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Objective: To analyze risk factors for developing a cerebrospinal fluid (CSF) fistula after vestibular schwannoma (VS) surgery through the retrosigmoid transmeatal approach and to assess the potential role of the endoscope assisted sealing of the drilled inner auditory canal (IAC) in reducing the incidence[for full text, please go to the a.m. URL], 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Objective: The high didactic potential of Virtual Reality (VR) contrasts with the point of view of students that the technology only has a relatively low significance for current and future teaching. This discrepancy was studied in a differentiated manner in order to gear the further development and implementation of VR towards the target group. Methods: From January 2020 to July 2020, medical students (N=318) were asked to watch ten videos online and rate them on the basis of acceptance indicators (e.g., fun and fairness). Using obstetrics as an example, the videos demonstrated five levels of VR technology functionality (e.g., haptic and adaptive feedback), some of which were visionary, in two use scenarios (teaching and the OSCE). The individual and aggregate indicators were compared with non-parametric testing procedures across application scenarios, functional levels and genders. In addition, correlations between the acceptance and the factors of semester, age, computer affinity, and previous VR experience were analyzed. Results: Across all functional levels, VR was more likely to be accepted in the classroom than in the OSCE. Comparisons across functional levels also revealed that the VR ready to be marketed was significantly more accepted than the visionary functions. This skepticism toward advancing VR technology was most pronounced with regard to the vision of autonomous VR examinations and among female students with a low computer affinity. Conclusion: The results suggest that the students’ reservations are due to a lack of experience with the VR technology. In order for young physicians to become familiar with the technology and to be able to use it competently in the everyday clinical practice in the future, VR should not only be used as a teaching tool but also be part of the curriculum. Practical examinations using VR, on the other hand, are only recommended once the technology has become established in teaching and has been proven to be reliable., Zielsetzung: Das hohe didaktische Potenzial von VR steht im Kontrast zur studentischen Einschätzung, dass die Technologie nur eine relativ geringe Bedeutung für die gegenwärtige und zukünftige Lehre hat. Diese Diskrepanz wurde differenziert untersucht, um die Weiterentwicklung und Implementierung von VR zielgruppenorientiert auszurichten. Methodik: Von Januar bis Juli 2020 wurden Medizinstudierende (N=318) gebeten, zehn Videos online anzusehen und anhand von Akzeptanzindikatoren (z.B. Spaß und Fairness) zu bewerten. Am Beispiel der Geburtshilfe demonstrierten die Videos fünf teils visionäre Funktionsgrade der VR-Technologie (z.B. haptisches und adaptives Feedback) in zwei Einsatzszenarien (Lehre und OSCE-Prüfung). Die einzelnen und aggregierten Indikatoren wurden mit nicht-parametrischen Testverfahren zwischen den Einsatzszenarien, Funktionsgraden und Geschlechtern verglichen. Darüber hinaus wurden Zusammenhänge zwischen der Akzeptanz und den Faktoren Fachsemester, Alter, Computeraffinität und VR-Vorerfahrung analysiert. Ergebnisse: Über alle Funktionsgrade hinweg wurde VR in der Lehre eher akzeptiert als in der OSCE-Prüfung. Die Vergleiche zwischen den Funktionsgraden offenbarten außerdem, dass der marktreife Status Quo von VR signifikant besser angenommen wurde als die visionären Funktionen. Diese Skepsis gegenüber der fortschreitenden VR-Technologie war bei der Vision autonomer VR-Prüfungen und unter weiblichen Studierenden mit geringer Computeraffinität am stärksten ausgeprägt. Schlussfolgerung: Die Ergebnisse legen nahe, dass die Vorbehalte der Studierenden auf mangelnde Erfahrungswerte mit der VR-Technologie zurückzuführen sind. Damit die angehenden Ärzte die Technologie kennenlernen und zukünftig kompetent im Klinikalltag anwenden können, sollte VR nicht nur als Lehrmedium sondern auch als Lerngegenstand curricular eingeführt werden. Praktische Prüfungen in VR empfehlen sich dagegen erst, wenn sich die Technologie in der Lehre etabliert und als verlässlich erwiesen hat.

Cardiac arrest is the aprupt loss of cardiac function and circulation, follwed by the loss of consciousness and breathing. Most patients succumb before admission to hospital and survivors frequently suffer from anoxic-ischemic brain injury. The number of patients who survive with good neurological outcome, is low. In this thesis, we investigated the association of abnormal arterial partial pressures of carbon dioxide and oxygen in the phase following the return of spontaneous circulation (ROSC) with neurological outcome at hospital discharge or at follow-up 6 months after out-of hospital cardiac arrest (OHCA). We also investigated the association of abnormal arterial partial pressures of carbon dioxide and oxygen in the phase following ROSC with a brain specific serum biomarker of neurological injury, as a sensitive surrogate marker for anoxic-ischemic brain injury. In a final analysis, we investigated the biomarkers of neurological injury, i.e., glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1) measured at 24, 48 and 72 hours after out-of-hospital cardiac arrest and their predictive accuracy for neurological outcome at 6-month follow-up. Exposure to abnormal arterial partial pressures of carbon dioxide and oxygen was common in resuscitated patients after OHCA, but we did not find an independent association with poor neurological outcome. Abnormal arterial partial pressures of carbon dioxide and oxygen were also not associated with peak levels of the serum biomarker tau at 48 and 72 hours, after OHCA.Serum GFAP, UCH-L1 and their combination (GFAP+UCH-L1) predicted neurological outcome after OHCA with high accuracy over all measuring points. Overall predictive accuracy of GFAP+UCH-L1 was superior compared to neuron specific enolase (NSE), the serum biomarker presently used in clinical practice

Additional file 1: Table S1. Baseline characteristics of all patients and the PaO2 analysis groups. Table S2. Baseline characteristics of all patients and the PaCO2 analysis groups. Table S3. Sensitivity analysis. Association of exposure to extreme PaO2 and PaCO2 values with poor neurological outcome (Patients with extreme PaO2 or PaCO2 value double exposure removed). Table S4. Association of exposure to extreme PaO2 and PaCO2 values with poor neurological long term outcome. n = 1850. Table S5. Association of exposure to extreme PaO2 and PaCO2 values with poor neurological long term outcome. Imputed values. (n = 2135). Table S6. Baseline characteristics of patients with complete PaO2 and PaCO2 values and patients with PaO2 or PaCO2 missing.

Objective: To analyze the size of sporadic vestibular schwannoma (VS) based on volumetric measurements in correlation to growth rate, occurrence of a cystic component and its respective volume. Methods: We retrospectively assessed the tumor volumetry of patients with a sporadic vestibular schwannoma[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie