A Qualitative Study of Biomedical Engineering Student Critical Reflection During Clinical Immersion Experiences.

Purpose: Clinical immersion experiences provide engineering students with opportunities to identify unmet user needs and to interact with clinical professionals. These experiences have become common features of undergraduate biomedical engineering curricula, with many published examples in the literature. There are, however, few or no published studies that describe rigorous qualitative analysis of biomedical engineering student reflections from immersion programs. Methods: Fifteen reflection prompts that align with program learning goals were developed and structured based on the DEAL model for critical reflection. Undergraduate participants in a summer immersion program responded to these prompts throughout five weeks of clinical rotations. Data from two summer cohorts of participants (n = 20) were collected, and thematic analysis was performed to characterize student responses. Results: Students reported learning about key healthcare topics, such as medical insurance, access to healthcare (and lack thereof), stakeholder perspectives, and key medical terminology and knowledge. Most reflections also noted that students could apply newly gained medical knowledge to biomedical engineering design. Further, clinical immersion provided students with a realistic view of the biomedical engineering profession and potential areas for future professional growth, with many reflections identifying the ability to communicate with a variety of professionals as key to student training. Some students reflected on conversations with patients, noting that these interactions reinvigorated their passion for the biomedical engineering field. Finally, 63% of student reflections identified instances in which patients of low socioeconomic status were disadvantaged in health care settings. Conclusions: Clinical immersion programs can help close the gap between academic learning and the practical experience demands of the field, as design skills and product development experience are becoming increasingly necessary for biomedical engineers. Our work initiates efforts toward more rigorous analysis of students' reactions and experiences, particularly around socioeconomic and demographic factors, which may provide guidance for continuous improvement and development of clinical experiences for biomedical engineers.

Porous covalent organic framework nanofibrous membrane for excellent enrichment and ultra-high sensitivity detection of trace organochlorine pesticides in water.

Developing adsorbents with high performance and long service life for effective extracting the trace organochlorine pesticides (OCPs) from real water is attracting numerous attentions. Herein, a self-standing covalent organic framework (COF-TpPa) membrane with fiber morphology was successfully synthesized by using electrospun nanofiber membranes as template and employed as solid-phase microextraction (SPME) coating for ultra-high sensitivity extraction and analysis of trace OCPs in water. The as-synthesized COF-TpPa membrane exhibited a high specific surface area (800.83 m2 g-1), stable nanofibrous structure, and excellent chemical and thermal stability. Based on the COF-TpPa membrane, a new SPME analytical method in conjunction with gas chromatography-mass spectrometry (GC-MS) was established. This proposed method possessed favorable linearity in concentration of 0.05-2000 ng L-1, high sensitivity with enrichment factors ranging from 2175 to 5846, low limits of detection (0.001-0.150 ng L-1), satisfactory precision (RSD < 10 %), and excellent repeatability (>150 cycles), which was better than most of the reported works. Additionally, the density functional theory (DFT) calculations and XPS results demonstrated that the outstanding enrichment performance of the COF-TpPa membrane was owing to synergistic effect of π-π stacking effects, high specific surface area and hydrogen bonding. This work will expect to extend the applications of COF membrane to captures trace organic pollutants in complex environmental water, as well as offer a multiscale interpretation for the design of effective adsorbents.

High-Fidelity, Indigenously Prepared, Low-Cost Moulage as a Valid Simulation Tool to Improve Trauma Education.

