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.

Blended Learning through Google Classroom

This paper discusses that good learning involves all academic groups in the school. Blended learning is learning outside the classroom. Google Classroom is a free service learning app for schools, non-profit organizations and anyone with a personal Google account. Facilities accessed through computers and mobile phones are very useful for school teachers and students. Blended learning classrooms using both traditional and technology-based methods for teaching have become the norm for many educators. Using Google Classroom gives students access to online learning. Even if the teacher is not in the classroom, the teacher can provide learning. This is the supervision of the form of the teacher when the student is outside the school.

The Estimation of Bird Diversity Loss and Gain as an Impact of Oil Palm Plantation: Study Case in KJNP Estate Riau Province

The rapid growth of oil palm industry in Indonesia raised many negative accusations from various parties, who said that oil palm plantation is damaging the environment and biodiversity, including birds. Since research on oil palm plantation impacts on bird diversity is still limited, this study needs to be developed in order to gain further learning and understanding. Data on bird diversity were collected in March 2018 in KJNP Estate, Riau Province using strip transect method on five different land cover types (young, intermediate, and old growth of oil palm plantation, high conservation value area, and crops field or the baseline). The observations were conducted simultaneously, with three repetitions. The result shows that the baseline has 19 species of birds and land cover after the oil palm plantation has 39 species. HCV (high conservation value) area has the highest increase in diversity value. Oil palm plantation has changed the composition of bird species. The highest similarity index is shown by young growth oil palm land cover with total score 0.65, meanwhile the lowest similarity index with total score 0.43 is shown by HCV area. Overall, the existence of oil palm plantation made a positive impact by increasing bird species diversity, with total 23 species gained and 3 species lost.

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.

Simulation and Analysis of Polyetheretherketone Implants for Diaphysis Femur Fracture

In the present work, reverse engineering approach has been used to create a 3D model of a fractured femur diaphysis bone using the computed tomography (CT) scan data. Thereafter, a counter fit fixation plate of polyetheretherketone (PEEK) composite has been designed and analyzed considering static physiological loading conditions. Static stress distribution and deformation analysis of the plate have been performed. From the analysis, it has been found that the stresses and deformation developed are quite low. This implies that these designed fixation plates will be able to provide stable fixation and thus resulting in improved fracture union.

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.

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.

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.

The Design of a Die for the Processing of Aluminum through Equal Channel Angular Pressing

The processing of metals through Equal Channel Angular Pressing (ECAP) leads to their remarkable strengthening. The ECAP dies control the amount of strain imposed on the material through its geometry, especially through the angle between the die channels, and thus the microstructural and mechanical properties evolution of the material. The present study describes the design of an ECAP die whose utilization and maintenance are facilitated, and that also controls the eventual undesired flow of the material during processing. The proposed design was validated through numerical simulations procedures using commercial software. The die was manufactured according to the present design and tested. Tests using aluminum alloys also indicated to be suitable for the processing of higher strength alloys.

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.

A Neuroscience-Based Learning Technique: Framework and Application to STEM

Existing learning techniques such as problem-based learning, project-based learning, or case study learning are learning techniques that focus mainly on technical details, but give no specific guidelines on learner’s experience and emotional learning aspects such as arousal salience and valence, being emotional states important factors affecting engagement and retention. Some approaches involving emotion in educational settings, such as social and emotional learning, lack neuroscientific rigorousness and use of specific neurobiological mechanisms. On the other hand, neurobiology approaches lack educational applicability. And educational approaches mainly focus on cognitive aspects and disregard conditioning learning. First, authors start explaining the reasons why it is hard to learn thoughtfully, then they use the method of neurobiological mapping to track the main limbic system functions, such as the reward circuit, and its relations with perception, memories, motivations, sympathetic and parasympathetic reactions, and sensations, as well as the brain cortex. The authors conclude explaining the major finding: The mechanisms of nonconscious learning and the triggers that guarantee long-term memory potentiation. Afterward, the educational framework for practical application and the instructors’ guidelines are established. An implementation example in engineering education is given, namely, the study of tuned-mass dampers for earthquake oscillations attenuation in skyscrapers. This work represents an original learning technique based on nonconscious learning mechanisms to enhance long-term memories that complement existing cognitive learning methods.

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.