Clinical characteristics and diagnostic accuracy of preliminary diagnoses in adults with infections in Danish emergency departments: a multicentre combined cross-sectional and diagnostic study.

Objective: Rapid and accurate infection diagnosis is a prerequisite for appropriate antibiotic prescriptions in an ED. Accurately diagnosing acute infections can be difficult due to nonspecific symptoms and limitations of diagnostic testing. The accuracy of preliminary diagnoses, established on the initial clinical assessment, depends on a physician's skills and knowledge.

Automatic Final-Product Assessment of Virtual Reality Mastoidectomy Performance: A Validity and Reliability Study.

Objective: Assessment is key in modern surgical education to monitor progress and document sufficient skills. Virtual reality (VR) temporal bone simulators allow automated tracking of basic metrics such as time, volume removed, and collisions. However, adequate performance assessment further includes compound rating of the stepwise bony excavation, and exposure and preservation of soft tissue structures.

3D-printed temporal bone models for training: Does material transparency matter?

Purpose: To investigate the impact of 3D-printed temporal bone models with two different material transparencies on trainees' mastoidectomy performance.

Methods: Eleven ORL residents performed two anatomical mastoidectomies with posterior tympanotomy on two 3D-printed models with different transparency and VR simulation training. Participants where divided into two groups based on their experience.

Automated screening of control potential with spatially explicit results to support dialogue about sewer overflow reduction and beyond.

For real-time control to become a standard measure for upgrading urban drainage systems, control potential screenings need to be easily integrated into the early planning processes that already take place. However, current screening methods are either not aligned with the present planning process, unrelatable for water managers or too time-consuming. We therefore developed an automated screening methodology through a co-design process with six Danish utilities.

Temporal variations in micropollutant inlet concentrations matter when planning the design and compliance assessment of stormwater control measures.

Stormwater Control Measures (SCMs) contribute to reducing micropollutant emissions from separate sewer systems. SCM planning and design are often performed by looking at the hydrological performance. Assessment of pollutant removal and the ability to comply with discharge concentration limits is often simplified due to a lack of data and limited monitoring resources.

3-D-Printed Models for Temporal Bone Training: A Validity Study.

Objective: 3-D printing offers convenient and low-cost mastoidectomy training; nonetheless, training benefits using 3-D-printed temporal bones remain largely unexplored. In this study, we have collected validity evidence for a low-cost, 3-D-printed temporal bone for mastoidectomy training and established a credible pass/fail score for performance on the model.

Study Design: A prospective educational study gathering validity evidence using Messick's validity framework.

Flexor hallucis longus tendon morphology in dancers clinically diagnosed with tendinopathy.

Purpose: The unique demands of dance technique make dancers more prone to certain pathologies especially of the foot and ankle. Flexor hallucis longus (FHL) tendinopathy, colloquially known as "dancer's tendinopathy," is common in dancers and not well studied. The purpose of this study was to assess if morphological alterations in tendon structure occur as an adaptive response to dance activity by comparing the FHL tendon in dancers to non-dancers, and if pathology further alters tendon morphology in dancers clinically diagnosed with tendinopathy.

3D-printing a cost-effective model for mastoidectomy training.

Background: 3D-printed temporal bone models can potentially provide a cost-effective alternative to cadaver surgery that can be manufactured locally at the training department. The objective of this study was to create a cost-effective 3D-printed model suitable for mastoidectomy training using entry level and commercially available print technologies, enabling individuals, without prior experience on 3D-printing, to manufacture their own models for basic temporal bone training.

Methods: Expert technical professionals and an experienced otosurgeon identified the best material for replicating the temporal bone and created a cost-effective printing routine for the model using entry-level print technologies.

Printed dry electrode for neuromuscular electrical stimulation (NMES) for e-textile.

Muscle atrophy is a well-known consequence of immobilization and critical illness, leading to prolonged rehabilitation and increased mortality. In this study, we develop a solution to preserve muscle mass using customized biocompatible neuromuscular electrical stimulation (NMES) device. Commercially available NMES solutions with gel-based electrodes often lead to skin irritation.