Background Simulation-based trauma education facilitates repeated practice in a controlled and safer environment for the learner without any risk to the patient's well-being. Moulage contributes to the perception of reality during training using standardized patients. However, the high cost of commercial moulage items is often prohibitive for regular use. This study aimed to assess the effectiveness of indigenously prepared, low-cost moulage as a valid simulation tool to improve trauma education, explore possible replacements of commercial moulage products, and determine their merits and demerits. Methodology Readily available economic items were used to make low-cost moulage on the simulated patients to replicate trauma victims. A cross-sectional design used a pre-validated Modified Moulage Authenticity Rating Scale to collect data from 61 participants of Advanced Trauma Life Support and Advanced Trauma Care for Nurses courses to analyze the effectiveness and fidelity of moulage. Results In total, 54 (89%) participants scored the low-cost moulage to provide high fidelity effectively. The majority of respondents graded the authenticity of moulage as good. Overall, 46 (75%) participants felt moulage injuries were quite realistic. All agreed that the moulage-based simulation offered a good teaching-learning alternative to assess and manage trauma victims. Further, 45 (73%) participants felt they were in an actual clinical situation, and 58 (95%) stated it could help them in their clinical practice. Conclusions Indigenously prepared, low-cost moulage is a feasible and cost-effective means to enhance fidelity in simulation-based trauma education. It can also be a possible replacement for commercial moulage. Further research is needed to rigorously evaluate the effectiveness of indigenously prepared, cost-effective moulage in trauma education to enhance patient care outcomes. This technique can also be easily translated into other simulation-based medical education domains.

Sociodigital experiences and creativity in the metaverse: An integrative review.

Access to sociodigital experiences is constantly expanding, driven by the development of immersive technologies that capture the public's interest. These technological advances present a hypnotic nature, sparking curiosity, creating new experiences, and providing opportunities for expanding access and inclusion. This article aims to highlight the characteristics and requirements necessary for the development of creativity in new virtual environments, with a focus on the metaverse, a three-dimensional and interactive virtual space that offers users the sensation of existence within this environment. The study centers on the following question: what are the essential characteristics for an immersive environment to promote the development of creativity in its users? Understanding how technologies influence creativity is crucial to driving innovation, the progress of contemporary sciences, and education. This research analyzed various approaches and strategies for the use of the metaverse and immersive virtual environments to promote user creativity. Through an integrative literature review, practical characteristics that contribute to creativity in previous studies were identified. The results highlight the presence of common characteristics, organized into a model of articulation of the sociodigital analysis categories for creativity with potential for application.

The interprofessional practice experiences of final-semester prelicensure BSN students completing clinical immersion: A descriptive qualitative study.

BACKGROUND: The goal of interprofessional practice experiences in health professions programs is to develop interprofessional collaborative practice skills. PURPOSE: The purpose of the study was to explore the meaning final-semester Bachelor of Science in Nursing students attributed to interprofessional practice experiences during clinical immersion. METHODS: The theoretical framework for this descriptive qualitative study was experiential learning theory. A sample of 12 participants was drawn from final-semester prelicensure Bachelor of Science in Nursing students at a college of nursing at a public research university. Data were collected through one-on-one semi-structured interviews and analyzed through inductive thematic analysis. RESULTS: The analysis yielded four themes: professional and interprofessional identity, working with team members, communication practices, and trusting relationships. Patterns across themes were clinical environment culture, nursing school preparation, nurse preceptor role, fear/concern/worry, and night shift. CONCLUSION: Consistency in preceptors, welcoming clinical environments, and opportunities to practice communicating with team members contributed to interprofessional collaborative practice skill development and improved perceptions of readiness for practice. Academic and clinical educators may use findings to (a) identify immersion placements for interprofessional practice experiences, (b) design curricula reflective of interprofessional practice, (c) advance teaching strategies to promote interprofessional practice, and (d) create learning environments that aid in professional and interprofessional identity formation.

Predicting neural activity of whole body cast shadow through object cast shadow in dynamic environments.

