Zielsetzung: In dieser Studie wurde an 15 gesunden Rindern die Methode der Thorakoskopie erprobt mit dem Ziel, eine Grundlage für den weiteren Einsatz dieses Verfahrens am bovinen Thorax zu schaffen. Im Mittelpunkt standen die Entwicklung einer geeigneten Untersuchungstechnik und die Beschreibung der endoskopisch dargestellten, im Pleuraspalt gelegenen Organe sowie möglicher pathologischer Befunde. Weiterhin galt es Komplikationen zu ermitteln und anhand der Erfahrungen aus diesem Versuch Indikationen für den Einsatz dieses minimal-invasiven Verfahrens beim Rind zu formulieren. Methodik: Alle Tiere wurden einer links- und rechtsseitigen Thorakoskopie jeweils mit und ohne intrapleurale Insufflation von Kohlenstoffdioxid über einen interkostalen Zugang unterzogen. Im Rahmen des Versuches fanden folglich vier Thorakoskopien je Rind und insgesamt 60 Thorakoskopien mit einer Wartezeit von 24 Stunden zwischen den einzelnen Untersuchungen statt. Die Untersuchungen erfolgten am im Zwangsstand fixierten, lokal anästhesierten Tier. Der endoskopische Zugang lag stets auf Höhe des Tuber coxae und variierte vom 8. bis zum 10. Interkostalraum. Nach interkostaler Schnittinzision wurde eine Zitzenkanüle bis in den Pleuraspalt vorgeschoben. Der spontane Einstrom von Raumluft in das Cavum pleurae führte zum Teilkollaps des ipsilateralen Lungenflügels. Die Kanüle wurde durch eine Trokar-Hülsen-Einheit ersetzt und die Hülse stellte nach Entfernung des Trokars den Zugang für die Optik. Je Hemithorax wurde die Untersuchungszeit auf 20 Minuten festgelegt. Sie begann im kranialen Pleuraspalt, wurde über (dorso)-kranial, (dorso)-medial, (dorso)-kaudal, ventrokaudal und ventral fortgeführt und endete mit ventrokranial ausgerichteter Optik. Ergebnisse: Die meisten im Cavum pleurae gelegenen Organe konnten ohne die Insufflation von CO2 ausreichend adspiziert werden. Während der links- und rechtsseitigen Thorakoskopien gelang die Adspektion großer Bereiche der Pleura costalis mit den Mm. intercostales interni sowie den Aa. et Vv. intercostales dorsales, Anteile der Lungenflügel und des Ligamentum pulmonale, der Aorta thoracica, des thorakalen Ösophagus, des M. longus colli, von Lymphknoten des Lc. thoracicum dorsale sowie der Lnn. mediastinales caudales, der Pars thoracica des Truncus sympathicus und des Truncus vagalis dorsalis des N. vagus. Des Weiteren konnten der M. psoas major, Anteile des Diaphragmas und der V. phrenica cranialis, der Hiatus aorticus, der Arcus lumbocostalis sowie unregelmäßig die A. et V. bronchoesophagea adspiziert werden. Die Untersuchung des rechten kranialen Pleuraspaltes war mit Einschränkungen behaftet und spiegelte sich in einer reduzierten Darstellung der sympathische Nervenfasern aus dem Ggl. cervicothoracicum, des Truncus costocervicalis dextra sowie der V. costocervicalis dextra wider. Linksseitig war die Betrachtung dieser Organe bzw. der korrespondierenden linksseitig angelegten Organe regelmäßig möglich. Weiterhin gelang während der linksseitigen Untersuchung die Adspektion des Ln. tracheobronchalis sinister, des Truncus brachiocephalicus sowie der V. azygos sinistra. Rechtsseitig konnte die V. azygos dextra stets adspiziert werden. Die Darstellung des Ductus thoracicus erfolgte nur bei einem der untersuchten Rinder infolge einer pathologischen Kompression. Während der Untersuchungen unter passivem Lungenkollaps war das Perikard nur bei einer rechtsseitigen Thorakoskopie zu sehen. Die Zweituntersuchungen des ipsilateralen Pleuraspaltes fanden während der Insufflation von CO2 bis zu einem Überdruck von 5 mm Hg statt. Dies sollte einen stärkeren Lungenkollaps bewirken und damit die Sicht auf intrapleural gelegene Organe verbessern. Während der Insufflation waren beidseits größere Anteile der Rippen und des Zwerchfells sowie das Perikard linksseitig bei drei Rindern und rechtsseitig bei einem Rind darstellbar. Postoperative Röntgenaufnahmen dienten dem Ausschluss des Vorhandenseins eines ipsi- oder kontralateralen Pneumothorax. Schlussfolgerung: Die Studie zeigt, dass Thorakoskopien an stehenden, gesunden Rindern sicher und komplikationsarm durchzuführen sind. Die beschriebene, minimal-invasive Technik stellt eine wertvolle, zusätzliche Methode zur tierschonenden Abklärung intrathorakaler Erkrankungen beim Rind dar. Der diagnostische, palliative oder therapeutische Nutzen muss in weiterführenden Untersuchungen ermittelt werden. / Objective: A study on 15 healthy cows was conducted to prove the thoracoscopic technique with the aim to establish a basis for further application of this procedure on cattle. Focus was on developing an adequate examination technique, displaying and describing of physical as well as pathological findings on intrathoracic organs examined endoscopically. Furthermore perioperative complications and indications of this minimally invasive method on cattle should be presented. Methods: The animals underwent a left and right side thoracoscopy under passive lung collapse and under insufflation of CO2. Therefore four thoracoscopies at each cow and a total of 60 thoracoscopies were performed with a waiting time of 24 hours between each examination. The cows were restrained in a stock and locally anesthetized. The endoscopic portal was lined up horizontally with the level of the ventral margin of the coxal tuber, at the point where the local anaesthetic had been injected and varied between the eighth and the tenth intercostal space. After a