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 Truth about Good and Evil: A Mixed-Methods Approach to Color Theory

The color theory of good and evil is the association of colors to the omnipresent concept of good and evil, where human behavior and perception can be highly influenced by seeing black and white, making these connotations almost dangerously distinctive where they can be very hard to distinguish. This theory is a human construct that dates back to ancient Egypt and has been used since then in almost all forms of communication and expression, such as art, fashion, literature, and religious manuscripts, helping the implantation of preconceived ideas that influence behavior and society. This is a mixed-methods research that uses both surveys to collect quantitative data related to the theory and a vignette to collect qualitative data by using a scenario where participants aged between 18-25 will style two characters of good and bad characteristics with color contrasting clothes, both yielding results about the nature of the preconceived perceptions associated with ‘black and white’ and ‘good and evil’, illustrating the important role of media and communications in human behavior and subconscious, and also uncover how far this theory goes in the age of social media enlightenment.

Providing a Secure, Reliable and Decentralized Document Management Solution Using Blockchain by a Virtual Identity Card

In today's world, we need documents everywhere for a smooth workflow in the identification process or any other security aspects. The current system and techniques which are used for identification need one thing, that is ‘proof of existence’, which involves valid documents, for example, educational, financial, etc. The main issue with the current identity access management system and digital identification process is that the system is centralized in their network, which makes it inefficient. The paper presents the system which resolves all these cited issues. It is based on ‘blockchain’ technology, which is a 'decentralized system'. It allows transactions in a decentralized and immutable manner. The primary notion of the model is to ‘have everything with nothing’. It involves inter-linking required documents of a person with a single identity card so that a person can go anywhere without having the required documents with him/her. The person just needs to be physically present at a place wherein documents are necessary, and using a fingerprint impression and an iris scan print, the rest of the verification will progress. Furthermore, some technical overheads and advancements are listed. This paper also aims to layout its far-vision scenario of blockchain and its impact on future trends.

Human Factors Considerations in New Generation Fighter Planes to Enhance Combat Effectiveness

Role of fighter planes in modern network centric military warfare scenarios has changed significantly in the recent past. New generation fighter planes have multirole capability of engaging both air and ground targets with high precision. Multirole aircraft undertakes missions such as Air to Air combat, Air defense, Air to Surface role (including Air interdiction, Close air support, Maritime attack, Suppression and Destruction of enemy air defense), Reconnaissance, Electronic warfare missions, etc. Designers have primarily focused on development of technologies to enhance the combat performance of the fighter planes and very little attention is given to human factor aspects of technologies. Unique physical and psychological challenges are imposed on the pilots to meet operational requirements during these missions. Newly evolved technologies have enhanced aircraft performance in terms of its speed, firepower, stealth, electronic warfare, situational awareness, and vulnerability reduction capabilities. This paper highlights the impact of emerging technologies on human factors for various military operations and missions. Technologies such as ‘cooperative knowledge-based systems’ to aid pilot’s decision making in military conflict scenarios as well as simulation technologies to enhance human performance is also studied as a part of research work. Current and emerging pilot protection technologies and systems which form part of the integrated life support systems in new generation fighter planes is discussed. System safety analysis application to quantify the human reliability in military operations is also studied.

Non-parametric Linear Technique for Measuring the Efficiency of Winter Road Maintenance in the Arctic Area

Improving the performance of Winter Road Maintenance (WRM) can increase the traffic safety and reduce the cost as well as environmental impacts. This study evaluates the efficiency of WRM technique, named salting, in the Arctic area by using Data Envelopment Analysis (DEA), which is a non-parametric linear method to measure the efficiencies of decision-making units (DMUs) based on handling multiple inputs and multiple outputs at the same time that their associated weights are not known. Here, roads are considered as DMUs for which the efficiency must be determined. The three input variables considered are traffic flow, road area and WRM cost. In addition, the two output variables included are level of safety in the roads and environment impacts resulted from WRM, which is also considered as an uncontrollable factor in the second scenario. The results show the performance of DMUs from the most efficient WRM to the inefficient/least efficient one and this information provides decision makers with technical support and the required suggested improvements for inefficient WRM, in order to achieve a cost-effective WRM and a safe road transportation during wintertime in the Arctic areas.

