A Study to Evaluate the Effectiveness of Simulation on Anaesthetic Non-Technical Skills in the Management of Major Trauma Patients

Background: Dynamic, challenging instances during the management of major trauma patients requires optimal team intervention to ensure patient safety and effective crisis management. These factors highlight the importance of increased awareness in both technical and non-technical skills (NTS) training. Simulation based training (SBT) is an effective tool that replicates and teaches the required clinical skills, resulting in teamwork improvement, better patient safety, and care. Aims: This study investigates change in NTS, during the management of major trauma patients, using SBT. We also investigated the relationship between NTS performance and participation in previous NTS workshop (NTSW), years of experience, previous simulation (PS), previous exposure to major trauma patient management (MTPM) and group size. Methods: NTS behaviours were assessed by a single rater using previously validated framework for observing and rating Anaesthetists’ Non-Technical Skills (ANTS) for anaesthetists and Anaesthetic Non-Technical Skills for Anaesthetic Practitioners (ANTS-AP) for anaesthetic nurses during SBT. Two anaesthetists (one senior, one junior) together with one to four registered anaesthetic nurses formed 17 teams. The SBT consisted of 3 major trauma scenarios: 1) Major haemorrhage following multiple stab wounds to the torso, 2) Traumatic brain injury complicated by unanticipated difficult intubation, and 3) Penetrating neck injury with major haemorrhage, complicated by a failed intubation. The scores of each NTS category for each scenario are evaluated for significance in change and used to correlate whether NTS during the simulation were affected by previous NTSW, PS, previous exposure to MTPM and group size. Results: The resulting anaesthetists and anesthetic nurses’ p-values were < 0.05 indicating a significant improvement in all NTS resulting from score differences between scenarios 1 & 2 and 1 & 3. Anaesthetists’ NTS categories were not influenced by PS, previous NTSW, and exposure to MTPM. However, anaesthetic nurses NTS categories were influenced by PS, exposure to MTPM but not by NTSW. Conclusions: SBT has shown to be effective in improving the NTS for both anaesthetists and anaesthetic nurses. This enhances safety and team performance for MTPM. The impact of SBT in the clinical environment for patient management and safety warrants further research.

The Study of Japanese Religion and State Power in Early Tokugawa Period Based on the Religious Rule of Tokugawa Ieyasu

Tokugawa period has been highly discussed by many scholars as the transition from feudal society to capitalist nation. Religion was a very significant feature of Tokugawa period because of the association of religion and state power in Tokugawa period. One important way to interpret the relationship between religion and state power in Tokugawa period is to discuss the religious rule of Tokugawa Ieyasu, who was the first general in Tokugawa period. In the past researches, Sonehara and Hirano have discussed the religious belief of Tokugawa Ieyasu. Sonehara focuses on the Tokugawa Ieyasu’s religious belief of Tiantai Buddhist and his religious activities. He holds the view that Tokugawa Ieyasu proceeded religious activities frequently in his old age is aimed at consolidating his political position. Compared with the analysis of Sonehara, Hirano’s analysis pays more attention to the connection between Tokugawa Ieyasu and Jingtu buddhist. On the other hand, such as Takaki, Okuwa and other researchers have also discussed the religious belief of Tokugawa Ieyasu. However, most of the research has focused on the exploration of Tokugawa Ieyasu's religious view, ignoring the specific religious rules and interpretation of the concept of Tokugawa Ieyasu’s deification. This paper aims to focus on the religious policy and religious activities and the deification of Tokugawa Ieyasu to investigate the religious rule of the early Tokugawa period by the method of thought history and religious history. Through analyzing the historical data of temples and the last words of Tokugawa Ieyasu, this paper concludes that Tokugawa Ieyasu adopted flexible policies for different denominations in the early period. At the same time, Tokugawa Ieyasu was aimed at creating godship which the main factor is the spirit of warriors, thereby making religion turn into a vital part of the shogunate power.