vertical stab incision through the skin and subcutaneous tissues a blunt stainless teat cannula was introduced into the pleural space. At this point air streamed spontaneously into the pleural space following by an ipsilateral lung collapse. The teat cannula was then removed and replaced by a sharp guarded trocar. After that the trocar was removed and the endoscope was passed through the remaining cannula. The time assessment for examination of each thorax was 20 minutes, started in the cranial pleural space, was continued in the (dorso)-cranial, (dorso)-medial, (dorso)-caudal, ventrocaudal und ventral direction and ended with ventrocranially aligned optic. Results: Most of the intrathoracic organs were seen without additional CO2 insufflation. During left and right side thoracoscopies large parts of the costal pleura, the internal intercostal muscles, the dorsal intercostal veins and arteries, parts of the lungs and the pulmonary ligament, the thoracic aorta, the thoracic part of the esophagus and the longus colli muscle, caudal mediastinal lymph nodes and lymph nodes associated with the dorsal thoracic lymph center, the thoracic part of the sympathic trunk and the dorsal vagus nerve were seen. Furthermore the psoas major muscle, parts of the diaphragm and the cranial phrenic vein, the aortic hiatus, the lumbocostal arch and intermittently the broncho-esophageal artery and vein could be identified. There were some constraints during right side thoracoscopy of the cranial pleural space which caused a limited view at the sympathic nerve fibres associated with the cervicothoracic ganglion, the right costocervical trunk and the right costocervical vein. At the left side these organs, the corresponding left side organs respectively, were constantly seen. Moreover during the exam at the left pleural space the left tracheobronchial lymph node, the brachiocephalic trunk and the left azygos could be well identified. During right side thoracoscopy the right azygos vein was always visible. In one case the presentation of the thoracic duct succeeded as a result of its pathological compression. During examination under passive lung collapse the pericard was visualized in one cow during right side thoracoscopy. The second thoracoscopies of the ipsilateral pleural space were conducted during insufflation of CO2 with a pressure of 5 mm Hg. A stronger lung collapse should result during insufflation with an enhanced view of the organs located intrapleurally. During insufflation at both sides larger parts of the ribs and diaphragm as well as the pericard on the left side at three cattle and on the right side at one cattle could be seen. Postoperative radiographies ensured the absence of an ipsi- or contralateral pneumothorax. Conclusion: This study shows that thoracoscopies on standing healthy cattle could be safely performed without major perioperative complications or side effects. The described minimally invasive procedure is a valuable, gentle and additional method to diagnose intrathoracic diseases in cattle. The use of thoracoscopy as diagnostic tool, for curative and palliative therapy should be identified in further studies.

Background: Open reduction and internal fixation with a plate is deemed to represent the gold standard of surgical treatment for displaced intra-articular calcaneal fractures. Standard plate fixation is usually placed through an extended lateral approach with high risk for wound complications. Minimally invasive techniques might avoid wound complications but provide limited construct stability. Therefore, 2 different types of locking nails were developed to allow for minimally invasive technique with sufficient stability. The aim of this study was to quantify primary stability of minimally invasive calcaneal interlocking nail systems in comparison to a variable-angle interlocking plate. Material and Methods: After quantitative CT analysis, a standardized Sanders type IIB fracture model was created in 21 fresh-frozen cadavers. For osteosynthesis, 2 different interlocking nail systems (C-Nail; Medin, Nov. Město n. Moravě, Czech Republic; Calcanail; FH Orthopedics SAS; Heimsbrunn, France) as well as a polyaxial interlocking plate (Rimbus; Intercus GmbH; Rudolstadt, Germany) were used. Biomechanical testing consisted of a dynamic load sequence (preload 20 N, 1000 N up to 2500 N, stepwise increase of 100 N every 100 cycles, 0.5 mm/s) and a load to failure sequence (max. load 5000 N, 0.5 mm/s). Interfragmentary movement was detected via a 3-D optical measurement system. Boehler angle was measured after osteosynthesis and after failure occurred. Results: No significant difference regarding load to failure, stiffness, Boehler angle, or interfragmentary motion was found between the different fixation systems. A ignificant difference was found with the dynamic failure testing sequence where 87.5% of the Calcanail implants failed in contrast to 14% of the C-Nail group (P < .01) and 66% of the Rimbus plate. The highest load to failure was observed for the C-Nail. Boehler angle showed physiologic range with all implants before and after the biomechanical tests. Conclusion: Both minimally invasive interlocking nail systems displayed a high primary stability that was not inferior to an interlocking plate. Clinical relevance: Based on our results, both interlocking nails appear to represent a viable option for treating displaced intra-articular calcaneal fractures.

