Face-to-face meetings on a conference table are a frequent form of communication. The short-range exposure risk of aerosol disease transmission is high in the scenario of susceptible facing the infectious person over the table. We propose a mitigation methodology using the air curtain to reduce direct exposure to virus-laden aerosols. A numerical model was validated with experimental data to simulate the dispersion of aerosols. A dynamic mesh was adopted to consider the head movement of a 3D thermal manikin model. Results show that nodding head increase the potential risk by 74 % compared to motionless. Subsequently, for a single air curtain, placing it in the middle of the table is more effective in preventing risks than on the sides. For double air curtains, increasing the distance between them has a greater risk reduction effect than a shorter distance. Increasing the air velocity or width is more effective than increasing the number of air curtains. A moderate velocity (1 m s-1) works well to reduce the risk of nasal breathing. A higher velocity (2 m s-1) is needed for the coughing scenario. For similar indoor environments, the air curtains on the table can offer active precautions without changing the current ventilation system.

UNASSIGNED: Medical students in the U.S. must demonstrate urgent and emergent care competence before graduation. Urgent and emergent care competence involves recognizing, evaluating and initiating management of an unstable patient. High-fidelity (HF) simulation can improve urgent and emergent care skills, but because it is resource intense, alternative methods are needed.
UNASSIGNED: Our primary purpose was to use program evaluations to compare medical student experiences with HF and virtual reality (VR) simulations as assessment platforms for urgent and emergent care skills.
UNASSIGNED: During their emergency medicine clerkship, students at The Ohio State University College of Medicine must demonstrate on HF manikins, competence in recognizing and initiating care of a patient requiring urgent or emergent care. Students evaluated these simulations on a five-point quality scale and answered open-ended questions about simulation strengths and weaknesses. Faculty provided feedback on student competence in delivering urgent or emergent care. In 2022, we introduced VR as an alternative assessment platform. We used Wilcoxon Signed Ranks and Boxplots to compare ratings of HF to VR and McNemar Test to compare competence ratings. Comments were analyzed with summative content analysis or thematic coding.
UNASSIGNED: We received at least one evaluation survey from 160 of 216 (74.1%) emergency medicine clerkship students. We were able to match 125 of 216 (57.9%) evaluation surveys for students who completed both. Average ratings of HF simulations were 4.6 of 5, while ratings of VR simulations were slightly lower at 4.4. Comments suggested that feedback from both simulation platforms was valued. Students described VR as novel, immersive, and good preparation for clinical practice. Constructive criticism identified the need for additional practice in the VR environment. Student performance between platforms was significantly different with 91.7% of students achieving competence in HF, but only 65.5% in VR (p≤.001, odds-ratio = 5.75).
UNASSIGNED: VR simulation functions similarly to HF for formative assessment of urgent and emergent care competence. However, using VR simulation for summative assessment of urgent and emergent care competence must be considered with caution because students require considerable practice and acclimation to the virtual environment.
Medical students found value in using virtual reality simulation as a platform for practice and feedback in a formative assessment arrangement.Students described the virtual reality simulation as immersive and good preparation for clinical practice.Technical difficulties were common and the student learning curve for acclimating and learning how to function in the virtual environment was noteworthy.

Purpose: Drownings are a societal phenomenon occurring worldwide, hence the importance of rescue skills, including directly towing a victim to a safe place. The purpose of this study was to evaluate the most effective towing techniques based on kinematic parameters, considering different types of drowning cases, for their recommendation for widespread use in water rescue. Methods: The research involved 18 water lifeguards aged 18-25 years. The evaluation included speed tests in towing a mannequin over a distance of 50 m using the Extended Arm Tow (EAT), Double Armpit Tow (DAT), \"Sailor\" Technique Tow (STT) and with a rescue tube (RT), accompanied by video recording to measure in the designated measurement area the number of cyclic paddling movements by the lower limbs, angles of the body attack, towing velocity, and its decrease during towing. Results: Number of cyclic paddling movements by the lower limbs, towing with a RT was considered the most beneficial, and least beneficial was the DAT. In the DAT, the lifeguard swam with the smallest body angle, in contrast to the STT, where this angle was the largest. The effect of the number of cyclic paddling movements and the body angle by the lifeguard was the velocity, with the highest value recorded in towing using a RT; in other techniques, velocity were similar. Conclusions: Institutions associated with water rescue should recommend towing using a RT for direct rescue actions in the water, as its use shortens the time, while simultaneously increasing safety for both the rescuer and the victim.