Challenges and Professional Perspectives for Pedagogy Undergraduates with Specific Learning Disability: A Greek Case Study

Specific learning disability (SLD) in higher education has been partially explored in Greece so far. Moreover, opinions on professional perspectives for university students with SLD, is scarcely encountered in Greek research. The perceptions of the hidden character of SLD along with the university policy towards it and professional perspectives that result from this policy have been examined in the present research. This study has applied the paradigm of a Greek Tertiary Pedagogical Education Department (Early Childhood Education). Via mixed methods, data have been collected from different groups of people in the Pedagogical Department: students with SLD and without SLD, academic staff and administration staff, all of which offer the opportunity for triangulation of the findings. Qualitative methods include ten interviews with students with SLD and 15 interviews with academic staff and 60 hours of observation of the students with SLD. Quantitative methods include 165 questionnaires completed by third and fourth-year students and five questionnaires completed by the administration staff. Thematic analyses of the interviews’ data and descriptive statistics on the questionnaires’ data have been applied for the processing of the results. The use of medical terms to define and understand SLD was common in the student cohort, regardless of them having an SLD diagnosis. However, this medical model approach is far more dominant in the group of students without SLD who, by majority, hold misconceptions on a definitional level. The academic staff group seems to be leaning towards a social approach concerning SLD. According to them, diagnoses may lead to social exclusion. The Pedagogical Department generally endorses the principles of inclusion and complies with the provision of oral exams for students with SLD. Nevertheless, in practice, there seems to be a lack of regular academic support for these students. When such support does exist, it is only through individual initiatives. With regards to their prospective profession, students with SLD can utilize their personal experience, as well as their empathy; these appear to be unique weapons in their hands –in comparison with other educators− when it comes to teaching students in the future. In the Department of Pedagogy, provision towards SLD results sporadic, however the vision of an inclusive department does exist. Based on their studies and their experience, pedagogy students with SLD claim that they have an experiential internalized advantage for their future career as educators.

Pilot Trial of Evidence-Based Integrative Group Therapy to Improve Executive Functioning among Adults: Implications for Community Mental Health and Training Clinics

Objective: Executive functioning (EF) deficits underlie several mental health diagnoses including ADHD, anxiety, and depression. Community mental health clinics face extensive waitlists for services with many referrals involving EF deficits. A pilot trial of a four-week group therapy was developed using key components from Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and mindfulness with an aim to improve EF skills and offer low-fee services. Method: Eight adults (M = 34.5) waiting for services at a community clinic were enrolled in a four-week group therapy at an in-house training clinic for doctoral trainees. Baseline EF, pre-/post-intervention ADHD and distress symptoms, group satisfaction, and curriculum helpfulness were assessed. Results: Downward trends in ADHD and distress symptoms pre/post-intervention were not significant. Favorable responses on group satisfaction and helpfulness suggest clinical utility. Conclusion: Preliminary pilot data from a brief group therapy to improve EF may be an efficacious, acceptable, and feasible intervention for adults waiting for services at community mental health and training clinics where there are high demands and limits to services and staffs.

A Review of Ultralightweight Mutual Authentication Protocols

Radio Frequency Identification (RFID) is one of the most commonly used technologies in IoTs and Wireless Sensor Networks which makes the devices identification and tracking extremely easy to manage. Since RFID uses wireless channel for communication, which is open for all types of adversaries, researchers have proposed many Ultralightweight Mutual Authentication Protocols (UMAPs) to ensure security and privacy in a cost-effective manner. These UMAPs involve simple bitwise logical operators such as XOR, AND, OR & Rot, etc., to design the protocol messages. However, most of these UMAPs were later reported to be vulnerable against many malicious attacks. In this paper, we have presented a detailed overview of some eminent UMAPs and also discussed the many security attacks on them. Finally, some recommendations and suggestions have been discussed, which can improve the design of the UMAPs.

Omni: Data Science Platform for Evaluate Performance of a LoRaWAN Network

Nowadays, physical processes are becoming digitized by the evolution of communication, sensing and storage technologies which promote the development of smart cities. The evolution of this technology has generated multiple challenges related to the generation of big data and the active participation of electronic devices in society. Thus, devices can send information that is captured and processed over large areas, but there is no guarantee that all the obtained data amount will be effectively stored and correctly persisted. Because, depending on the technology which is used, there are parameters that has huge influence on the full delivery of information. This article aims to characterize the project, currently under development, of a platform that based on data science will perform a performance and effectiveness evaluation of an industrial network that implements LoRaWAN technology considering its main parameters configuration relating these parameters to the information loss.