Invasive plants can outcompete native plants, replacing diverse plant communities with monocultures, which can negatively impact the whole ecosystem. One invasive plant, Phragmites australis, has invaded wetlands across North America. In Utah’s Great Salt Lake, it has greatly reduced the area of native plants that are important habitat for migratory birds. Here we describe experiments that assess multiple treatments for Phragmites removal and evaluate the return of native plants after Phragmites management. The treatments were applied to Phragmites patches at two scales (small 1/4-acre plots and large 3-acre plots) and across multiple sites to evaluate how patch size and environmental differences can influence the plants that return after Phragmites removal. The treatments (applied over 3 years and monitored two more) compared two different herbicides (glyphosate and imazapyr) and different herbicide and mowing timings. The treatments evaluated in the large patch study were 1.) untreated control 2.) fall glyphosate, winter mow, 3.) summer imazapyr, winter mow, 4.) summer glyphosate, winter mow. The treatments evaluated in the small patch study included treatments 1-4 above plus 5.) summer mow, fall glyphosate, 6.) summer mow, then black plastic solarization. In the small patches, we also monitored the seeds in the soil to assess how Phragmites management treatments can change the densities of Phragmites and native seeds. Fall glyphosate treatments were superior for Phragmites cover reduction. After the initial treatment, summer herbicide and mow treatments reduced Phragmites seed production, while fall glyphosate did not. Phragmites seeds were plentiful in the soil but were reduced following three years of all herbicide treatments. Native plant recovery following Phragmites management was extremely variable across sites. Sites with high soil moisture had better Phragmites removal and more native plants. But when flooding was deep, native plants were rare. Native seed density in the soil did not change due to Phragmites management, but soil seed densities were different across sites, which influenced native plant recruitment. Phragmites was removed more effectively and native plants returned in greater numbers in small patches compared with large. This was because small patches were typically near established native plant communities, which likely provided more native plant seeds and had hydrology that was less disturbed by human activity. In sites where native plants do not return after Phragmites management, practitioners may need to try revegetation with native plant seeds to restore important native plant communities.

Hintergrund: Die Simulation wichtiger Handgriffe und Techniken in der Chirurgie wurde bereits seit der Antike praktiziert. Pflanzen, Menschen- und Tierkadaver, Puppen sowie Phantome haben seit Jahrhunderten diesem Zweck gedient. Das 21. Jahrhundert ist jedoch von virtueller Realität geprägt und es gibt viele technische Neuerungen in der Chirurgie. Erste virtuelle Simulationsmöglichkeiten tauchten auf dem Markt bereits im 20. Jahrhundert auf. Zuerst nur schwarzweiß, rudimentär und nur andeutungsweise einer echten Situation im OP-Saal ähnlich, überzeugen die heutigen Simulatoren durch schnelle Prozessoren, qualitative graphische Darstellung und haptisches Feedback. Der Simulator selbst wird zum Forschungsobjekt, endlich können in Simulationsbedingungen Fragestellungen untersucht werden, die bisher unter Operationsbedingungen weder ethisch vertretbar noch technisch möglich waren. Fragestellung: Zwischen 2016 und 2017 fand am VTG Klinikum des Universitätsklinikums der TU Dresden Carl Gustav Carus eine Studie am chirurgischen Simulator für virtuelle Realität statt. Die untersuchte Fragestellung war die Übertragbarkeit von Fertigkeiten zwischen zwei laparoskopischen Operationen: Appendektomie und Cholezystektomie. Material und Methode: Es wurden 44 Studierende aus dem 3. bis 6. Studienjahr rekrutiert und in zwei Gruppen rand-omisiert. Beide Gruppen übten zunächst die Basisübungen bis bestimmte Leistungskriterien erfüllt wurden. Danach haben Probanden der ersten Gruppe die virtuelle Appendektomie und im Anschluss die virtuelle Cholezystektomie trainiert. Die zweite Gruppe ging sofort zum Cholezystektomie Training über. In beiden Gruppen wurden zum Schluss jeweils drei Wiederholungen der kompletten Cholezystektomie absolviert. Verglichen wurden Geschwindigkeit, Sicherheitsparameter wie z. B. aufgetretene Komplikationen sowie Motorik-Parameter der Instrumente. Des Weiteren wurde der mögliche Einfluss von Schlafverhalten, Koffeinkonsum und Erfahrung mit Videospielen auf die Leistung am Simulator untersucht. Ergebnisse: In der statistischen Analyse zeigte die erste Gruppe eine signifikante Verbesserung der Moto-rik-Parameter wie Instrumentenbewegungen und -strecke. Andere Werte wie Geschwindigkeit und Sicherheitsparameter waren innerhalb der zwei Gruppen ähnlich. Zwischen Schlaf-verhalten, Koffeinkonsum und Erfahrung mit Videospielen und der Leistung am Simulator konnte kein Zusammenhang festgestellt werden. Schlussfolgerungen: Die Studie ergab nur einen partiellen Übertragungseffekt zwischen laparoskopischer Appendektomie und Cholezystektomie. Die Gründe liegen in den jeweils unterschiedlichen Schlüsselmomenten, die die Beherrschung prozedurspezifischer Techniken erfordern. Diese müssen für jede Prozedur separat geübt werden. Die Verbesserung der feinmotorischen Fähigkeiten spricht jedoch dafür, dass eine Übertragung der Fertigkeiten bis zu einem gewissen Grad dennoch stattfand und durch