Shadows, as all other objects that surround us, are incorporated into the body and extend the body mediating perceptual information. The current study investigates the hypothesis according to which the perception of object shadows would predict the perception of body shadows. 38 participants (19 males and 19 females) aged 23 years on average were immersed into a virtual reality environment and instructed to perceive and indicate the coincidence or non coincidence between the movement of a ball shadow with regard to ball movement on the one hand, and between their body shadow and their body position in space on the other. Their brain activity was recording via a 32-channel EEG system, in which beta (13.5-30 Hz) oscillations were analyzed. A series of Multiple Regression Analysis (MRA) revealed that the beta dynamic oscillations patterns of the bilateral occipito-parieto-frontal pathway associated with the perception of ball shadow appeared to be a significant predictor of the increase in beta oscillations across frontal areas related to the body shadow perception and the decrease in beta oscillations across frontal areas connected to the decision making of the body shadow. Taken together, the findings suggest that inferential thinking ability relative to body shadow would be reliably predicted from object shadows and that the bilateral beta oscillatory modulations would be indicative of the formation of predictive neural frontal assemblies, which encode and infer body shadow neural representation, that is, a substitution of the physical body.

Discrimination of untreated and sodium sulphite treated bean sprouts by Fourier transform infrared spectroscopy and chemometrics.

Sprouts of black beans (Phaseolus vulgaris L.), soybeans (Glycine max L.) and mung beans (Vigna radiata L.) are widely consumed foods containing abundant nutrients with biological activities. They are commonly treated with sulphites for the preservation and extension of shelf-life. However, our previous investigation found that immersing the bean sprouts in sulphite might convert the active components into sulphur-containing derivatives, which can affect both the quality and safety of the sprouts. This study explores the use of FTIR in conjunction with chemometric techniques to differentiate between non-immersed (NI) and sodium sulphite immersed (SI) black bean, soybean and mung bean sprouts. A total of 168 batches of raw spectra were obtained from NI and SI-bean sprouts using FTIR spectroscopy. Four pre-processing techniques, three modelling assessment techniques and four model evaluation indices were examined for differences in performance. The results show that the multiplicative scatter correction is the most effective pre-processing method. Among the models, the accuracy rate of the three models was as follows: radial basis function neural network (95%) > convolutional neural network (91%) > random forest (82%). The overall findings indicate that FTIR spectroscopy, in conjunction with appropriate chemometric approaches, has a high potential for rapidly determining the difference between NI and SI-bean sprouts.

Exertional Heatstroke Survivors' Knowledge and Beliefs about Exertional Heatstroke Diagnosis, Treatment, and Return to Play.

CONTEXT: Little information exists regarding what exertional heatstroke (EHS) survivors know and believe about EHS best practices. Understanding this would help clinicians focus educational efforts to ensure survival and safe return-to-play following EHS. OBJECTIVE: We sought to better understand what EHS survivors knew about EHS seriousness (e.g., lethality, short- and long-term effects), diagnosis and treatment procedures, and recovery. Design: Multi-year, cross-sectional, descriptive design. SETTING: An 11.3-km road race located in the Northeastern United States in August 2022 and 2023. PATIENTS OR OTHER PARTICIPANTS: Forty-two of 62 runners with EHS (15 women, 27 men; age: 33±15 y; pre-treatment rectal temperature [TREC]: 41.5±0.9°C). INTERVENTIONS: Medical professionals evaluated runners requiring medical attention at the finish line. If they observed TREC ≥40°C with concomitant central nervous system dysfunction (CNS) EHS was diagnosed and patients were immersed in a 189.3-L tub filled with ice-water. Before medical discharge, we asked EHS survivors 15 questions about their experience and knowledge of select EHS best practices. Survey items were piloted and validated by experts and laypersons a priori (content validity index ≥0.88 for items and scale). MAIN OUTCOME MEASURES: Survey responses. RESULTS: Sixty-seven percent (28/42) of patients identified EHS as potentially fatal and 76% (32/42) indicated it negatively affected health. Seventy-nine percent (33/42) correctly identified TREC as the best temperature site to diagnose EHS. Most patients (74%, 31/42) anticipated returning to normal exercise within 1 week post-EHS; 69% (29/42) stated EHS would not impact future race participation. Patients (69%, 29/42) indicated it was important to tell their primary care physician about their EHS. CONCLUSIONS: Our patients were knowledgeable on the potential seriousness and adverse health effects of EHS and the necessity of TREC for diagnosis. However, educational efforts should be directed towards helping patients understand safe recovery and return-to-play timelines following EHS.

