Developing and testing transferability and feasibility of a model for educators using simulation-based learning — A European collaboration

BackgroundThere is a pragmatic and often inconsistent approach of embedding simulation-based learning into nursing programmes. This paper details a European collaboration that designed a model for educator facilitation for educators utilizing simulation-based education.ObjectivesThe objectives of the study were to develop a model to educate the educators who deliver simulation-based learning and to test to which extent this model could be transferred to education providers in different national settings.MethodsThis model, its transferability and feasibility, was tested across three European countries. Educators from three Schools of Nursing participated in the study. Design-based Research was used as an overall methodology. Data were collected by the use of pre- and post-programme questionnaires and focus groups.ResultsThe content of the NESTLED model is consistent with the needs of the participants. The testing also demonstrated that the model is transferable across-countries. Additionally, the participants' preferences regarding amount of time and pre-reading for the different sessions vary depending on the background and level of seniority of the individual participant.ConclusionThe testing of the NESTLED model demonstrated that participants gained confidence and knowledge from undertaking the programme. Delivering the NESTLED model across-countries was found to be feasible, but flexibility is required in terms of logistical delivery of the programme.     

Magnetic resonance imaging of resting OEF and CMRO₂ using a generalized calibration model for hypercapnia and hyperoxia

We present a method allowing determination of resting cerebral oxygen metabolism (CMRO?) from MRI and end-tidal O? measurements acquired during a pair of respiratory manipulations producing different combinations of hypercapnia and hyperoxia. The approach is based on a recently introduced generalization of calibrated MRI signal models that is valid for arbitrary combinations of blood flow and oxygenation change. Application of this model to MRI and respiratory data during a predominantly hyperoxic gas manipulation yields a specific functional relationship between the resting BOLD signal M and the resting oxygen extraction fraction OEF?. Repeating the procedure using a second, primarily hypercapnic, manipulation provides a different functional form of M vs. OEF?. These two equations can be readily solved for the two unknowns M and OEF?. The procedure also yields the resting arterial O? content, which when multiplied by resting cerebral blood flow provides the total oxygen delivery in absolute physical units. The resultant map of oxygen delivery can be multiplied by the map of OEF? to obtain a map of the resting cerebral metabolic rate of oxygen consumption (CMRO?) in absolute physical units. Application of this procedure in a group of seven human subjects provided average values of 0.35 ± 0.04 and 6.0 ± 0.7% for OEF? and M, respectively in gray-matter (M valid for 30 ms echo-time at 3T). Multiplying OEF? estimates by the individual values of resting gray-matter CBF (mean 52 ± 5 ml/100 g/min) and the measured arterial O? content gave a group average resting CMRO? value of 145 ± 30 μmol/100 g/min. The method also allowed the generation of maps depicting resting OEF, BOLD signal, and CMRO?.     

Master Amino acid pattern® as sole and total substitute for dietary proteins during a weight-loss diet to achieve the body’s nitrogen balance equilibrium

Results of this multicentric study have shown that by giving Master Amino acid Pattern (MAP) as a sole and total substitute of dietary proteins to 500 overweight participants undergoing the American Nutrition Clinics/Overweight Management Program (ANC/OMP), the participants' body nitrogen balance could be maintained in equilibrium with essentially no calories (MAP 1 g=0.04 kcal), thereby preserving the body's structural and functional proteins, eliminating excessive water retention from the interstitial compartment, and preventing the sudden weight increase after study conclusion commonly known as the yo-yo effect. Study results have shown that the use of MAP, in conjunction with the ANC/OMP regimen, has proven to be safe and effective by preventing those adverse effects associated with a negative nitrogen balance, such as oversized or flabby tissue, stretch marks, the sagging of breast tissue, increased hair loss, faded hair color, and fragile or brittle nails. Also prevented were those anomalies commonly associated with weight-loss diets, such as hunger, weakness, headache caused by ketosis, constipation, and decreased libido. The use of MAP in conjunction with the ANC/OMP also allowed for mean weight loss of 2.5 kg (5.5 lb) per week, achieved through reduction of excessive fat tissue and elimination of excessive water retention from the interstitial compartment.     

Design, implementation and evaluation of an independent real-time safety layer for medical robotic systems using a force–torque–acceleration (FTA) sensor

Purpose Most medical robotic systems require direct interaction or contact with the robot. Force–Torque (FT) sensors can easily be mounted to the robot to control the contact pressure. However, evaluation is often done in software, which leads to latencies. Methods To overcome that, we developed an independent safety system, named FTA sensor, which is based on an FT sensor and an accelerometer. An embedded system (ES) runs a real-time monitoring system for continuously checking of the readings. In case of a collision or error, it instantaneously stops the robot via the robot’s external emergency stop. Results We found that the ES implementing the FTA sensor has a maximum latency of $1\pm 0.03$  ms to trigger the robot’s emergency stop. For the standard settings in the application of robotized transcranial magnetic stimulation, the robot will stop after at most 4 mm. Conclusion Therefore, it works as an independent safety layer preventing patient and/or operator from serious harm.