properties. Here, we address both challenges through co-melting of zeolitic imidazole frameworks (ZIFs), a subset of MOFs, with heterocycle-based halide salts.

Assessment of Basic Skills in Ultrasound-Based Neuraxial Access-A Protocol of a Study Gathering Validity Evidence.

Background: Neuraxial access procedures, such as spinal blocks, are routine but can be challenging in for example, obese, pregnant, and elderly patients. Ultrasound-based techniques offer a promising alternative, yet standardized assessment tools for evaluating competence are lacking. This study aims to develop and gather validity evidence for a simulation-based assessment tool in ultrasound-assisted and ultrasound-guided neuraxial access, and establish a credible pass/fail score.

Prognostic value of tumor-infiltrating lymphocytes in irradiated node-positive breast cancer patients.

Introduction: Radiotherapy significantly reduces locoregional recurrence (LRR) and improves survival. Yet, reliable biomarkers predicting radiotherapy response are not well-defined. Tumor-infiltrating lymphocytes (TILs) have emerged as a promising prognostic and predictive marker, but their role in irradiated patients remains underexplored.

Training and assessment of skills in neuraxial space access: a scoping review of educational approaches to lumbar puncture, epidural anaesthesia, and spinal anaesthesia.

Background: Neuraxial space access, including lumbar puncture, spinal anaesthesia, and epidural anaesthesia, is important in clinical practise for diagnostics and anaesthesia. Despite frequent use, standardised educational recommendations for training and assessing proficiency in these procedures are not well-integrated. The following research question was formulated: what is known from published literature to guide future educational recommendations for training and skills assessment of neuraxial space access with and without the use of ultrasound?

Methods: On May 7, 2024, searches were performed in the Cochrane Library, MEDLINE (Ovid), Scopus, PubMed, CINAHL (EBSCO), and EMBASE (Ovid).

Eliminating viscosity challenges in continuous cultivation of yeast producing a GLP-1 like peptide.

Background: The emergence of GLP-1s for the treatment of diabetes, obesity and other diseases has led to increased focus on finding efficient ways to produce the peptides in sufficient amounts to satisfy the ever-increasing demand. Although the use of microbial hosts constitutes the cheapest, easiest and safest way to produce these peptides in high volumes, process challenges still exist that reduce the production capacity. One of the main production challenges is the high viscosity of cultivation broths, which reduces the mass and oxygen transfer, thereby creating substrate and oxygen gradients that potentially lead to unwanted secondary metabolism and eventually compromises capacity.

Intraosseous vs. intravenous access during out-of-hospital cardiac arrest: a Bayesian secondary analysis of a randomised clinical trial.

Aim Of The Study: This study aimed to apply a Bayesian probabilistic framework to the Intravenous vs. Intraosseous Vascular Access for Out-of-Hospital Cardiac Arrest (IVIO) trial data to evaluate the likelihood of benefit for each vascular access method while incorporating various prior beliefs.

Methods: The IVIO trial was a randomised trial comparing intraosseous to intravenous access in 1,479 adults with non-traumatic out-of-hospital cardiac arrest.

Local recurrence with and without a tumour-bed boost: A post-hoc analysis of the DBCG IMN2 study.

Background And Purpose: In early-stage breast cancer, a tumour-bed boost (TBB) reduces the risk of local recurrence (LR) by around 50 % but increases the risk of breast induration. LR incidences of 3 % at 5 years and 6 % at 10 years have been proposed as thresholds where benefits outweigh the potentially detrimental effects of a TBB. Therefore, this post-hoc analysis of the Danish Breast Cancer Group (DBCG) IMN2 study aimed to investigate LR rates according to prognostic risk factors to identify indications for a TBB.

Bridging Dynamic Nuclear Polarization and Solid-State NMR Dipolar Recoupling: From Static Single Crystal to Spinning Powders.

Spin engineering of advanced pulse sequences has had a transformative impact on the development of nuclear magnetic resonance (NMR) spectroscopy, to an extending degree also electron paramagnetic resonance (EPR), and the hybrid between the two, dynamic nuclear polarization (DNP). Based on a simple formalism, we demonstrate that (i) single-crystal static-sample optimizations may tremendously ease design and understanding of experiments for rotating powders and (ii) pulse sequences may readily be exchanged between these distinct spectroscopies. Specifically, we design broadband heteronuclear solid-state NMR magic-angle-spinning (MAS) dipolar recoupling experiments based on the recently developed PLATO (PoLarizAtion Transfer via nonlinear Optimization) microwave (MW) pulse sequence optimized on a single crystal for powder static-sample DNP.

Coupling SWAT+ and GOTM-WET models to assess agricultural management practices for mitigating harmful algal blooms in Mar Menor, Spain.