A Survey of Key Challenges of Adopting Agile in Global Software Development: A Case Study with Malaysia Perspective

Agile methodology is the current most popular technique in software development projects. Agile methods in software development bring optimistic impact on software performances, quality and customer satisfaction. There are some organizations and small-medium enterprises adopting agile into their local software development projects as well as in distributed software development projects. Adopting agile methods in local software development projects is valuable. However, agile global software deployment needs an attention. There are different key challenges in agile global software development that need to resolve and enhance the global software development cycles. The proposed systematic literature review investigates all key challenges of agile in global software development. Moreover, a quantitative methodology (an actual survey) targeted to present a real case scenario of these particular key challenges faced by one of the software houses that is BestWeb Malaysia. The outcomes of systematic literature and the results of quantitative methodology are compared with each other to evaluate if the key challenges pointed out in systematic review still exist. The proposed research and its exploratory results can assist small medium enterprises to avoid these challenges by adopting the best practices in their global software development projects. Moreover, it is helpful for novice researchers to get valuable information altogether.

Development of Requirements Analysis Tool for Medical Autonomy in Long-Duration Space Exploration Missions

Improving resources for medical autonomy of astronauts in prolonged space missions, such as a Mars mission, requires not only technology development, but also decision-making support systems. The Advanced Crew Medical System - Medical Condition Requirements study, funded by the Canadian Space Agency, aimed to create knowledge content and a scenario-based query capability to support medical autonomy of astronauts. The key objective of this study was to create a prototype tool for identifying medical infrastructure requirements in terms of medical knowledge, skills and materials. A multicriteria decision-making method was used to prioritize the highest risk medical events anticipated in a long-term space mission. Starting with those medical conditions, event sequence diagrams (ESDs) were created in the form of decision trees where the entry point is the diagnosis and the end points are the predicted outcomes (full recovery, partial recovery, or death/severe incapacitation). The ESD formalism was adapted to characterize and compare possible outcomes of medical conditions as a function of available medical knowledge, skills, and supplies in a given mission scenario. An extensive literature review was performed and summarized in a medical condition database. A PostgreSQL relational database was created to allow query-based evaluation of health outcome metrics with different medical infrastructure scenarios. Critical decision points, skill and medical supply requirements, and probable health outcomes were compared across chosen scenarios. The three medical conditions with the highest risk rank were acute coronary syndrome, sepsis, and stroke. Our efforts demonstrate the utility of this approach and provide insight into the effort required to develop appropriate content for the range of medical conditions that may arise.

An Efficient Approach for Shear Behavior Definition of Plant Stalk

The information of the impact cutting behavior of plants stalk plays an important role in the design and fabrication of plants cutting equipment. It is difficult to investigate a theoretical method for defining cutting properties of plants stalks because the cutting process is complex. Thus, it is necessary to set up an experimental approach to determine cutting parameters for a single stalk. To measure the shear force, shear energy and shear strength of plant stalk, a special impact cutting tester was fabricated. It was similar to an Izod impact cutting tester for metals but a cutting blade and data acquisition system were attached to the end of pendulum's arm. The apparatus was included four strain gages and a digital indicator to show the real-time cutting force of plant stalk. To measure the shear force and also testing the apparatus, two plants’ stalks, like buxus and privet, were selected. The samples (buxus and privet stalks) were cut under impact cutting process at four loading rates 1, 2, 3 and 4 m.s-1 and three internodes fifth, tenth and fifteenth by the apparatus. At buxus cutting analysis: the minimum value of cutting energy was obtained at fifth internode and loading rate 4 m.s-1 and the maximum value of shear energy was obtained at fifteenth internode and loading rate 1 m.s-1. At privet cutting analysis: the minimum value of shear consumption energy was obtained at fifth internode and loading rate: 4 m.s-1 and the maximum value of shear energy was obtained at fifteenth internode and loading rate: 1 m.s-1. The statistical analysis at both plants showed that the increase of impact cutting speed would decrease the shear consumption energy and shear strength. In two scenarios, the results showed that with increase the cutting speed, shear force would decrease.