das Trainieren einer zusätzlichen Modalität Vorteile insbesondere in der Bewegungsökonomie gewonnen werden können.:Inhaltsverzeichnis 3 Abkürzungsverzeichnis 7 1. Einleitung 8 1.1 Einblick in die Geschichte der chirurgischen Simulation 8 1.2 Entwicklung chirurgischer Simulatoren 9 1.3 Einsatz der Laparoskopie-Simulatoren in der heutigen chirurgischen Ausbildung 11 1.4 Übertragbarkeit von Fähigkeiten in der minimal invasiven Chirurgie 13 1.5 Laparoskopische Appendektomie und Cholezystektomie 17 1.5.1 Laparoskopische Appendektomie 17 1.5.2 Laparoskopische Cholezystektomie 18 1.6 Sonstige Aspekte des Trainings 19 1.6.1 Kriterien-basiertes Training 19 1.6.2 Betreuerfeedback 19 1.6.3 Leistung unter Beobachtung 20 1.6.4 Leistung unter Simulationsbedingungen 20 1.6.5.1 Schlafdauer 20 1.6.5.2 Kaffeekonsum 21 1.6.5.3 Motivation 21 1.6.5.4 Erfahrung mit Videospielen 22 2. Materialen und Methoden 23 2.1 Fragestellung 23 2.2 Ablauf der MIC Studie 24 2.3. Probandenrekrutierung 25 2.4 Lap Mentor von Simbionix (3D Systems) 27 2.5 Trainingsprotokolle am VRT-Simulator 28 2.5.1 Organisatorische Aspekte 28 2.5.2 Leistungsfeedback am VRT-Simulator 28 2.5.3 Training der Basis-Fertigkeiten (Basic Skills Training) 29 2.5.3.1 Peg Transfer 31 2.5.3.2 Clipping and Grasping 32 2.5.3.3 Electrocautery 33 2.5.3.4 Cutting 34 2.5.3.5 Pattern Cutting: Training Gauze 35 2.5.4 Training der Appendektomie Prozedur 36 2.5.5 Training der Cholezystektomie Prozedur 39 2.5.6 Subjektiver Schwierigkeitsgrad 43 2.6 Statistische Auswertung 44 3. Ergebnisse 45 3.1. Zusammenfassung der Probandencharakteristiken 45 3.2 Alter und Geschlecht der Probanden 45 3.3 Fragebogen 46 3.3.1 Schlaf 46 3.3.2 Kaffeekonsum 48 3.3.3 Motivation 49 3.3.4 Erfahrung mit Videospielen 50 3.3.5 Einflussfaktoren auf das Basistraining 50 3.4 Allgemeine Ergebnisse des Trainings am VRT Simulator 51 3.5 Ergebnisse des Trainings der Basis-Fertigkeiten 52 3.5.1 Peg Transfer 52 3.5.2 Clipping and Grasping 53 3.5.3 Electrocautery 54 3.5.4 Cutting 55 3.5.5 Pattern Cutting (Test Gauze) 56 3.5.6 Subjektiver Schwierigkeitsgrad für die Basis-Übungen 57 3.5.7. Zeitbedarf für das Erreichen der Könner-Kriterien 59 3.6 Ergebnisse des Appendektomie Trainings 60 3.7 Ergebnisse der Cholezystektomie Komplettprozedur 61 3.7.1 Geschwindigkeit 61 3.7.2 Sicherheitskriterien 62 3.7.2.1 Anzahl lebensbedrohlicher Komplikationen 62 3.7.2.2 Sichere Kauterisation 63 3.7.2.3 Anzahl verlorener Clips 63 3.7.2.4 Anzahl der Leberperforationen 64 3.7.2.5 Anzahl nicht kauterisierter Blutungen 64 3.7.3 Effizienz Kriterien 64 3.7.3.1 Anzahl der Instrumentenbewegungen 64 3.7.3.2 Gesamtstrecke der Instrumente 65 3.7.4 Subjektiver Schwierigkeitsgrad für die Cholezystektomie 65 3.7.5 Zeit für Basis Training und Cholezystektomie Parameter 65 4. Diskussion 67 4.1 Der Begriff des Übertragungsphänomens in Sportwissenschaften und seine Anwendbarkeit auf die laparoskopischen Fertigkeiten 67 4.2 Übertragbarkeit von Fertigkeiten zwischen virtueller Appendektomie und Cholezystektomie und Vergleich mit anderen Studien 74 4.3 Exploration zweitrangiger Fragestellungen 78 4.4 Vergleich zentraler Tendenzen der Cholezystektomie-Parameter mit Hersteller-Kriterien und externen Studien 79 4.5 Schlussfolgerungen aus dem Training der Basis-Fertigkeiten 81 4.6 Schlussfolgerungen aus dem Appendektomie Training 82 4.7 Schlussfolgerungen aus dem Cholezystektomie Training 83 4.8 Empfehlungen für das Ausbildungscurriculum an einem VR Simulator 85 4.9 Vorschlag für das Anfängertraining an einem VRT Simulator 91 4.10 Limitierungen der Arbeit 92 4.11 Ausblick 93 5. Zusammenfassung 94 5.1 Summary 96 6. Literatur 98 6.1 Abbildungsverzeichnis 106 6.2 Tabellenverzeichnis 108 7. Anhang 109 7.1 Probandenrandomisierung 109 7.2 Probandeninformationsblatt 110 7.3 Einwilligungserklärung 112 7.4 Beispiel Teilnahmebescheinigung 114 7.5 Zusammenfassung der aufgetretenen Softwarefehler am Lap Mentor II 115 8. Danksagung 116 9. Eigenständigkeitserklärung 117 Anlage 1 118 Anlage 2 120 / Background: Simulation of important surgical procedures and techniques has been practiced since ancient times. Plants, human and animal cadavers, dolls and phantoms have served this purpose for hundreds of years. However, the 21st century is characterized by virtual reality and there are also many technical innovations in the field of surgery. The first virtual simulation possibilities appeared on the market in the 20th century. Initially only black and white, rudimentary and only suggestively similar to a real situation in the operating room, today's simulators convince with fast processors, qualitative graphical representation and haptic feedback. The simulator itself becomes an object of research. At last, questions can be investigated in simulation conditions that were previously neither ethically nor technically possible under operating conditions. Hypothesis: Between 2016 and 2017, at the VTG clinic of the Carl Gustav Carus University Hospital of the TU Dresden a study using a surgical simulator for virtual reality took place. The question investigated was the transferability of skills between two laparoscopic procedures: appendectomy and cholecystectomy. Methods: 44 students from the 3rd to 6th year of study were recruited and randomly divided into two groups. Both groups initially practiced the basic exercises until certain criteria were met. Afterwards, the first group practiced virtual appendectomy and then virtual cholecystectomy. The second group immediately moved on to cholecystectomy training. In both groups, three repetitions of the complete cholecystectomy were