Effect of a single immersion in cold water below 4 °C on haemorheological properties of blood in healthy men.

Cold water immersion (CWI) involves rapid cooling of the body, which, in healthy individuals, triggers a defence response to an extreme stimulus, to which the body reacts with stress. The aim of the study was to determine the effect of CWI on hemorheological blood indicators. The study group consisted of 13 young males. Blood samples were collected before and after CWI. The assessed parameters included the complete blood count, fibrinogen, hs-C-reactive protein (CRP), proteinogram, and blood rheology factors, such as erythrocyte elongation index (EI), half-time of total aggregation, and aggregation index. Additionally, the effect of reduced temperature on primary human vascular endothelium was investigated in vitro. CWI resulted in the decrease of body temperature to 31.55 ± 2.87 °C. After CWI, neutrophil count and mean corpuscular volume (MCV) were significantly increased in the study group, while lymphocyte count was significantly decreased. Significantly higher levels of total blood protein and albumin concentration were detected after the immersion. Among hemorheological characteristics, erythrocyte EIs at shear stress values ranging from 2.19 to 60.30 Pa were significantly lower after CWI. No significant changes in other rheological, morphological or biochemical parameters were observed. In vitro, human umbilical vein endothelial cells responded to 3 h of temperature decrease to 25 °C with unchanged viability, but increased recruitment of THP-1 monocytic cells and changes in cell morphology were observed. This was the first study to evaluate the effect of single CWI on rheological properties of blood in healthy young men. The results indicate that a single CWI may increase blood protein concentrations and worsen erythrocyte deformability parameters.

Evaluation of power wheelchair driving performance in simulator compared to driving in real-life situations: the SIMADAPT (simulator ADAPT) project-a pilot study.

OBJECTIVE: The objective of this study was to evaluate users' driving performances with a Power Wheelchair (PWC) driving simulator in comparison to the same driving task in real conditions with a standard power wheelchair. METHODS: Three driving circuits of progressive difficulty levels (C1, C2, C3) that were elaborated to assess the driving performances with PWC in indoor situations, were used in this study. These circuits have been modeled in a 3D Virtual Environment to replicate the three driving task scenarios in Virtual Reality (VR). Users were asked to complete the three circuits with respect to two testing conditions during three successive sessions, i.e. in VR and on a real circuit (R). During each session, users completed the two conditions. Driving performances were evaluated using the number of collisions and time to complete the circuit. In addition, driving ability by Wheelchair Skill Test (WST) and mental load were assessed in both conditions. Cybersickness, user satisfaction and sense of presence were measured in VR. The conditions R and VR were randomized. RESULTS: Thirty-one participants with neurological disorders and expert wheelchair drivers were included in the study. The driving performances between VR and R conditions were statistically different for the C3 circuit but were not statistically different for the two easiest circuits C1 and C2. The results of the WST was not statistically different in C1, C2 and C3. The mental load was higher in VR than in R condition. The general sense of presence was reported as acceptable (mean value of 4.6 out of 6) for all the participants, and the cybersickness was reported as acceptable (SSQ mean value of 4.25 on the three circuits in VR condition). CONCLUSION: Driving performances were statistically different in the most complicated circuit C3 with an increased number of collisions in VR, but were not statistically different for the two easiest circuits C1 and C2 in R and VR conditions. In addition, there were no significant adverse effects such as cybersickness. The results show the value of the simulator for driving training applications. Still, the mental load was higher in VR than in R condition, thus mitigating the potential for use with people with cognitive disorders. Further studies should be conducted to assess the quality of skill transfer for novice drivers from the simulator to the real world. Trial registration Ethical approval n ∘ 2019-A001306-51 from Comité de Protection des Personnes Sud Mediterranée IV. Trial registered the 19/11/2019 on ClinicalTrials.gov in ID: NCT04171973.

Post-exercise management of exertional hyperthermia in dogs participating in dog sport (canicross) events in the UK.