Spatial Disparity in Education and Medical Facilities: A Case Study of Barddhaman District, West Bengal, India

The economic scenario of any region does not show the real picture for the measurement of overall development. Therefore, economic development must be accompanied by social development to be able to make an assessment to measure the level of development. The spatial variation with respect to social development has been discussed taking into account the quality of functioning of a social system in a specific area. In this paper, an attempt has been made to study the spatial distribution of social infrastructural facilities and analyze the magnitude of regional disparities at inter- block level in Barddhman district. It starts with the detailed account of the selection process of social infrastructure indicators and describes the methodology employed in the empirical analysis. Analyzing the block level data, this paper tries to identify the disparity among the blocks in the levels of social development. The results have been subsequently explained using both statistical analysis and geo spatial technique. The paper reveals that the social development is not going on at the same rate in every part of the district. Health facilities and educational facilities are concentrated at some selected point. So overall development activities come to be concentrated in a few centres and the disparity is seen over the blocks.

Triple Intercell Bar for Electrometallurgical Processes: A Design to Increase PV Energy Utilization

PV energy prices are declining rapidly. To take advantage of the benefits of those prices and lower the carbon footprint, operational practices must be modified. Undoubtedly, it challenges the electrowinning practice to operate at constant current throughout the day. This work presents a technology that contributes in providing modulation capacity to the electrode current distribution system. This is to raise the day time dc current and lower it at night. The system is a triple intercell bar that operates in current-source mode. The design is a capping board free dogbone type of bar that ensures an operation free of short circuits, hot swapability repairs and improved current balance. This current-source system eliminates the resetting currents circulating in equipotential bars. Twin auxiliary connectors are added to the main connectors providing secure current paths to bypass faulty or impaired contacts. All system conductive elements are positioned over a baseboard offering a large heat sink area to the ventilation of a facility. The system works with lower temperature than a conventional busbar. Of these attributes, the cathode current balance property stands out and is paramount for day/night modulation and the use of photovoltaic energy. A design based on a 3D finite element method model predicting electric and thermal performance under various industrial scenarios is presented. Preliminary results obtained in an electrowinning facility with industrial prototypes are included.

Interactive Effects in Blended Learning Mode: Exploring Hybrid Data Sources and Iterative Linkages

This paper presents an approach for identifying interactive effects using Network Science (NS) supported by Social Network Analysis (SNA) techniques. Based on general observations that learning processes and behaviors are shaped by the social relationships and influenced by learning environment, the central idea was to understand both the human and non-human interactive effects for a blended learning mode of delivery of computer science modules. Important findings include (a) the importance of non-human nodes to influence the centrality and transfer; (b) the degree of non-human and human connectivity impacts learning. This project reveals that the NS pattern and connectivity as measured by node relationships offer alternative approach for hypothesis generation and design of qualitative data collection. An iterative process further reinforces the analysis, whereas the experimental simulation option itself is an interesting alternative option, a hybrid combination of both experimental simulation and qualitative data collection presents itself as a promising and viable means to study complex scenario such as blended learning delivery mode. The primary value of this paper lies in the design of the approach for studying interactive effects of human (social nodes) and non-human (learning/study environment, Information and Communication Technologies (ICT) infrastructures nodes) components. In conclusion, this project adds to the understanding and the use of SNA to model and study interactive effects in blended social learning.

Demonstration of Land Use Changes Simulation Using Urban Climate Model

Cities in their historical evolution have always adapted their internal structure to the needs of society (for example protective city walls during classicism era lost their defense function, became unnecessary, were demolished and gave space for new features such as roads, museums or parks). Today it is necessary to modify the internal structure of the city in order to minimize the impact of climate changes on the environment of the population. This article discusses the results of the Urban Climate model owned by VITO, which was carried out as part of a project from the European Union's Horizon grant agreement No 730004 Pan-European Urban Climate Services Climate-Fit city. The use of the model was aimed at changes in land use and land cover in cities related to urban heat islands (UHI). The task of the application was to evaluate possible land use change scenarios in connection with city requirements and ideas. Two pilot areas in the Czech Republic were selected. One is Ostrava and the other Hodonín. The paper provides a demonstration of the application of the model for various possible future development scenarios. It contains an assessment of the suitability or inappropriateness of scenarios of future development depending on the temperature increase. Cities that are preparing to reconstruct the public space are interested in eliminating proposals that would lead to an increase in temperature stress as early as in the assignment phase. If they have evaluation on the unsuitability of some type of design, they can limit it into the proposal phases. Therefore, especially in the application of models on Local level - in 1 m spatial resolution, it was necessary to show which type of proposals would create a significant temperature island in its implementation. Such a type of proposal is considered unsuitable. The model shows that the building itself can create a shady place and thus contribute to the reduction of the UHI. If it sensitively approaches the protection of existing greenery, this new construction may not pose a significant problem. More massive interventions leading to the reduction of existing greenery create a new heat island space.