A decade of monitoring micropollutants in urban wet-weather flows: What did we learn?

Urban wet-weather discharges from combined sewer overflows (CSO) and stormwater outlets (SWO) are a potential pathway for micropollutants (trace contaminants) to surface waters, posing a threat to the environment and possible water reuse applications. Despite large efforts to monitor micropollutants in the last decade, the gained information is still limited and scattered. In a metastudy we performed a data-driven analysis of measurements collected at 77 sites (683 events, 297 detected micropollutants) over the last decade to investigate which micropollutants are most relevant in terms of 1) occurrence and 2) potential risk for the aquatic environment, 3) estimate the minimum number of data to be collected in monitoring studies to reliably obtain concentration estimates, and 4) provide recommendations for future monitoring campaigns.

Classifying pollutant flush signals in stormwater using functional data analysis on TSS MV curves.

Pollution levels in stormwater vary significantly during rain events, with pollutant flushes carrying a major fraction of an event pollutant load in a short period. Understanding these flushes is thus essential for stormwater management. However, current studies mainly focus on describing the first flush or are limited by predetermined flush categories.

Using multi-event hydrologic and hydraulic signatures from water level sensors to diagnose locations of uncertainty in integrated urban drainage models used in living digital twins.

Digital twins of urban drainage systems require simulation models that can adequately replicate the physical system. All models have their limitations, and it is important to investigate when and where simulation results are acceptable and to communicate the level of performance transparently to end users. This paper first defines a classification of four possible 'locations of uncertainty' in integrated urban drainage models.

Cochlear implantation: Exploring the effects of 3D stereovision in a digital microscope for virtual reality simulation training - A randomized controlled trial.

Unlabelled: In cochlear implantation (CI), excellent surgical technique is critical for hearing outcomes. Recent advances in temporal bone Virtual Reality (VR) training allow for specific training of CI and through introduction of new digital microscopes with ultra-high-fidelity (UHF) graphics. This study aims to investigate whether UHF increases performance in VR simulation training of CI electrode insertion compared with conventional, screen-based VR (cVR).

[Electrical stimulation against loss of muscles and function in a patient admitted with COVID-19].

This is a case report of a hospitalised 62-year-old male patient with COVID-19, who received unilateral neuromuscular electrical stimulation treatment with a customised anti-embolic compression stocking and maintained muscle mass as well as maximum voluntary quadriceps contraction and balance during six days of illness-induced immobilisation. This illustrates, that short durations of neuromuscular electrical stimulation can help maintaining muscle mass and physical function in patients with SARS-CoV-2.

OpenEar Image Data Enables Case Variation in High Fidelity Virtual Reality Ear Surgery.

Background: Virtual reality (VR) simulation is an established option for temporal bone surgical training. Most VR simulators are based on computed tomography imaging, whereas the Visible Ear Simulator (VES) is based on high-fidelity cryosections of a single temporal bone specimen. Recently published OpenEar datasets combine cone-beam computed tomography (CBCT) and micro-slicing to achieve similar model quality.

Prioritize effluent quality, operational costs or global warming? - Using predictive control of wastewater aeration for flexible management of objectives in WRRFs.

This study presents a general model predictive control (MPC) algorithm for optimizing wastewater aeration in Water Resource Recovery Facilities (WRRF) under different management objectives. The flexibility of the MPC is demonstrated by controlling a WRRF under four management objectives, aiming at minimizing: (A) effluent concentrations, (B) electricity consumption, (C) total operations costs (sum electricity costs and discharge effluent tax) or (D) global warming potential (direct and indirect nitrous oxide emissions, and indirect from electricity production) . The MPC is tested with data from the alternating WRRF in Nørre Snede (Denmark) and from the Danish electricity grid.

Assessing competence in cochlear implant surgery using the newly developed Cochlear Implant Surgery Assessment Tool.

