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Competing Interests: Prof. C.F. Dietrich CFD has received lecture fees from Bracco, Siemens, Mindray, Hitachi (Fuji) and Janssen. CFD has received research support from Mindray, GE Healthcare, Fresenius, Youkey and Schallware. Prof. V. Cantisani VC has receidved lecture fees from Samsung, Canon and Bracco Prof. B. Jarman BJ has received honoraria for educational activities from Sonosite Fujifilm UK in the past 3 years; BJ has benefited from ultrasound equipment loans from Canon HealthCare Prof. C. Jenssen CJ has received lecture honoraria from FALK Foundation, Freiburg/ Germany; Support of ultrasound courses CJ has received research support from GE Healthcare, Siemens Healthineers, Mindray and Bracco Prof. J. Conoly JC has received educational honoraria from Sonosite

Emergency Medicine Point-of-Care Ultrasound (EMPoCUS) is a convincing concept. It has spread rapidly because of its intuitive, simple applicability and low equipment costs. The speed of its emerging growth frequently outpaces the development of quality assurance and education. Indeed, education standards vary worldwide, and in some cases seem to neglect the principles of modern competence-based education. Additional challenges are encountered such as remote or low resource medical practice. Here, EMPoCUS might be the only ad-hoc imaging modality available. Once mastery of EMPoCUS is achieved, emergency physicians should be able to independently and efficiently care for their patients using a variety of PoCUS skills. However, most curricula only define these tasks as non-binding and in general terms or use outdated measures, such as length of training and self-reporting of achieved examinations with variable oversight, or administrative measures to create educational milestones. This threatens to take quality assurance down the wrong path. It created a scenario in which concrete EMPoCUS skill outcome measures that would realistically reflect the training objectives and simultaneously would be easily observable and verifiable are lacking. In view of the dangers of poorly controlled EMPoCUS dissemination and the current lack of European guidelines, we would like to set central standards for European EMPoCUS stewardship based on a critical review of the current situation. This position paper, which was jointly developed by EuSEM and EFSUMB and endorsed by IFEM and WFUMB, is also intended to accompany the EFSUMB/EuSEM guidelines on PoCUS currently being prepared for publication., Competing Interests: Prof. C.F. Dietrich CFD has received lecture fees from Bracco, Siemens, Mindray, Hitachi (Fuji) and Janssen. CFD has received research support from Mindray, GE Healthcare, Fresenius, Youkey and Schallware. Prof. V. Cantisani VC has receidved lecture fees from Samsung, Canon and Bracco Prof. B. Jarman BJ has received honoraria for educational activities from Sonosite Fujifilm UK in the past 3 years; BJ has benefited from ultrasound equipment loans from Canon HealthCare Prof. C. Jenssen CJ has received lecture honoraria from FALK Foundation, Freiburg/ Germany; Support of ultrasound courses CJ has received research support from GE Healthcare, Siemens Healthineers, Mindray and Bracco Prof. J. Conoly JC has received educational honoraria from Sonosite, (Thieme. All rights reserved.)

This first position paper of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) on professional standards presents a common position across the different medical professions within EFSUMB regarding optimal standards for the performing and reporting of ultrasound examinations by any professional ultrasound operator. It describes general aspects of professionality that ensure procedure quality, effectiveness, efficiency, and sustainability in virtually all application fields of medical ultrasound. Recommendations are given related to safety and indication of ultrasound examinations, requirements for examination rooms, structured examination, systematic reporting of results, and management, communication and archiving of ultrasound data. The print version of this article is a short version. The long version is published online., Competing Interests: The authors disclose reimbursement of travel expenses by EFSUMB or national scientific societies, resulting from their involvement in EFSUMB ExB or related committee activities. Further disclosures: Matthias Wuestner: Lecture fees in Ultrasound courses and congresses from Ultrasound academy of DEGUM, Campus ACADEMY, SonoABCD – UEC & Partners Medical Education GmbH, Landesärztekammer Niedersachsen, Falk Foundation, Support to perform ultrasound courses from Philips and Mindray. Vito Cantisani: Lecturer fee as speaker for bracco, Samsung, Canon. Klaus Jenderka: shares of GAMPT mbH (Company for Applied Medical Physics and Technique). Julian Kuenzel: fees for participation in expert meetings from BMS and for performing DEGUM certified ultrasound courses by SonoForKlinik. Support to perform ultrasound courses by GE Healthcare, travelling support by Merz. Adrian Lim: Fees for lectures and articles from Canon Medical Systems, Siemens Medical Systems and Bracco. Research Grants and Support – Philips Medical Systems and Canon Medical Systems. Vladimir Mitkov: Lecture fees in Ultrasound courses, webinars and congresses from Canon Medical Systems (Japan), GE Healthcare (USA), Mindray (China), Philips. Adrian Saftoiu: Lecture fees in Ultrasound / EUS courses and congresses from Bracco Suisse and Pentax Medical Singapore. 100% shares held in EchoEndoPlus company, involved in Romania in healthcare. Christian Jenssen: fees for lectures and/or participation in expert meetings from FALK Foundation, Hitachi Medical Ultrasound, GE Healthcare, Bracco and Ultrasound Academy of DEGUM. Support to perform ultrasound courses by Canon, Hitachi, GE Healthcare and Bracco., (Thieme. All rights reserved.)