Single-Camera Basketball Tracker through Pose and Semantic Feature Fusion

Tracking sports players is a widely challenging scenario, specially in single-feed videos recorded in tight courts, where cluttering and occlusions cannot be avoided. This paper presents an analysis of several geometric and semantic visual features to detect and track basketball players. An ablation study is carried out and then used to remark that a robust tracker can be built with Deep Learning features, without the need of extracting contextual ones, such as proximity or color similarity, nor applying camera stabilization techniques. The presented tracker consists of: (1) a detection step, which uses a pretrained deep learning model to estimate the players pose, followed by (2) a tracking step, which leverages pose and semantic information from the output of a convolutional layer in a VGG network. Its performance is analyzed in terms of MOTA over a basketball dataset with more than 10k instances.

Measuring Banks’ Antifragility via Fuzzy Logic

Analysing the world banking sector, we realize that traditional risk measurement methodologies no longer reflect the actual scenario with uncertainty and leave out events that can change the dynamics of markets. Considering this, regulators and financial institutions began to search more realistic models. The aim is to include external influences and interdependencies between agents, to describe and measure the operationalization of these complex systems and their risks in a more coherent and credible way. Within this context, X-Events are more frequent than assumed and, with uncertainties and constant changes, the concept of antifragility starts to gain great prominence in comparison to others methodologies of risk management. It is very useful to analyse whether a system succumbs (fragile), resists (robust) or gets benefits (antifragile) from disorder and stress. Thus, this work proposes the creation of the Banking Antifragility Index (BAI), which is based on the calculation of a triangular fuzzy number – to "quantify" qualitative criteria linked to antifragility.

Vr-GIS and Ar-GIS In Education: A Case Study

ICT tools and platforms endorse more and more educational process. Many models and techniques for people to be educated and trained about specific topics and skills do exist, as classroom lectures with textbooks, computers, handheld devices and others. The choice to what extent ICT is applied within learning contexts is related to personal access to technologies as well as to the infrastructure surrounding environment. Among recent techniques, the adoption of Virtual Reality (VR) and Augmented Reality (AR) provides significant impulse in fully engaging users senses. In this paper, an application of AR/VR within Geographic Information Systems (GIS) context is presented. It aims to provide immersive environment experiences for educational and training purposes (e.g. for civil protection personnel), useful especially for situations where real scenarios are not easily accessible by humans. First acknowledgments are promising for building an effective tool that helps civil protection personnel training with risk reduction.

Analyzing Façade Scenarios and Daylight Levels in the Reid Building: A Reflective Case Study on the Designed Daylight under Overcast Sky

This study presents the use of daylight in the case study of the Reid building at the Glasgow School of Art in the city of Glasgow, UK. In Nordic countries, daylight is one of the main considerations within building design, especially in the face of long, lightless winters. A shortage of daylight, contributing to dark and gloomy conditions, necessitates that designs incorporate strong daylight performance. As such, the building in question is designed to capture natural light for varying needs, where studios are located on the North and South façades. The study’s approach presents an analysis of different façade scenarios, where daylight from the North is observed, analyzed and compared with the daylight from the South façade for various design studios in the building. The findings then are correlated with the results of daylight levels from the daylight simulation program (Autodesk Ecotect Analysis) for the investigated studios. The study finds there to be a dramatic difference in daylight nature and levels between the North and South façades, where orientation, obstructions and designed façade fenestrations have major effects on the findings. The study concludes that some of the studios positioned on the North façade do not have a desirable quality of diffused northern light, due to the outside building’s obstructions, area and volume of the studio and the shadow effect of the designed mezzanine floor in the studios.

Investigating the Pedestrian Willingness to Pay to Choose Appropriate Policies for Improving the Safety of Pedestrian Facilities