completed in the end. Speed, safety parameters such as complications that occurred and efficiency parameters of the instruments were compared. Furthermore, the possible influence of sleep behavior, caffeine consumption and experience with video games on simulator performance was investigated. Results: In the statistical analysis, the first group showed a significant reduction in the efficiency parameters such as instrument movements and distance travelled. Other values like speed and safety parameters were similar within two groups. There was no correlation between sleep behavior, caffeine consumption and experience with video games and simulator performance. Conclusion: The study showed only a partial skill transfer between laparoscopic appendectomy and cholecystectomy. The reasons are the different key moments that require the mastery of procedure-specific techniques. These must be practiced separately for each procedure. However, the improvement of fine motor skills indicates, that by training an additional modality a skill transfer nevertheless took place to a certain degree and that advantages, especially in the economy of movement, were gained.:Inhaltsverzeichnis 3 Abkürzungsverzeichnis 7 1. Einleitung 8 1.1 Einblick in die Geschichte der chirurgischen Simulation 8 1.2 Entwicklung chirurgischer Simulatoren 9 1.3 Einsatz der Laparoskopie-Simulatoren in der heutigen chirurgischen Ausbildung 11 1.4 Übertragbarkeit von Fähigkeiten in der minimal invasiven Chirurgie 13 1.5 Laparoskopische Appendektomie und Cholezystektomie 17 1.5.1 Laparoskopische Appendektomie 17 1.5.2 Laparoskopische Cholezystektomie 18 1.6 Sonstige Aspekte des Trainings 19 1.6.1 Kriterien-basiertes Training 19 1.6.2 Betreuerfeedback 19 1.6.3 Leistung unter Beobachtung 20 1.6.4 Leistung unter Simulationsbedingungen 20 1.6.5.1 Schlafdauer 20 1.6.5.2 Kaffeekonsum 21 1.6.5.3 Motivation 21 1.6.5.4 Erfahrung mit Videospielen 22 2. Materialen und Methoden 23 2.1 Fragestellung 23 2.2 Ablauf der MIC Studie 24 2.3. Probandenrekrutierung 25 2.4 Lap Mentor von Simbionix (3D Systems) 27 2.5 Trainingsprotokolle am VRT-Simulator 28 2.5.1 Organisatorische Aspekte 28 2.5.2 Leistungsfeedback am VRT-Simulator 28 2.5.3 Training der Basis-Fertigkeiten (Basic Skills Training) 29 2.5.3.1 Peg Transfer 31 2.5.3.2 Clipping and Grasping 32 2.5.3.3 Electrocautery 33 2.5.3.4 Cutting 34 2.5.3.5 Pattern Cutting: Training Gauze 35 2.5.4 Training der Appendektomie Prozedur 36 2.5.5 Training der Cholezystektomie Prozedur 39 2.5.6 Subjektiver Schwierigkeitsgrad 43 2.6 Statistische Auswertung 44 3. Ergebnisse 45 3.1. Zusammenfassung der Probandencharakteristiken 45 3.2 Alter und Geschlecht der Probanden 45 3.3 Fragebogen 46 3.3.1 Schlaf 46 3.3.2 Kaffeekonsum 48 3.3.3 Motivation 49 3.3.4 Erfahrung mit Videospielen 50 3.3.5 Einflussfaktoren auf das Basistraining 50 3.4 Allgemeine Ergebnisse des Trainings am VRT Simulator 51 3.5 Ergebnisse des Trainings der Basis-Fertigkeiten 52 3.5.1 Peg Transfer 52 3.5.2 Clipping and Grasping 53 3.5.3 Electrocautery 54 3.5.4 Cutting 55 3.5.5 Pattern Cutting (Test Gauze) 56 3.5.6 Subjektiver Schwierigkeitsgrad für die Basis-Übungen 57 3.5.7. Zeitbedarf für das Erreichen der Könner-Kriterien 59 3.6 Ergebnisse des Appendektomie Trainings 60 3.7 Ergebnisse der Cholezystektomie Komplettprozedur 61 3.7.1 Geschwindigkeit 61 3.7.2 Sicherheitskriterien 62 3.7.2.1 Anzahl lebensbedrohlicher Komplikationen 62 3.7.2.2 Sichere Kauterisation 63 3.7.2.3 Anzahl verlorener Clips 63 3.7.2.4 Anzahl der Leberperforationen 64 3.7.2.5 Anzahl nicht kauterisierter Blutungen 64 3.7.3 Effizienz Kriterien 64 3.7.3.1 Anzahl der Instrumentenbewegungen 64 3.7.3.2 Gesamtstrecke der Instrumente 65 3.7.4 Subjektiver Schwierigkeitsgrad für die Cholezystektomie 65 3.7.5 Zeit für Basis Training und Cholezystektomie Parameter 65 4. Diskussion 67 4.1 Der Begriff des Übertragungsphänomens in Sportwissenschaften und seine Anwendbarkeit auf die laparoskopischen Fertigkeiten 67 4.2 Übertragbarkeit von Fertigkeiten zwischen virtueller Appendektomie und Cholezystektomie und Vergleich mit anderen Studien 74 4.3 Exploration zweitrangiger Fragestellungen 78 4.4 Vergleich zentraler Tendenzen der Cholezystektomie-Parameter mit Hersteller-Kriterien und externen Studien 79 4.5 Schlussfolgerungen aus dem Training der Basis-Fertigkeiten 81 4.6 Schlussfolgerungen aus dem Appendektomie Training 82 4.7 Schlussfolgerungen aus dem Cholezystektomie Training 83 4.8 Empfehlungen für das Ausbildungscurriculum an einem VR Simulator 85 4.9 Vorschlag für das Anfängertraining an einem VRT Simulator 91 4.10 Limitierungen der Arbeit 92 4.11 Ausblick 93 5. Zusammenfassung 94 5.1 Summary 96 6. Literatur 98 6.1 Abbildungsverzeichnis 106 6.2 Tabellenverzeichnis 108 7. Anhang 109 7.1 Probandenrandomisierung 109 7.2 Probandeninformationsblatt 110 7.3 Einwilligungserklärung 112 7.4 Beispiel Teilnahmebescheinigung 114 7.5 Zusammenfassung der aufgetretenen Softwarefehler am Lap Mentor II 115 8. Danksagung 116 9. Eigenständigkeitserklärung 117 Anlage 1 118 Anlage 2 120