For maximum effectiveness of a simulation-based educational experience, the correct modality must be chosen. Modality refers to the equipment or platform used to conduct the simulation. There are a variety of options available to clinical simulation educators, ranging from simple task trainers to full-body manikins to virtual experiences. The correctly chosen modality will allow the learners to achieve the learning objectives.

OBJECTIVE: To characterise applied force on the face and head during simulated mask ventilation with varying mask, device and expertise level.
METHODS: Randomised cross-over simulation study.
METHODS: A quiet, empty room in the children\'s hospital.
METHODS: Neonatal healthcare providers, categorised as novices and experts in positive pressure ventilation (PPV).
METHODS: PPV for 2 min each in a 2×2 within-subjects design with two masks (round and anatomic) and two ventilation devices (T-piece and self-inflating bag (SIB)).
METHODS: Applied force (Newton (N)) measured under the head and at four locations on the manikin\'s face (nasal bridge, mentum, left and right zygomatic arches) and symmetry of force applied around the mask rim.
RESULTS: For the 51 participants, force applied to the head was greater with the SIB than the T-piece (mean (SD): 16.03 (6.96) N vs 14.31 (5.16) N) and greater with the anatomic mask than the round mask (mean (SD): 16.07 (6.80) N vs 14.26 (5.35) N). Underhead force decreased over the duration of PPV for all conditions. Force measured on the face was greatest at the left zygomatic arch (median (IQR): 0.97 (0.70-1.43) N) and least at the mentum (median (IQR): 0.44 (0.28-0.61) N). Overall, experts applied more equal force around the mask rim compared with novices (median (IQR): 0.46 (0.26-0.79) N vs 0.65 (0.24-1.18) N, p<0.001).
CONCLUSIONS: We characterised an initial dataset of applied forces on the face and head during simulated PPV and described differences in force when considering mask type, device type and expertise.

BACKGROUND: As the global community begins recovering from the COVID-19 pandemic, the challenges due to its aftermath remain. This health crisis has highlighted challenges associated with airborne pathogens and their capacity for rapid transmission. While many solutions have emerged to tackle this challenge, very few devices exist that are inexpensive, easy to manufacture, and versatile enough for various settings.
METHODS: This paper presents a novel suction device designed to counteract the spread of aerosols and droplets and be cost-effective and adaptable to diverse environments. We also conducted an experimental study to evaluate the device\'s effectiveness using an artificial cough generator, a particle counter, and a mannequin in an isolated system. We measured droplet removal rates with simulated single and repeated cough incidents. Also, measurements were taken at four distinct areas to compare its effectiveness on direct plume versus indirect particle removal.
RESULTS: The device reduced airborne disease transmission risk, as evidenced by its capacity to decrease the half-life of aerosol volume from 23.6 minutes to 15.6 minutes, effectively capturing aerosol-sized droplets known for their extended airborne persistence. The suction device lessened the peak total droplet volume from peak counts. At 22 minutes post peak droplet count, the count had dropped 24% without the suction device and 43% with the suction device.
CONCLUSIONS: The experiment\'s findings confirm the suction device\'s capability to effectively remove droplets from the environment, making it a vital tool in enhancing indoor air quality. Given the sustained performance of the suction device irrespective of single or multiple cough events, this demonstrates its potential utility in reducing the risk of airborne disease transmission. 3D printing for fabrication opens the possibility of a rapid iterative design process, flexibility for different configurations, and rapid global deployment for future pandemics.

Mastery learning with fixed end points and variable training time leads to more consistent expertise but is difficult to implement. Here we piloted mastery learning of laryngoscopy with independent practice. 35 learners participated in independent mastery learning on a manikin that provides automated performance feedback. A pre- and postpractice assessment of intubation skills was completed. After an average of 21 minutes of open practice, the percentage of subjects that met mastery criteria improved from 24% to 89% (P < .05). Independent intubation practice with manikin feedback facilitated mastery learning, enhanced procedural education, and may impact clinical care.