Road traffic accidents lead to a higher rate of death and injury, especially in vulnerable road users such as pedestrians. Improving the safety of facilities for pedestrians is a major concern for policymakers because of the high number of pedestrian fatalities and direct and indirect costs which are imposed to the society. This study focuses on the idea of determining the willingness to pay of pedestrians for increasing their safety while crossing the street. In this study, three different scenarios including crossing the street with zebra crossing facilities, crossing the street with zebra crossing facilities and installing a pedestrian traffic light and constructing a pedestrian bridge with escalator are presented. The research was conducted based on stated preferences method. The required data were collected from a questionnaire that consisted of three parts: pedestrian’s demographic characteristics, travel characteristics and scenarios. Four different payment amounts are presented for each scenario and a logit model has been built for each proposed payment. The results show that sex, age, education, average household income and individual salary have significant effect on choosing a scenario. Among the policies that have been mentioned through the questionnaire scenarios, the scenario of crossing the street with zebra crossing facilities and installing a traffic lights is the most frequent, with willingness to pay 10,000 Rials and the scenario of crossing the street with a zebra crossing with a willingness to pay 100,000 Rials having the least frequency. For all scenarios, as the payment is increasing, the willingness to pay decreases.

Game-Theory-Based on Downlink Spectrum Allocation in Two-Tier Networks

The capacity of conventional cellular networks has reached its upper bound and it can be well handled by introducing femtocells with low-cost and easy-to-deploy. Spectrum interference issue becomes more critical in peace with the value-added multimedia services growing up increasingly in two-tier cellular networks. Spectrum allocation is one of effective methods in interference mitigation technology. This paper proposes a game-theory-based on OFDMA downlink spectrum allocation aiming at reducing co-channel interference in two-tier femtocell networks. The framework is formulated as a non-cooperative game, wherein the femto base stations are players and frequency channels available are strategies. The scheme takes full account of competitive behavior and fairness among stations. In addition, the utility function reflects the interference from the standpoint of channels essentially. This work focuses on co-channel interference and puts forward a negative logarithm interference function on distance weight ratio aiming at suppressing co-channel interference in the same layer network. This scenario is more suitable for actual network deployment and the system possesses high robustness. According to the proposed mechanism, interference exists only when players employ the same channel for data communication. This paper focuses on implementing spectrum allocation in a distributed fashion. Numerical results show that signal to interference and noise ratio can be obviously improved through the spectrum allocation scheme and the users quality of service in downlink can be satisfied. Besides, the average spectrum efficiency in cellular network can be significantly promoted as simulations results shown.

Meeting Criminogenic Needs to Reduce Recidivism: The Diversion of Vulnerable Offenders from the Criminal Justice System into Care

Once in touch with the Criminal Justice System, offenders with mental disorder tend to return to custody more often than nondisordered individuals, which suggests they have not been receiving appropriate treatment in prison. In this scenario, diverting individuals into care as early as possible in their trajectory seems to be the appropriate approach to rehabilitate mentally unwell offenders and alleviate overcrowded prisons. This paper builds on an ethnographic research investigating the challenges encountered by practitioners working to divert offenders into care while attempting to establish cross-boundary interactions with professionals in the Criminal Justice System and Mental Health Services in the UK. Drawing upon the findings of the study, this paper suggests the development of adequate tools to enable liaison between agencies which ultimately results in successful interventions.

Maximization of Lifetime for Wireless Sensor Networks Based on Energy Efficient Clustering Algorithm

Since last decade, wireless sensor networks (WSNs) have been used in many areas like health care, agriculture, defense, military, disaster hit areas and so on. Wireless Sensor Networks consist of a Base Station (BS) and more number of wireless sensors in order to monitor temperature, pressure, motion in different environment conditions. The key parameter that plays a major role in designing a protocol for Wireless Sensor Networks is energy efficiency which is a scarcest resource of sensor nodes and it determines the lifetime of sensor nodes. Maximizing sensor node’s lifetime is an important issue in the design of applications and protocols for Wireless Sensor Networks. Clustering sensor nodes mechanism is an effective topology control approach for helping to achieve the goal of this research. In this paper, the researcher presents an energy efficiency protocol to prolong the network lifetime based on Energy efficient clustering algorithm. The Low Energy Adaptive Clustering Hierarchy (LEACH) is a routing protocol for clusters which is used to lower the energy consumption and also to improve the lifetime of the Wireless Sensor Networks. Maximizing energy dissipation and network lifetime are important matters in the design of applications and protocols for wireless sensor networks. Proposed system is to maximize the lifetime of the Wireless Sensor Networks by choosing the farthest cluster head (CH) instead of the closest CH and forming the cluster by considering the following parameter metrics such as Node’s density, residual-energy and distance between clusters (inter-cluster distance). In this paper, comparisons between the proposed protocol and comparative protocols in different scenarios have been done and the simulation results showed that the proposed protocol performs well over other comparative protocols in various scenarios.