Hybrid Gravity Gradient Inversion-Ant Colony Optimization Algorithm for Motion Planning of Mobile Robots

Motion planning is a common task required to be fulfilled by robots. A strategy combining Ant Colony Optimization (ACO) and gravity gradient inversion algorithm is proposed for motion planning of mobile robots. In this paper, in order to realize optimal motion planning strategy, the cost function in ACO is designed based on gravity gradient inversion algorithm. The obstacles around mobile robot can cause gravity gradient anomalies; the gradiometer is installed on the mobile robot to detect the gravity gradient anomalies. After obtaining the anomalies, gravity gradient inversion algorithm is employed to calculate relative distance and orientation between mobile robot and obstacles. The relative distance and orientation deduced from gravity gradient inversion algorithm is employed as cost function in ACO algorithm to realize motion planning. The proposed strategy is validated by the simulation and experiment results.

Analytical Authentication of Butter Using Fourier Transform Infrared Spectroscopy Coupled with Chemometrics

Fourier Transform Infrared (FT-IR) spectroscopy coupled with chemometrics was used to distinguish between butter samples and non-butter samples. Further, quantification of the content of margarine in adulterated butter samples was investigated. Fingerprinting region (1400-800 cm–1) was used to develop unsupervised pattern recognition (Principal Component Analysis, PCA), supervised modeling (Soft Independent Modelling by Class Analogy, SIMCA), classification (Partial Least Squares Discriminant Analysis, PLS-DA) and regression (Partial Least Squares Regression, PLS-R) models. PCA of the fingerprinting region shows a clustering of the two sample types. All samples were classified in their rightful class by SIMCA approach; however, nine adulterated samples (between 1% and 30% w/w of margarine) were classified as belonging both at the butter class and at the non-butter one. In the two-class PLS-DA model’s (R2 = 0.73, RMSEP, Root Mean Square Error of Prediction = 0.26% w/w) sensitivity was 71.4% and Positive Predictive Value (PPV) 100%. Its threshold was calculated at 7% w/w of margarine in adulterated butter samples. Finally, PLS-R model (R2 = 0.84, RMSEP = 16.54%) was developed. PLS-DA was a suitable classification tool and PLS-R a proper quantification approach. Results demonstrate that FT-IR spectroscopy combined with PLS-R can be used as a rapid, simple and safe method to identify pure butter samples from adulterated ones and to determine the grade of adulteration of margarine in butter samples.

Stress Distribution in Axisymmetric Indentation of an Elastic Layer-Substrate Body

We focus on internal stress and displacement of an elastic axisymmetric contact problem for indentation of a layer-substrate body. An elastic layer is assumed to be perfectly bonded to an elastic semi-infinite substrate. The elastic layer is smoothly indented with a flat-ended cylindrical indenter. The analytical and exact solutions were obtained by solving an infinite system of simultaneous equations using the method to express a normal contact stress at the upper surface of the elastic layer as an appropriate series. This paper presented the numerical results of internal stress and displacement distributions for hard-coating system with constant values of Poisson’s ratio and the thickness of elastic layer.

Geographic Information Systems as a Tool to Support the Sustainable Development Goals

Geographic Information Systems (GIS) is a multipurpose computer-based tool that provides a sophisticated ability to map and analyze data on different spatial layers. However, GIS is far more easily applied in some policy areas than others. This paper seeks to determine the areas of sustainable development, including environmental, economic, and social dimensions, where GIS has been used to date to support efforts to implement the United Nations Sustainable Development Goals (SDGs), and to discuss potential areas where it might be used more. Based on an extensive analysis of published literature, we ranked the SDGs according to how frequently GIS has been used to study related policy. We found that SDG#15 “Life on Land” is most often addressed with GIS, following by SDG#11 “Sustainable Cities and Communities”, and SDG#13 “Climate Action”. On the other hand, we determined that SDG#2 “Zero Hunger”, SDG#8 “Decent Work and Economic Growth”, and SDG#16 “Peace, Justice, and Strong Institutions” are least addressed with GIS. The paper outlines some specific ways that GIS might be applied to the SDGs least linked to this tool currently.

