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• The effective performance of resuscitation is one of the most important emergency skills in the health care environment • Confidence and stress are important variables that impact on resuscitation proficiency • Virtual reality (VR) simulation is emerging as a new method for resuscitation training • Multiple VR modalities exist, with outcomes in confidence, and stress differing depending on the VR intervention • Ongoing changes and improvements in VR technologies highlight the need for further research in this area In the context of performing resuscitation, research has demonstrated that provider confidence and stress levels are related to patient survival outcomes. Virtual reality (VR) offers innovative simulation training opportunities to improve confidence and reduce stress. Whittemore and Knafl's (2005) integrative review method was used. An electronic database literature search and evaluation of studies using the BEME critical appraisal tool yielded five papers for this review. Four studies examined confidence and one stress. Identified themes included: Variation in virtual reality intervention; Timing of measurement outcome; and variation in VR interactivity. Confidence was noted to generally increase through the use of VR across the studies reviewed, with no significant impact on stress outcomes. Differences in study heterogeneity reflects that further research is required to determine if the use of VR technologies impacts on confidence and stress in resuscitation training. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the hemodynamics of blood flow through the V3 region of the vertebral artery contralateral to the side manipulated during different rotary head positions and post–cervical spinal manipulation. This quasi-experimental study was performed on 25 healthy, asymptomatic participants, both male and female, between 20 and 30 years of age. Each participant presented with a C0/C1 or C1/C2 cervical facet restriction (as determined by motion palpation). Participation was voluntary, and participants had no symptoms of vertebrobasilar artery insufficiency or contraindications to cervical spinal manipulation. Doppler ultrasound was used to measure vertebral artery blood flow (V3 region) hemodynamics, contralateral side of manipulation, as close to C1/C2 region as possible in 4 positions of cervical rotation (neutral, 45°, maximum, and post-manipulation neutral). Doppler ultrasound parameters included peak systolic flow velocity, end diastolic flow velocity, mean flow velocity, vessel diameter, and flow rate. The nonparametric Friedman test was used for analysis across each head and neck position, and post manipulation. No clinical or statistically significant results (P >.05) were found for any of the hemodynamic parameters in any of the head positions. Hemodynamic measurements of the V3 region of the vertebral artery do not show significant changes in the measured head positions or following manipulation of the upper cervical spine in patients without pre-existing risk factors. [ABSTRACT FROM AUTHOR]

The phycosome – the algal microbiome – can impact microalgal cultivation productivity and stability through metabolic interaction networks. Polycultures can be designed based upon complementary traits and metabolic potential to maximize yields. Stable and resilient consortia are a sustainable approach to contamination challenges compared to the traditional use of pesticides and extensive sterilizing methods. High-pH/high-alkalinity microalgal cultivation can better control inputs and outputs via direct air CO 2 capture. Less is known about the ecology of extreme and productive systems, with implications for long-term, repeated cultivations. Lessons learned from natural and industrial systems with varying pH, alkalinity, temperature, and salinity can inform input and output control of algal growth systems. Algal–bacterial interactions are ubiquitous in both natural and industrial systems, and the characterization of these interactions has been reinvigorated by potential applications in biosystem productivity. Different growth conditions can be used for operational functions, such as the use of low-quality water or high pH/alkalinity, and the altered operating conditions likely constrain microbial community structure and function in unique ways. However, research is necessary to better understand whether consortia can be designed to improve the productivity, processing, and sustainability of industrial-scale cultivations through different controls that can constrain microbial interactions for maximal light-driven outputs. The review highlights current knowledge and gaps for relevant operating conditions, as well as suggestions for near-term and longer-term improvements for large-scale cultivation and polyculture engineering. [ABSTRACT FROM AUTHOR]