This first position paper of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) on professional standards presents a common position across the different medical professions within EFSUMB regarding optimal standards for the performing and reporting of ultrasound examinations by any professional ultrasound operator. It describes general aspects of professionality that ensure procedure quality, effectiveness, efficiency, and sustainability in virtually all application fields of medical ultrasound. Recommendations are given related to safety and indication of ultrasound examinations, requirements for examination rooms, structured examination, systematic reporting of results, and management, communication and archiving of ultrasound data. The print version of this article is a short version. The long version is published online., Competing Interests: The authors disclose reimbursement of travel expenses by EFSUMB or national scientific societies, resulting from their involvement in EFSUMB ExB or related committee activities. Further disclosures: Matthias Wuestner: Lecture fees in Ultrasound courses and congresses from Ultrasound academy of DEGUM, Campus ACADEMY, SonoABCD – UEC & Partners Medical Education GmbH, Landesärztekammer Niedersachsen, Falk Foundation, Support to perform ultrasound courses from Philips and Mindray. Vito Cantisani: Lecturer fee as speaker for bracco, Samsung, Canon. Klaus Jenderka: shares of GAMPT mbH (Company for Applied Medical Physics and Technique). Julian Kuenzel: fees for participation in expert meetings from BMS and for performing DEGUM certified ultrasound courses by SonoForKlinik. Support to perform ultrasound courses by GE Healthcare, travelling support by Merz. Adrian Lim: Fees for lectures and articles from Canon Medical Systems, Siemens Medical Systems and Bracco. Research Grants and Support – Philips Medical Systems and Canon Medical Systems. Vladimir Mitkov: Lecture fees in Ultrasound courses, webinars and congresses from Canon Medical Systems (Japan), GE Healthcare (USA), Mindray (China), Philips. Adrian Saftoiu: Lecture fees in Ultrasound/EUS courses and congresses from Bracco Suisse and Pentax Medical Singapore. 100 % shares held in EchoEndoPlus company, involved in Romania in healthcare. Christian Jenssen: fees for lectures and/or participation in expert meetings from FALK Foundation, Hitachi Medical Ultrasound, GE Healthcare, Bracco and Ultrasound Academy of DEGUM. Support to perform ultrasound courses by Canon, Hitachi, GE Healthcare and Bracco., (Thieme. All rights reserved.)

Subsurface chlorophyll maxima layers (SCML) are ubiquitous features of stratified aquatic systems. Availability of the micronutrient iron is known to influence marine SCML, but iron has not been explored in detail as a factor in the development of freshwater SCML. This study investigates the relationship between dissolved iron and the SCML within the dimictic, ferruginous lake Grosses Heiliges Meer in northern Germany. The occurrence of the SCML under nonferruginous conditions in the spring and ferruginous conditions in the fall are context to explore temporal changes in the phytoplankton community and indicators of primary productivity. Results indicate that despite more abundant chlorophyll in the spring, the SCML sits below a likely primary productivity maximum within the epilimnion, inferred based on colocated dissolved oxygen, δ 13 C DIC , and pH maxima. The peak amount of chlorophyll in the SCML is lower in the fall than in the spring, but in the fall the SCML is colocated with elevated dissolved iron concentrations and a local δ 13 C DIC maximum. Cyanobacteria and Chlorophyta have elevated abundances within the SCML in the fall. Further investigation of the relationship of iron to primary productivity within ferruginous SCML may help to understand the environmental controls on primary productivity in past ferruginous oceans., (© 2022 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.)

Interventional sonography describes the step from pure sonographic imaging diagnostics to sonographically controlled treatment that can be connected directly to sonographic imaging diagnostics instead of postponing it over a longer time interval with possibly further (X-ray, computed tomography, magnetic resonance imaging) diagnostics. The sonographically controlled interventional measures range from a simple puncture of fluid-filled spaces to infiltration of deeper lying areas, such as the labrum acetabulare, the dorsal knee joint capsule and facet joints up to infiltration of the sciatic nerve. The safety is guaranteed by adhering to clearly defined hygiene standards as well as by qualified training as part of the 3‑stage model of certification of the surgery section of the German Society of Ultrasound in Medicine (DEGUM). By using modern sonography devices, structures in the submillimeter range are visible even at close range, so that nowadays even splitting of the annular ligament of the finger has become possible under ultrasound control., (© 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)