Methyltrioctylammonium Chloride as a Separation Solvent for Binary Mixtures: Evaluation Based on Experimental Activity Coefficients

An ammonium based ionic liquid (methyltrioctylammonium chloride) [N8 8 8 1] [Cl] was investigated as an extraction potential solvent for volatile organic solvents (in this regard, solutes), which includes alkenes, alkanes, ketones, alkynes, aromatic hydrocarbons, tetrahydrofuran (THF), alcohols, thiophene, water and acetonitrile based on the experimental activity coefficients at infinite THF measurements were conducted by the use of gas-liquid chromatography at four different temperatures (313.15 to 343.15) K. Experimental data of activity coefficients obtained across the examined temperatures were used in order to calculate the physicochemical properties at infinite dilution such as partial molar excess enthalpy, Gibbs free energy and entropy term. Capacity and selectivity data for selected petrochemical extraction problems (heptane/thiophene, heptane/benzene, cyclohaxane/cyclohexene, hexane/toluene, hexane/hexene) were computed from activity coefficients data and compared to the literature values with other ionic liquids. Evaluation of activity coefficients at infinite dilution expands the knowledge and provides a good understanding related to the interactions between the ionic liquid and the investigated compounds.

Adaptive Multiple Transforms Hardware Architecture for Versatile Video Coding

The Versatile Video Coding standard (VVC) is actually under development by the Joint Video Exploration Team (or JVET). An Adaptive Multiple Transforms (AMT) approach was announced. It is based on different transform modules that provided an efficient coding. However, the AMT solution raises several issues especially regarding the complexity of the selected set of transforms. This can be an important issue, particularly for a future industrial adoption. This paper proposed an efficient hardware implementation of the most used transform in AMT approach: the DCT II. The developed circuit is adapted to different block sizes and can reach a minimum frequency of 192 MHz allowing an optimized execution time.

Study on the Use of Manganese-Containing Materials as a Micro Fertilizer Based on the Local Mineral Resources and Industrial Wastes in Hydroponic Systems

Hydroponic greenhouses systems (production of the artificial substrate without soil) are becoming popular in the world. Mostly the system is used to grow vegetables and berries. Different countries are taking action to participate in the development of hydroponic technology and solutions such as EU members, Turkey, Australia, New Zealand, Israel, Scandinavian countries, etc. Many vegetables and berries are grown by hydroponics in Europe. As a result of our research, we have obtained material containing manganese and nitrogen. It became possible to produce this fertilizer by means of one-stage thermal processing, using industrial waste containing manganese (ores and sludges) and mineral substance (ammonium nitrate) that exist in Georgia. The received material is usable as a micro-fertilizer with economic efficiency. It became possible to turn practically water-insoluble manganese dioxide substance into the soluble condition from industrial waste in an indirect way. The ability to use the material as a fertilizer is predetermined by its chemical and phase composition, as the amount of the active component of the material in relation to manganese is 30%. At the same time, the active component elements presented non-ballast sustained action compounds. The studies implemented in Poland and in Georgia by us have shown that the manganese-containing micro-fertilizer- Mn(NO3)2 can provide the plant with nitrate nitrogen, which is a form that can be used for plants, providing the economy and simplicity of the application of fertilizers. Given the fact that the application of the manganese-containing micro-fertilizers significantly increases the productivity and improves the quality of the big number of agricultural products, it is necessary to mention that it is recommended to introduce the manganese containing fertilizers into the following cultures: sugar beet, corn, potato, vegetables, vine grape, fruit, berries, and other cultures. Also, as a result of the study, it was established that the material obtained is the predominant fertilizer for vegetable cultures in the soil. Based on the positive results of the research, we consider it expedient to conduct research in hydroponic systems, which will enable us to provide plants the required amount of manganese; we also introduce nitrogen in solution and regulate the solution of pH, which is one of the main problems in hydroponic production. The findings of our research will be used in hydroponic greenhouse farms to increase the fertility of vegetable crops and, consequently, to get bountiful and high-quality harvests, which will promote the development of hydroponic greenhouses in Georgia as well as abroad.