Purpose: To develop and gather validity evidence for a novel tool for assessment of cochlear implant (CI) surgery, including virtual reality CI surgery training.

Methods: Prospective study gathering validity evidence according to Messick's framework. Four experts developed the CI Surgery Assessment Tool (CISAT).

Effects of a "toes-off" modified heel raise on muscle coordination in non-dancers, dancers, and dancers with flexor hallucis longus tendinopathy.

Background: Tendinopathy of the flexor hallucis longus, commonly called "dancer's tendinitis", is a prevalent injury among female ballet dancers. Limited success of non-surgical interventions leads to many dancers undergoing tenolysis surgeries with risks and recovery times that can be detrimental to a dance career. The purpose of this study was to evaluate lower limb kinematics and muscle coordination during a modified traditional heel raise exercise where the toes hang off the edge of the support surface.

Modulation of Exercise-Induced Hypoalgesia Following an Exercise Intervention in Healthy Subjects.

Background: Exercise is recommended to promote and maintain health and as treatment for more than 25 diseases and pain conditions. Exercise-induced hypoalgesia (EIH), a measure of descending pain inhibitory control, has been found to be impaired in some chronic pain conditions, but it is currently unclear if EIH is modifiable. This study investigated whether a long-term exercise intervention could modulate EIH in healthy subjects.

Integrated model predictive control of water resource recovery facilities and sewer systems in a smart grid: example of full-scale implementation in Kolding.

An integrated model predictive control (MPC) strategy to control the power consumption and the effluent quality of a water resource recovery facility (WRRF) by utilizing the storage capacity from the sewer system was implemented and put into operation for a 7-day trial period. This price-based MPC reacted to electricity prices and forecasted pollutant loads 24 hours ahead. The large storage capacity available in the sewer system directly upstream from the plant was used to control the incoming loads and, indirectly, the power consumption of the WRRF during dry weather operations.

Evaluating the performance of a simple phenomenological model for online forecasting of ammonium concentrations at WWTP inlets.

A simple model for online forecasting of ammonium (NH ) concentrations in sewer systems is proposed. The forecast model utilizes a simple representation of daily NH profiles and the dilution approach combined with information from online NH and flow sensors. The method utilizes an ensemble approach based on past observations to create model prediction bounds.

Ultra-high-fidelity virtual reality mastoidectomy simulation training: a randomized, controlled trial.

Purpose: Ultra-high-fidelity (UHF) graphics in virtual reality (VR) simulation might improve surgical skill acquisition in temporal bone training. This study aims to compare UHF VR simulation training with conventional, screen-based VR simulation training (cVR) with respect to performance and cognitive load (CL).

Methods: In a randomized trial with a cross-over design, 24 students completed a total of four mastoidectomies in a VR temporal bone surgical simulator: two performances under UHF conditions using a digital microscope and two performances under conventional conditions using screen-based VR simulation.

The Effect of Simulator-Integrated Tutoring for Guidance in Virtual Reality Simulation Training.

Introduction: Simulation-integrated tutoring in virtual reality (VR) simulation training by green lighting is a common learning support in simulation-based temporal bone surgical training. However, tutoring overreliance can negatively affect learning. We therefore wanted to investigate the effects of simulator-integrated tutoring on performance and learning.

The effect of structured self-assessment in virtual reality simulation training of mastoidectomy.

Purpose: Virtual reality (VR) simulation surgical skills training is well established, but self-directed practice is often associated with a learning curve plateau. In this study, we investigate the effects of structured self-assessment as a means to improve performance in mastoidectomy training.

Methods: The study was a prospective, educational study.

Robust model for estimating pumping station characteristics and sewer flows from standard pumping station data.

Flow data represent crucial input for reliable diagnostics of sewer functions and identification of potential problems such as unwanted inflow and infiltration. Flow estimates from pumping stations, which are an integral part of most separate sewer systems, might help in this regard. A robust model and an associated optimization procedure is proposed for estimating inflow to a pumping station using only registered water levels in the pump sump and power consumption.