Exercise is a common trigger of heat-related illness (HRI) events in dogs, accounting for 74% of canine HRI cases treated under primary veterinary care in the United Kingdom. However, few empirical studies have evaluated the effectiveness of differing cooling methods for dogs with exertional hyperthermia or HRI. This study aimed to prospectively evaluate effects of ambient conditions and post-exercise management practices (cooling methods and vehicular confinement) on the post-exercise temperature change of dogs participating in UK canicross events. Canine temperature was recorded at three intervals post-exercise: as close as possible to 0- (immediately post-exercise), 5-, and 15-min post-exercise. Ambient conditions and post-exercise management were recorded for 115 cooling profiles from 52 dogs. In 28/115 (24.4%) profiles, the dog's temperature increased during the first 5-min post-exercise. Overall, 68/115 (59.1%) profiles included passive cooling (stood or walked outside), 35 (30.4%) active cooling (cold-water immersion or application of a cooling coat), and 12 (10.4%) involved no cooling and were immediately housed in vehicles. No dogs developed hypothermia during the study and no adverse effects were observed from any cooling method. In hyperthermic dogs, overall post-exercise body temperature change was significantly negatively associated (i.e. the dogs cooled more) with 0-min post-exercise body temperature (ß = -0.93, p < 0.001), and not being housed in a vehicle (ß = -0.43, p = 0.013). This study provides evidence cold-water immersion (in water at 0.1-15.0 °C) can be used to effectively and safely cool dogs with exertional hyperthermia. Progressive temperature increases in many dogs - even after exercise has terminated - supports the message to "cool first, transport second" when managing dogs with HRI. When transporting dogs post-exercise or with HRI even after active cooling, care should be taken to cool the vehicle before entry and promote air movement around the dog during transport to facilitate ongoing cooling and prevent worsening of hyperthermia during travel.

Transient Interfacial Pattern Formation in Block Copolymer Thin Films via Sequential Thermal and Solvent Immersion Annealing.

A variety of structures encountered in nature only arise in materials under highly nonequilibrium conditions, suggesting to us that the scope for creating new functional block copolymer (BCP) structures might be significantly enlarged by embracing complex processing histories that allow for the fabrication of structures quite unlike those created under "near-equilibrium" conditions. The present work examines the creation of polymer film structures in which highly nonequilibrium processing conditions allow for the creation of entirely new types of transient BCP morphologies achieved by transitioning between different ordered states. Most previous studies of BCP materials have emphasized ordering them from their disordered state obtained from a solution film casting process, followed by a slow thermal annealing (TA) process at elevated temperatures normally well above room temperature. We have previously shown that achieving the equilibrium TA state can be accelerated by a direct solvent immersion annealing (DIA) preordering step that creates nascent ordered microstructures, followed by TA. In the present work, we examine the reverse nonequilibrium sequential processing in which we first thermally anneal the BCP film to different levels of partial (lamellar) order and then subject it to DIA to swell the lamellae. This sequential processing rapidly leads to a swelling-induced wrinkle pattern that initially grows with immersion time and can be quenched by solvent evaporation into its corresponding glassy state morphology. The article demonstrates the formation of wrinkling "defect" patterns in entangled BCP films by this sequential annealing that does not form under ordinary TA conditions. At long DIA times, these highly "defective" film structures evolve in favor of the equilibrium morphology of parallel lamellae observed with DIA alone. In conjunction with our previous study of sequential DIA + TA, the present TA + DIA study demonstrates that switching the order of these processing methods for block copolymer films gives the same final state morphology in the limit of long time as any one method alone, but with drastically different intermediate transient state morphologies. These transient morphologies could have many applications.

The value of audiovisual sexual stimulation with virtual reality in diagnosing erectile dysfunction.