BACKGROUND: Simulation-based training (SBT) is vital to complex medical procedures such as ultrasound guided central venous catheterization (US-IJCVC), where the experience level of the physician impacts the likelihood of incurring complications. The Dynamic Haptic Robotic Trainer (DHRT) was developed to train residents in CVC as an improvement over manikin trainers, however, the DHRT and manikin trainer both only provide training on one specific portion of CVC, needle insertion. As such, CVC SBT would benefit from more comprehensive training. An extended version of the DHRT was created, the DHRT + , to provide hands-on training and automated feedback on additional steps of CVC. The DHRT + includes a full CVC medical kit, a false vein channel, and a personalized, reactive interface. When used together, the DHRT and DHRT + systems provide comprehensive training on needle insertion and catheter placement for CVC. This study evaluates the impact of the DHRT + on resident self-efficacy and CVC skill gains as compared to training on the DHRT alone.
METHODS: Forty-seven medical residents completed training on the DHRT and 59 residents received comprehensive training on the DHRT and the DHRT + . Each resident filled out a central line self-efficacy (CLSE) survey before and after undergoing training on the simulators. After simulation training, each resident did one full CVC on a manikin while being observed by an expert rater and graded on a US-IJCVC checklist.
RESULTS: For two items on the US-IJCVC checklist, \"verbalizing consent\" and \"aspirating blood through the catheter\", the DHRT + group performed significantly better than the DHRT only group. Both training groups showed significant improvements in self-efficacy from before to after training. However, type of training received was a significant predictor for CLSE items \"using the proper equipment in the proper order\", and \"securing the catheter with suture and applying dressing\" with the comprehensive training group that received additional training on the DHRT + showing higher post training self-efficacy.
CONCLUSIONS: The integration of comprehensive training into SBT has the potential to improve US-IJCVC education for both learning gains and self-efficacy.

Fit and accommodation are critical design goals for a body armor system to maximize Soldiers\' protection, comfort, mobility, and performance. The aim of this study is to assess fit and accommodation of body armor plates for the US Army. A virtual fit assessment technique, developed, validated, and deployed by NASA for spacesuit design, was adopted for this work. Specifically, 3D manikins of the Soldier population were overlaid virtually with geometrically similar surrogates of the armor plates. Trained subject matter experts with the US Army and NASA manually assessed the fit of the armor plates to manikins using a computer visualization tool and selected the appropriate plate size and position. A prediction model was built from the assessment data to predict the plate size from an arbitrary body shape and the resultant patterns of body-to-plate contact were quantified. The outcome indicated a unique trend of the plate sizes covarying with anthropometry. More pronouncedly, when the overlap between the body tissue and armor plate was quantified, female Soldiers are likely to experience a 25 times larger body-to-plate contact volume and 6.5 times larger contact depth than males on average, due to sex-based anthropometric differences. Overall, the prediction model and contact patterns provided key metrics for virtual body armor fit assessments, of which the locations, patterns, and magnitudes can help to improve sizing and fit of body armor systems, as previously demonstrated for NASA spacesuit design.

Simulation-based training (SBT) has emerged as a transformative approach in medical education, significantly enhancing healthcare professionals\' learning experience and clinical competency. This article explores the impact of SBT, tracing its historical development and examining the various types of simulations utilized today, including high-fidelity mannequins, virtual reality environments, standardized patients, and hybrid simulations. These methods offer a safe and controlled environment for students to practice and hone technical and non-technical skills, ultimately improving patient safety and clinical outcomes. The benefits of SBT are manifold, including enhanced skill acquisition, error reduction, and the opportunity for repeated practice without risk to actual patients. Immediate feedback and structured debriefing further solidify learning, making Simulation an invaluable tool in medical education. However, the implementation of SBT is challenging. It requires substantial financial investment, specialized equipment, and trained faculty. Additionally, there are concerns about the realism of simulations and the transferability of skills to real-world clinical settings. Despite these challenges, numerous case studies and empirical research underscore the effectiveness of SBT compared to traditional methods. Looking ahead, advancements in technology, such as artificial intelligence and improved virtual reality applications, promise to enhance the efficacy and accessibility of simulation training. The integration of Simulation with other training modalities and its adoption in diverse global contexts highlight its potential to revolutionize medical education worldwide. This article affirms the crucial role of SBT in preparing the next generation of healthcare professionals and its ongoing evolution driven by technological innovations.