Morphology of Indian Female Athletes of Different Track and Field Events

Participation in games and sports in the contemporary times has become more competing with the developed scientific knowledge, skills and methods, along with the equipment and applied research in the field. In spite of India being a large country having vast resources and potential, its performance in the world of sports on the whole needs sincere attention for better achievements. Beside numerous factors responsible for the dismal performance of a sportsperson, the physique and body composition, including the size, shape and form are known to play a significant role. The present investigation was undertaken to study the specific morphological characteristics of Indian female Track and Field athletes. A total of 300 athletes were randomly selected as sample for the purpose of the study from the six events having 50 athletes in each event including 100m., 400m., Shot Put, Discus Throw, Long Jump and High Jump. The study included body weight, body fat percentage, lean body weight, endomorphy, mesomorphy and ectomorphy as variables. The data were computed statistically by using Mean, Standard Deviation and Analysis of Variance. The post-hoc analysis was conducted where the F-ratio was found to be significant at .05 level. The study concluded that there is a significant difference with regard to the selected variables among the Indian female athletes of different track and field events.

Cultural Effects on the Performance of Non- Profit and For-Profit Microfinance Institutions

Using a large dataset of more than 2,400 individual microfinance institutions (MFIs) from 120 countries from 1999 to 2016, this study finds that nearly half of the international MFIs operate as for-profit institutions. Formal institutions (business regulatory environment, property rights, social protection, and a developed financial sector) impact the likelihood of MFIs being for-profit across countries. Cultural differences across countries (power distance, individualism, masculinity, and indulgence) seem to be a factor in the legal status of the MFI (non-profit or for-profit). MFIs in countries with stronger formal institutions, a greater degree of power distance, and a higher degree of collectivism experience better financial and social performance.

Natural Frequency Analysis of a Porous Functionally Graded Shaft System

The vibration characteristics of a functionally graded (FG) rotor model having porosities and micro-voids is investigated using three-dimensional finite element analysis. The FG shaft is mounted with a steel disc located at the midspan. The shaft ends are supported on isotropic bearings. The FG material is composed of a metallic (stainless-steel) and ceramic phase (zirconium oxide) as its constituent phases. The layer wise material property variation is governed by power law. Material property equations are developed for the porosity modelling. Python code is developed to assign the material properties to each layer including the effect of porosities. ANSYS commercial software is used to extract the natural frequencies and whirl frequencies for the FG shaft system. The obtained results show the influence of porosity volume fraction and power-law index, on the vibration characteristics of the ceramic-based FG shaft system.

Model Reference Adaptive Approach for Power System Stabilizer for Damping of Power Oscillations

In recent years, electricity trade between neighboring countries has become increasingly intense. Increasing power transmission over long distances has resulted in an increase in the oscillations of the transmitted power. The damping of the oscillations can be carried out with the reconfiguration of the network or the replacement of generators, but such solution is not economically reasonable. The only cost-effective solution to improve the damping of power oscillations is to use power system stabilizers. Power system stabilizer represents a part of synchronous generator control system. It utilizes semiconductor’s excitation system connected to the rotor field excitation winding to increase the damping of the power system. The majority of the synchronous generators are equipped with the conventional power system stabilizers with fixed parameters. The control structure of the conventional power system stabilizers and the tuning procedure are based on the linear control theory. Conventional power system stabilizers are simple to realize, but they show non-sufficient damping improvement in the entire operating conditions. This is the reason that advanced control theories are used for development of better power system stabilizers. In this paper, the adaptive control theory for power system stabilizers design and synthesis is studied. The presented work is focused on the use of model reference adaptive control approach. Control signal, which assures that the controlled plant output will follow the reference model output, is generated by the adaptive algorithm. Adaptive gains are obtained as a combination of the "proportional" term and with the σ-term extended "integral" term. The σ-term is introduced to avoid divergence of the integral gains. The necessary condition for asymptotic tracking is derived by means of hyperstability theory. The benefits of the proposed model reference adaptive power system stabilizer were evaluated as objectively as possible by means of a theoretical analysis, numerical simulations and laboratory realizations. Damping of the synchronous generator oscillations in the entire operating range was investigated. Obtained results show the improved damping in the entire operating area and the increase of the power system stability. The results of the presented work will help by the development of the model reference power system stabilizer which should be able to replace the conventional stabilizers in power systems.