Molecular dating (or molecular clock) is a powerful technique that uses the mutation rate of biomolecules to estimate divergence times among organisms. In the last two decades, the theory behind the molecular clock has been intensively developed, and it is now possible to employ sophisticated evolutionary models on genome-scaled datasets in a Bayesian framework. The molecular clock has been successfully applied to virtually all types of organisms and molecules to estimate timing of speciation, timing of gene duplications, and generation times: this knowledge allows contextualizing past and present events in the light of (paleo)ecological scenarios. Molecular clock studies are routinely used in evolutionary and ecological studies, but their use in applied fields such as agricultural and medical entomology is still scarce in particular because of a paucity of genome data. Genome-scaled clocks have been successfully applied, for example, to various model organisms such as Anopheles and Drosophila, as well as to invasive mosquitoes Aedes aegypti and Aedes albopictus. Many other invasive pests are emerging worldwide aided by global trade, increased connectivity among countries, lack of prevention, and flawed invasive species management. Among them, there is Aedes koreicus and Aedes japonicus, two invasive mosquito species which are monitored for public health concerns because of their harboured human pathogenic viruses. For these, as well as for other insects of societal relevance, such as the parasitoid Trissolcus japonicus, there is a paucity of gene markers and no genome data for large scale molecular clock studies. Invasive pests are typically studied using microevolutionary approaches that tackle events at an intraspecific level: these approaches provide important information for the pest management, for example, by revealing invasion routes and insecticide resistances. Approaches that tackle the deep-time evolution of the pest, such as the molecular clock, are instead less used in pest science. Many important traits associated with invasiveness have evolved by speciation over a long time frame: the molecular clock can reveal the paleo-ecological conditions that favoured these traits helping a better understanding of pest biology. Molecular clock, when coupled with phylogenomics, can further identify genes and patterns that characterize the pest: this knowledge can be used to enhance management practices. Although this is a data-driven thesis, its major aim is to provide new results to demonstrate the utility of the molecular clock in pest science. This has been done by systematically apply the molecular clock to various neglected organisms of medical and agricultural relevance. To this aim, I generated new genome data and/or assembled the largest genome-scaled data to date. I studied the molecular clock in mosquitoes, focusing on the Aedini radiation (Chapter 2) and identified a strong incongruence between the mitochondrial and nuclear phylogeny for what concerns their molecular clock. This result highlighted the importance of employing genome scaled data for these species to exclude stochastic effects due to poor/inaccurate sampling in clock studies. To tackle the absence of data, I further assembled the whole mitogenome of emerging invasive species Aedes koreicus and Aedes japonicus with the aim of producing useful data for molecular typing and of inferring divergence estimates using whole mitogenomes (Chapter 3). Dated phylogenies point toward more recent diversification of Aedini and Culicini compared to estimates from previous works, addressing the issue of taxon sampling sensitivity in dated phylogeny. Although it is possible to perform molecular clock studies on single/few gene markers, the current trend is to couple this methodology with genome-scaled datasets to reduce the stochastic effect of using few genes. For this reason, I sequenced the draft genome of A. koreicus and A. japonicus (Chapter 4). The assemblies were extremely fragmented, highlighting the problem of sequencing large genomes using short reads. The assemblies provided, however enough information for genome skimming allowing extraction of BUSCO genes for downstream analyses, whole mitogenome assemblies (used in Chapter 3), and characterisation of the associated metagenome. These data need to be integrated by long reads; it provides, however a first framework to investigate the genome evolution of these species. I further sequenced and assembled the genome of Trissolcus japonicus, the parasitoid wasp of the invasive pest Halyomorpha halys. To elucidate its divergence, estimate and define an intraspecific typing system to differentiate strains for biocontrol strategies, I reconstructed the mitochondrial genomes of two populations: the mitogenomes were surprisingly identical, suggesting that they belong to the same de facto population. I further provide a detailed clock investigation of Zika, a virus harboured and transmitted by some Aedes species (Chapter 5). Using the largest set of genomes to date, I could set the origin of ZIKV in the middle age and its first diversification in the mid-19th century. From a methodological point of view, the clocking of this virus highlighted the importance of checking for recombination and for cell-passages to obtain correct divergence estimates. I finally show my contributions to molecular clock studies of three other invasive species (Chapter 6): I helped disentangle the divergence times of Bactrocera, a genus of invasive fruit files pest of agriculture; I contributed in performing a phylogenomics study of opsin genes in Diptera; I used chloroplast and nuclear genome data to reconstruct the divergences of the invasive reed Arundo. In the various Chapters of my thesis, I highlighted the limits and the problems of current molecular clock methodologies and identified the best practices for different types of organisms in order to develop a cross-discipline understanding of the molecular clock techniques. The various results presented in this thesis further demonstrate the utility of the molecular clock approach in pest studies.