Background: The traditional audiovisual sexual stimulation (AVSS) test may experience limitations including low erectile response rate and lack of unified diagnostic criteria. Aim: We aimed to explore the clinical value of AVSS with virtual reality (VR-AVSS) test in assessing erectile function and diagnosing erectile dysfunction (ED). Methods: Participants 18 to 60 years of age were screened for analysis in 3 clinical centers from June 2020 to March 2022. Demographic data, 5-item International Index of Erectile Function (IIEF-5), erectile hardness score (EHS), and self-reported symptom questions were collected. The ED patients and control patients were confirmed according to the IIEF-5 and EHS. All subjects watched a 60-minute erotic video by VR device during RigiScan recording. The parameters including tip average rigidity, tip effective erectile duration (duration of rigidity ≥60%, tip effective erectile duration), base average rigidity, and base effective erectile duration were evaluated. Outcomes: The main outcome of interest was the application of VR immersion technology to improve the traditional AVSS test. Results: A total of 301 ED cases and 100 eligible control patients were included for final analysis. Compared with control patients, ED cases had significantly lower IIEF-5 scores, EHS, positive response rate, and erectile rigidity and duration. The positive response rate of ED and control patients were 75.5% and 90.9%, respectively. The cutoff points of tip average rigidity, tip effective erectile duration, base average rigidity, and base effective erectile duration were 40.5% (sensitivity: 77.6%, specificity: 70.2%; P < .001), 4.75 minutes (sensitivity: 75.9%, specificity: 75.4%; P < .001), 48.5% (sensitivity: 77.6%, specificity: 75.1%; P < .001), and 7.75 minutes (sensitivity: 79.3%, specificity: 75.7%; P < .001). Clinical Implications: The technological superiority of VR will enable the VR-AVSS immersion test to be a more accurate detection than traditional AVSS modes. Strengths and Limitations: Our study applied VR immersion technology to establish the standard operation procedure for the AVSS test, which could effectively reduce the interference of adverse factors and minimize the detecting errors. However, the test data only included positive response subjects, so the true erectile status of men with a negative response to the AVSS test cannot be obtained. Conclusions: The VR-AVSS test can effectively improve the diagnostic accuracy of ED. The average rigidity and effective erectile duration were the optimal diagnostic parameters for excluding ED.

Poly (Vinylidene Fluoride-Hexafluoropropylene)-Lithium Titanium Aluminum Phosphate-Based Gel Polymer Electrolytes Synthesized by Immersion Precipitation for High-Performance Lithium Metal Batteries.

Gel polymer electrolytes (GPEs) have high safety and excellent electrochemical performance, so applying GPEs in lithium batteries has received much attention. However, their poor lithium ion transfer number, cycling stability, and low room temperature ionic conductivity seriously affect the utilization of gel polymer electrolytes. This paper successfully synthesized flexible poly (vinylidene fluoride-hexafluoropropylene)-lithium titanium aluminum phosphate (PVDF-HFP-LATP) gel polymer electrolytes using the immersion precipitation method. The resulting GPE has a porous honeycomb structure, which ensures that the GPE has sufficient space to store the liquid electrolyte. The GPE has a high ionic conductivity of 1.03 ×10-3 S cm-1 at room temperature (25 °C). The GPE was applied to LiFePO4/GPE/Li batteries with good rate performance at room temperature. The discharge specific capacity of 1C was as high as 121.5 mAh/g, and the capacity retention rate was 94.0% after 300 cycles. These results indicate that PVDF-HFP-LATP-based GPEs have the advantage of simplifying the production process and can improve the utility of gel polymer lithium metal batteries.

Blood pressure, pulse rate, and skin temperature during hot-water bathing in real-world settings among community-dwelling older adults: the HEIJO-KYO Study.