The Strategic Engine Model: Redefined Strategy Structure, as per Market-and Resource-Based Theory Application, Tested in the Automotive Industry

The purpose of the paper is to redefine the levels of structure of corporate, business and functional strategies that were established over the past several decades, to a conceptual model, consisting of corporate, business and operations strategies, that are reinforced by functional strategies. We will propose a conceptual framework of different perspectives in the role of strategic operations as a separate strategic place and reposition the remaining functional strategies as supporting tools, existing at all three levels. The proposed model is called ‘the strategic engine’, since the mutual relationships of its ingredients are identical with main elements and working principle of the internal combustion engine. Based on theoretical essence, related to every strategic level, we will prove that the strategic engine model is useful for managers seeking to safeguard the competitive advantage of their companies. Each strategy level is researched through its basic elements. At the corporate level we examine the scope of firm’s product, the vertical and geographical coverage. At the business level, the point of interest is limited to the SWOT analysis’ basic elements. While at operations level, the key research issue relates to the scope of the following performance indicators: cost, quality, speed, flexibility and dependability. In this relationship, the paper provides a different view for the role of operations strategy within the overall strategy concept. We will prove that the theoretical essence of operations goes far beyond the scope of traditionally accepted business functions. Exploring the applications of Resource-based theory and Market-based theory within the strategic levels framework, we will prove that there is a logical consequence of the theoretical impact in corporate, business and operations strategy – at every strategic level, the validity of one theory is substituted to the level of the other. Practical application of the conceptual model is tested in automotive industry. Actually, the proposed theoretical concept is inspired by a leading global automotive group – Inchcape PLC, listed on the London Stock Exchange, and constituent of the FTSE 250 Index.

School and Teacher Level Predictors for Students’ Information Literacy in Chinese Rural and Urban Education

This study aimed to investigate the level of secondary school students’ information literacy in China and examine the contribution of school and teacher level factors on students’ information literacy between rural and urban schools. A total of 598 schools, 56415 students and 18286 teachers participated in this study. The findings of this study were as follows: (1) the overall of secondary schools students’ information literacy only reached an average level and urban school students’ information literacy were significantly higher than that of rural school students; (2) In rural schools, teachers’ ICT collaboration was a positive predictor for students’ information literacy, while teachers’ ICT use for learning was identified as a negative predictor of students’ information literacy; (3) In urban schools, ICT management, ICT operation and teachers’ ICT self-efficacy were found to be significantly associated with students’ information literacy. Based on the findings, suggestions for improving students’ information literacy between rural and urban schools were discussed.

Simplified Stress Gradient Method for Stress-Intensity Factor Determination

Several techniques exist for determining stress-intensity factors in linear elastic fracture mechanics analysis. These techniques are based on analytical, numerical, and empirical approaches that have been well documented in literature and engineering handbooks. However, not all techniques share the same merit. In addition to overly-conservative results, the numerical methods that require extensive computational effort, and those requiring copious user parameters hinder practicing engineers from efficiently evaluating stress-intensity factors. This paper investigates the prospects of reducing the complexity and required variables to determine stress-intensity factors through the utilization of the stress gradient and a weighting function. The heart of this work resides in the understanding that fracture emanating from stress concentration locations cannot be explained by a single maximum stress value approach, but requires use of a critical volume in which the crack exists. In order to understand the effectiveness of this technique, this study investigated components of different notch geometry and varying levels of stress gradients. Two forms of weighting functions were employed to determine stress-intensity factors and results were compared to analytical exact methods. The results indicated that the “exponential” weighting function was superior to the “absolute” weighting function. An error band +/- 10% was met for cases ranging from a steep stress gradient in a sharp v-notch to the less severe stress transitions of a large circular notch. The incorporation of the proposed method has shown to be a worthwhile consideration.