No description available.

<p>Biological invasion is a major and growing threat to global biodiversity and human well-being, but research on the impacts of invaders on their recipient environments lags behind that on the mechanisms driving invader establishment and spread. The total impact of an invader is defined by its range size, abundance per unit area, and per-capita effect, with both per-capita effects and abundance varying over time and across the invader’s range. These context-dependencies are determined, in part, by functional differentiation between the invader and its recipient system. In this thesis, I investigate how functional differentiation between invaders and their recipient communities regulates the impact of plant invaders on community diversity and/or biomass production.</p> <p>First, I compare the effects of invasive Callery pear (<em>Pyrus calleryana</em> Decne.) to functionally similar native trees in three early-successional meadow environments in Indiana’s eastern corn belt plains. Despite my prediction that <em>P. calleryana</em> would have greater negative effects on the total biomass and diversity of the understory plant community compared to native trees, I found that <em>P. calleryana</em> had no significant impact on total cover, species richness, or Shannon’s or Simpson’s diversity indices for the understory community, compared to native <em>Liriodendron tulipifera</em> L., <em>Platanus occidentalis</em> L., or non-tree control plots. Likewise, <em>P. calleryana</em> had no significant impact on the native, introduced, woody, or native tree subsets of the understory community. These results indicate that the trait differences between <em>P. calleryana</em> and functionally similar native trees – and thus the per-invader effect of <em>P. calleryana</em> on its recipient community – are not of a great enough magnitude to produce changes in the understory community composition of these highly invaded, low diversity meadow environments with relatively new and sparse <em>P. calleryana</em> invasions. </p> <p>I then investigate the role of functional overlap in moderating invader impacts in California serpentine grassland communities through the lens of classic niche theory, which predicts that functional differentiation minimizes competition and therefore allows functionally distinct invaders to achieve higher establishment success but lower per-capita effects on their recipient communities. I tested this prediction by establishing small-scale experimental communities composed of individual or multiple functional groups differentiated by phenology – early-season annuals, nitrogen-fixing early-season annuals, and late-season annuals – and seeding these communities with early- or late-season invaders. I found that as invader density increased, effects on resident community biomass depended on complex patterns of invader and resident functional overlap. Across all resident community functional groups, the high density of early-season invaders enables them to capture a greater portion of total community biomass than late-season invaders, but early-season invaders reduce the ratio of resident:total invader biomass production by less, per-unit-biomass, than late-season invaders. These results highlight the need to consider both niche and fitness differences in predicting invader impacts and the complex nature of resident-invader interactions, which may not be sufficiently captured by coarse functional groups.</p>

This work presents the development of a novel and non-invasive method that measures fluid flow rate and temperature in pipes. While current non-invasive flow meters are able to measure pipe flow rate, they cannot simultaneously measure the internal temperature of the fluid flow, which limits their widespread application. Moreover, devices that are able to determine flow temperature are primarily intrusive and require constant maintenance, which can shut down operation, resulting in downtime and economic loss. Consequently, non-invasive flow rate and temperature measurement systems are becoming increasingly attractive for a variety of operations, including for use in leak detection, energy metering, energy optimization, and oil and gas production, to name a few. In this work, a new solution method and parameter estimation scheme are developed and deployed to non-invasively determine fluid flow rate and temperature in a pipe. This new method is utilized in conjunction with a sensor-based apparatus--"namely, the Combined Heat Flux and Temperature Sensor (CHFT+), which employs simultaneous heat flux and temperature measurements for non-invasive thermal interrogation (NITI). In this work, the CHFT+ sensor embodiment is referred to as the British Thermal Unit (BTU) Meter. The fluid's flow rate and temperature are determined by estimating the fluid's convection heat transfer coefficient and the sensor-pipe thermal contact resistance. The new solution method and parameter estimation scheme were validated using both simulated and experimental data. The experimental data was validated for accuracy using a commercially available FR1118P10 Inline Flowmeter by Sotera Systems (Fort Wayne, IN) and a ThermaGate sensor by ThermaSENSE Corp. (Roanoke, VA). This study's experimental results displayed excellent agreement with values estimated from the aforementioned methods. Once tested in conjunction with the non-invasive BTU Meter, the proposed solution and parameter estimation scheme displayed an excellent level of validity and reliability in the results. Given the proposed BTU Meter's non-invasive design and experimental results, the developed solution and parameter estimation scheme shows promise for use in a variety of different residential, commercial, and industrial applications. / MS / This work documents the development of a novel and non-invasive method that measures fluid flow rate and temperature in pipes. While current non-invasive flow meters are able to measure pipe flow rate, they cannot simultaneously measure the internal temperature of the fluid flow, which limits their widespread application. Moreover, devices that are able to determine flow temperature are primarily intrusive and require constant maintenance, which can shut down operation, resulting in downtime and economic loss. Consequently, non-invasive flow rate and temperature measurement systems are becoming increasingly attractive for a variety of operations, including for use in leak detection, energy metering, energy optimization, and oil and gas production, to name a few. This paper presents a new method that utilizes a non-invasive British Thermal Unit (BTU) Meter based on Combined Heat Flux and Temperature Sensor (CHFT+) technology to determine fluid flow rate and temperature in pipes. The non-invasive BTU Meter uses thermal interrogation to determine different flow parameters, which are used to determine the fluid flow rate and temperature inside a pipe. The method was tested and validated for accuracy and reliability through simulations and experiments. Given the proposed BTU Meter’s noninvasive design and excellent experimental results, the developed novel sensing method shows promise for use in a variety of different residential, commercial, and industrial applications.