BACKGROUND: Home hot-tub bathing substantially increases drowning mortality rates among older adults in Japan. Previous laboratory studies on hemodynamic responses during hot-tub bathing have been inconsistent depending on the thermal conditions. Furthermore, real-world hemodynamic changes that occur during bathing remain poorly understood. This study investigated the association between individual thermal states and hemodynamic parameters during hot-tub bathing among community-dwelling older adults. METHODS: In this cross-sectional study conducted between January 2016 and April 2019, which involved 1,479 older adults (median [range] age, 68 [40-90] years), skin temperature on the abdominal surface was measured every minute. Ambulatory blood pressure and pulse rate were recorded at 15-min intervals for 24 h. Participants underwent simultaneous living room temperature measurements in their homes, and the time and methods of bathing were recorded. Associations between skin temperature and hemodynamic parameters during bathing and between the pre-bath living room temperature and in-bath maximum proximal skin temperature were evaluated using mixed-effects and linear regression models, respectively. RESULTS: A 1 °C increase in skin temperature was significantly associated with a 2.41 mmHg (95% confidence interval [CI]: 2.03-2.79) increase in systolic blood pressure and a 2.99 bpm (95% CI: 2.66-3.32) increase in pulse rate, after adjusting for potential confounders, including age, sex, body mass index, antihypertensive medication use, dyslipidemia, diabetes, and living room and outdoor temperatures. Significant interactions were not observed between sex and skin temperature in relation to systolic blood pressure and pulse rate (P = 0.088 and 0.490, respectively). One standard deviation lower living room temperature before bathing was significantly associated with a 0.41 °C (95% CI: 0.35-0.47) higher maximum skin temperature during bathing. CONCLUSIONS: Our findings suggest that pre-bath cold exposure may increase the skin temperature during hot-tub bathing, possibly resulting in excessive hemodynamic changes. This provides a framework for future interventions that utilize pre-bath thermal conditions and bathing environments to prevent bath-related deaths.

Positive Aspects and Potential Drawbacks of Implementing Digital Teaching/Learning Scenarios in Health Professions Using Nursing Education as an Example: A Research Report from Germany.

BACKGROUND: Learning arrangements in health care profession education are increasingly taking place in digital environments. Virtual reality (VR) in nursing education, as a digital element, is the subject of controversial debate. On one hand, it supports the authenticity of case studies by adding realistic perspectives and information. On the other hand, the costs of developing and maintaining software and hardware hinder its long-term implementation. Based in the German context, our aim is to promote the adoption of innovative digital methods in nursing education and to offer invaluable experiences from the field. METHODS: In this paper, we describe our findings and insights from two different research projects focused on the incorporation of digital tools, particularly VR, into nursing education. RESULTS: Starting with a brief recapitulation of the projects, we elucidate pedagogical strategies for embedding VR-driven scenarios in nursing education. Based on our experiences during the projects, we identify various positive aspects, such as changing perspective and simulating acute situations. KEY FINDINGS: Although potential drawbacks remain, we advocate the long-term implementation and specific use of VR at the interface between theory and practice. Nevertheless, it is crucial to establish regular evaluation, observing the value of digitalisation, especially VR, for nursing education.

New gel immersion endoscopic ultrasonography technique for accurate periampullary evaluation.

BACKGROUND: Visualization of the pancreatobiliary junction is one of the challenges faced by endoscopic ultrasonography (EUS). The water-filling technique, which allows for the observation of the ampulla at a suitable distance by injecting water into the lumen of the duodenum, was used for this purpose. However, a new gel immersion technique has recently been introduced for visualizing the gastrointestinal tract. This study investigated the effectiveness of visualizing the pancreatobiliary junction in EUS by comparing both water filling and the new gel immersion technique in identical cases. METHODS: The study ran from June to December 2021. Ten images from each technique were retrospectively compared by three independent researchers. The primary result of the study was the number of images depicting the "Pancreatic and Biliary Ducts Penetrating the Duodenal Muscularis Propria" (defined as Excellent observation) in each technique. The secondary outcome was defined as gel immersion technique's safety and impact on duodenal lumen distension. RESULTS: Ten patients used the gel immersion technique. All patients underwent the water-filling technique first, followed by gel injection after the water was completely aspirated. The average number of pictures rated as "Excellent observation," which is the primary outcome, was significantly higher with the gel immersion technique than with water filling, and no adverse events were observed. The subanalysis revealed that both convex and radial echoendoscopes are equally effective at depicting the ampulla with the gel immersion technique. CONCLUSIONS: The ability to depict the pancreatobiliary junction using the gel immersion technique is superior to that of the water-filling method, which may allow for a more detailed assessment of the ampullary region with both radial and convex echoendoscopes. This can be a useful EUS technique for diagnosing pancreaticobiliary maljunction or periampullary tumors.