We analysed the effectiveness of agricultural best management practices (BMPs) for mitigating harmful algal blooms (HABs) in the Mar Menor lagoon, Spain, by coupling SWAT + catchment and GOTM-WET lake models. We compared the effectiveness of different BMP scenarios, including "vegetative filter strips", "contour farming", "fertilizer reduction", "crop rotation", and their combination for reducing high chlorophyll a (Chl-a) events over the period 2003-2022. All BMPs significantly reduced nutrient inputs entering the lagoon, which limited the formation of HABs.

Low back pain and work-related factors among home health care workers with self-governing or conventional team structure - a natural experiment with a cross-sectional design.

Objectives: Compare home health care (HHC) with self-governing and conventional team structure regarding self-reported low back pain (LBP) and work-related factors.

Methods: A natural experiment was assessed using a cross-sectional design. Primary outcome was LBP intensity; secondary outcomes included LBP duration and work limitations as well as intensity, duration and work limitations of neck/shoulder pain, stress, productivity, influence at work, meaning at work, sickness absence, interpersonal collaboration, and variation in physical behaviour.

Training and assessment of skills in flexible optical intubation - Protocol of a scoping review.

Background: Flexible optical intubation (FOI) is the preferred technique for managing anticipated difficult airways, particularly in awake patients when anatomical factors complicate conventional laryngoscopy. Mastering the procedure requires skills, but a comprehensive overview of the evidence on training and assessment of FOI skills is lacking. There is no evidence-based consensus on educational strategies and recommendations for skill acquisition and retention, thus highlighting a significant gap in airway management training.

SentemQC - A novel and cost-efficient method for quality assurance and quality control of high-resolution frequency sensor data in fresh waters.

The growing use of sensors in fresh waters for water quality measurements generates an increasingly large amount of data that requires quality assurance (QA)/quality control (QC) before the results can be exploited. Such a process is often resource-intensive and may not be consistent across users and sensors. SentemQC (QC of high temporal resolution sensor data) is a cost-efficient, and open-source Python approach developed to ensure the quality of sensor data by performing data QC on large volumes of high-frequency (HF) sensor data.

Optimal control design strategies for pulsed dynamic nuclear polarization.

We present optimal control methods for the optimization of periodic pulsed dynamic nuclear polarization (DNP) sequences. Specifically, we address the challenge of the optimization of a basic and repeated pulse sequence element which, apart from being easily adaptable to spin systems with different coupling interaction sizes, also proves beneficial in terms of performance. It is demonstrated that matrix power and matrix logarithm functions combined with an auxiliary matrix formalism can be used to derive expressions for gradient ascent pulse engineering (GRAPE) optimization.

Internal mammary node irradiation in 4541 node-positive breast cancer patients treated with newer systemic therapies and 3D-based radiotherapy (DBCG IMN2): a prospective, nationwide, population-based cohort study.

Background: Internal mammary node irradiation (IMNI) improves overall survival (OS) in node-positive breast cancer patients. However, the effect is not documented in breast cancer patients treated with newer systemic therapies and 3D-based radiotherapy (RT). Therefore, the Danish Breast Cancer Group (DBCG) IMN2 study aimed to investigate the effect of IMNI in node-positive breast cancer patients treated with newer systemic therapies and 3D-based RT.

Inter-Session Reliability of Functional Performance and Muscle Power in Adults With Severe Obesity.

Reliable and sensitive testing of physical function is crucial for assessing the effects of treatment or exercise intervention in various patient populations. The present study investigated the test-retest reliability and sensitivity (smallest detectable difference: SDD) of selected physical performance tests commonly used in clinical rehabilitation, including tests of habitual and maximal walking speed, walking endurance capacity, handgrip strength (HGS), and lower limb muscle power (Sit-to-Stand (STS), stair climb) in adults with severe obesity meeting the criteria for bariatric surgery. Thirty-two adults (BMI 43.

Ergonomic challenges in healthcare: mapping physical load during patient transfers using electromyographic field measurements.

Purpose: Work-related musculoskeletal disorders are prevalent among healthcare workers. These workers experience high rates of low-back pain; partly due to the high physical demands of patient transfers. Understanding the specific transfer scenarios that contribute to high physical loads is therefore crucial for developing strategies to improve working conditions.

Quality assurance of internal mammary node irradiation in the DBCG IMN2 study.

Purpose/objective: The Danish Breast Cancer Group (DBCG) IMN2 study investigated the gain from internal mammary node irradiation (IMNI) in node-positive breast cancer patients. IMNI was indicated in right-sided patients, but not in left-sided. Target volume delineations were based on bony landmarks in contrast to the contemporary vessel-based ESTRO consensus guideline.

Abdominal POCUS Education for Clinicians: A Systematic Review of Teaching Methods for Point-of-Care Abdominal Ultrasonography.

This systematic review examines educational strategies in clinician-performed abdominal point-of-care ultrasound (POCUS), a critical skill with increasing relevance in medical care. Analyzing 28 studies, we highlight the strategies as well as advantages and disadvantages of various theoretical and practical components, including, for example, e-learning and simulation in training programs. The findings emphasize the necessity of blending various educational methods to enhance effectiveness and adaptability in training environments.