Terrapins are one of the most endangered vertebrate groups, with almost half of the more than 300 extant species threatened with extinction. This study was conducted to investigate parasite host-switching from the invasive American Red-eared slider, Trachemys scripta elegans, to the native Mediterranean pond terrapin, Mauremys leprosa in natural environments in southern France and Spain. The study also included a risk assessment approach that was developed to assess the viability of the native M. leprosa terrapins in a small river of southern France. The diversity of haemogregarine parasites within South African terrapins was also explored. The thesis is structured as follows: CHAPTER 1 gives a broad introduction to reptiles and chelonians as well as the importance of chelonians in ecosystems with emphasis to the threats that are driving terrapins to decline. The various terrapin species examined during this study as well as the parasite groups of interest (Monogenea and Apicomplexa) are also discussed in detail. CHAPTER 2 documents the extent of platyhelminth invasions from T. s. elegans to natural M. leprosa populations in northern Spain and southern France. From DNA barcoding analysis based on the sequencing of the Cytochrome c Oxidase I gene, the inferred Minimum Evolution tree and p-distance comparisons of closely related haplotypes revealed a greater polystome richness within M. leprosa than expected, suggesting that host switching may take place in natural environments. T. s. elegans would serve as a carrier for a variety of polystomes that usually infest American turtles in their home range. These are transmitted to M. leprosa throughout the south of France, also suggesting that turtle polystomes are not strictly host-specific. CHAPTER 3 investigates polystome egg production under changing environmental conditions. The experimental procedure that was conducted on M. leprosa showed that environmental temperature has an effect on the egg laying rhythm of its parasite, i.e., Neopolystoma sp., with a two day lag of egg production in response to environmental temperature change. Results suggest the adaptability of the parasite to the physiology of their chelonian hosts which are ecthothermic animals. They also show that eggs production may be attributable to the release of host factors like hormones that once secreted may act and stimulate parasite reproduction. CHAPTER 4 relates risk assessment for the viability of the native Mediterranean pond terrapin (M. leprosa) in a natural environment by using the Relative Risk Model (RRM) method, taking into consideration various threats and environmental conditions that may impact this species. CHAPTER 5 examines the diversity of South African terrapin haemogregarines (Protozoa: Apicomplexa: Haemogregarinidae) as well as their phylogenetic placement among haemogregarines based on molecular and morphological evidences. CHAPTER 6 summarizes all findings of the study and explores new ways of Research. / PhD (Zoology), North-West University, Potchefstroom Campus, 2014

Terrapins are one of the most endangered vertebrate groups, with almost half of the more than 300 extant species threatened with extinction. This study was conducted to investigate parasite host-switching from the invasive American Red-eared slider, Trachemys scripta elegans, to the native Mediterranean pond terrapin, Mauremys leprosa in natural environments in southern France and Spain. The study also included a risk assessment approach that was developed to assess the viability of the native M. leprosa terrapins in a small river of southern France. The diversity of haemogregarine parasites within South African terrapins was also explored. The thesis is structured as follows: CHAPTER 1 gives a broad introduction to reptiles and chelonians as well as the importance of chelonians in ecosystems with emphasis to the threats that are driving terrapins to decline. The various terrapin species examined during this study as well as the parasite groups of interest (Monogenea and Apicomplexa) are also discussed in detail. CHAPTER 2 documents the extent of platyhelminth invasions from T. s. elegans to natural M. leprosa populations in northern Spain and southern France. From DNA barcoding analysis based on the sequencing of the Cytochrome c Oxidase I gene, the inferred Minimum Evolution tree and p-distance comparisons of closely related haplotypes revealed a greater polystome richness within M. leprosa than expected, suggesting that host switching may take place in natural environments. T. s. elegans would serve as a carrier for a variety of polystomes that usually infest American turtles in their home range. These are transmitted to M. leprosa throughout the south of France, also suggesting that turtle polystomes are not strictly host-specific. CHAPTER 3 investigates polystome egg production under changing environmental conditions. The experimental procedure that was conducted on M. leprosa showed that environmental temperature has an effect on the egg laying rhythm of its parasite, i.e., Neopolystoma sp., with a two day lag of egg production in response to environmental temperature change. Results suggest the adaptability of the parasite to the physiology of their chelonian hosts which are ecthothermic animals. They also show that eggs production may be attributable to the release of host factors like hormones that once secreted may act and stimulate parasite reproduction. CHAPTER 4 relates risk assessment for the viability of the native Mediterranean pond terrapin (M. leprosa) in a natural environment by using the Relative Risk Model (RRM) method, taking into consideration various threats and environmental conditions that may impact this species. CHAPTER 5 examines the diversity of South African terrapin haemogregarines (Protozoa: Apicomplexa: Haemogregarinidae) as well as their phylogenetic placement among haemogregarines based on molecular and morphological evidences. CHAPTER 6 summarizes all findings of the study and explores new ways of Research. / PhD (Zoology), North-West University, Potchefstroom Campus, 2014