Experimental Study of a Representative Sample to Determine the Chemical Composition of Cast Iron.

In metallurgical practice, the material is considered of adequate quality if it meets the customer's expectations. It is necessary to take representative samples and perform quality testing to avoid financial and intangible losses. Sample contamination and matrix and surface quality play a significant role in the accuracy of chemical analyses. The purpose of this paper is to point out the advantages of specific methods of taking samples, such as immersion and spoon sampling of molten metal, and, in the experimental part, to assess the impacts of factors affecting the quality of the sampling. The influence of time of final sampling on determining the true amount of magnesium during a single melt and the influence of duration of mixing of molten cast iron on the accuracy of chemical analysis of the control sample were investigated. It is important that the time between the modification and casting of the liquid cast iron from the casting ladle be as short as possible. This is because the magnesium burns out and thus the chemical analysis of the sample taken is not accurate. Another important factor is ensuring the melt before sampling is homogenized and has the minimum prescribed temperature (1420 °C). Increasing sample collection time will cause changes in its chemical composition.

Mannose modified targeted immersion vaccine delivery system improves protective immunity against Infectious spleen and kidney necrosis virus in mandarin fish (Siniperca chuatsi).

Vaccination is an effective method to prevent viral diseases. However, the biological barrier prevents the immersion vaccine from achieving the best effect without adding adjuvants and carriers. Researches on the targeted presentation technology of vaccines with nanocarriers are helpful to develop immersion vaccines for fish that can break through biological barriers and play an effective role in fish defense. In our study, functionally modified single-walled carbon nanotubes (SWCNTs) were used as carriers to construct a targeted immersion vaccine (SWCNTs-M-MCP) with mannose modified major capsid protein (MCP) to target antigen-presenting cells (APCs), against iridovirus diseases. After bath immunization, our results showed that SWCNTs-M-MCP induced the presentation process and uptake of APCs, triggering a powerful immune response. Moreover, the highest relative percent survival (RPS) was 81.3% in SWCNTs-M-MCP group, which was only 41.5% in SWCNTs-MCP group. Altogether, this study indicates that the SWCNTs-based targeted immersion vaccine induces strong immune response and provided an effective protection against iridovirus diseases.

Post-reinforcement pauses during slot machine gambling are moderated by immersion.

The post-reinforcement pause (PRP) is an operant effect in which response latencies increase on trials following the receipt and consumption of reward. Human studies demonstrate analogous effects in electronic gambling machines that utilise random ratio reinforcement schedules. We sought to identify moderators of the human PRP effect, hypothesising that the magnitude of gamblers' PRPs is moderated by the type of reinforcing outcome (genuine wins vs. losses-disguised-as-wins [LDWs] vs. free-spin bonus features) and individuals' level of gambling immersion, a cognitive state linked to problem gambling. Experienced slot machine users (N = 53) played a real slot machine for 20 min. The dependent variable was defined as the time delay in the initiation of each bet ("Spin Initiation Latency"; SIL). Using 80% of trials, a linear model was fit regressing SIL on the independent variables (outcome type, immersion, and outcome-by-immersion interaction), and a larger group of covariates (participant ID, trial number, winnings, etc.) selected using double-robust LASSO-regularised regression. The previously unseen 20% of cases were used to validate the model. Positively reinforcing outcome types (wins, LDWs, bonus spins) showed significantly larger SILs than losses, indicating a PRP effect. Immersion did not predict response latencies, but win-by-immersion and LDW-by-immersion interactions indicated that pauses were greater among more immersed participants. The small number of free-spin bonus features showed similar trends that were not statistically significant. These results indicate that gamblers immersed in play remained sensitive to in-game reinforcement (contrary to a prevailing account), and provide guidance for researchers bridging laboratory research and real-world behaviour.