The S.T.A.B. Trial - Standardised Testing of Artificial Blood. A comparative study of various products that may be used as artificial blood for high fidelity simulation training in the critical care setting

Aim: In the current climate of medical education, there is an ever-increasing demand for and emphasis on simulation as both a teaching and training tool. The objective of our study was to compare the realism and practicality of a number of artificial blood products that could be used for high-fidelity simulation. Method: A literature and internet search was performed and 15 artificial blood products were identified from a variety of sources. One product was excluded due to its potential toxicity risks. Five observers, blinded to the products, performed two assessments on each product using an evaluation tool with 14 predefined criteria including color, consistency, clotting, and staining potential to manikin skin and clothing. Each criterion was rated using a five-point Likert scale. The products were left for 24 hours, both refrigerated and at room temperature, and then reassessed. Statistical analysis was performed to identify the most suitable products, and both inter- and intra-rater variability were examined. Results: Three products scored consistently well with all five assessors, with one product in particular scoring well in almost every criterion. This highest-rated product had a mean rating of 3.6 of 5.0 (95% posterior Interval 3.4-3.7). Inter-rater variability was minor with average ratings varying from 3.0 to 3.4 between the highest and lowest scorer. Intrarater variability was negligible with good agreement between first and second rating as per weighted kappa scores (K = 0.67). Conclusion: The most realistic and practical form of artificial blood identified was a commercial product called KD151 Flowing Blood Syrup. It was found to be not only realistic in appearance but practical in terms of storage and stain removal.

Teaching and learning science and mathematics through technology practice

In this chapter we review studies of the engagement of students in design projects that emphasise integration of technology practice and the enabling sciences, which include physics and mathematics. We give special attention to affective and conceptual outcomes from innovative interventions of design projects. This is important work because of growing international concern that demand for professionals with technological expertise is increasing rapidly, while the supply of students willing to undertake the rigors of study in the enabling sciences is proportionally reducing (e.g., Barringtion, 2006; Hannover & Kessels, 2004; Yurtseven, 2002). The net effect is that the shortage in qualified workers is having a detrimental effect upon economic and social potential in Westernised countries (e.g., Department of Education, Science and Training [DEST], 2003; National Numeracy Review Panel and National Numeracy Review Secretarial, 2007; Yurtseven, 2002). Interestingly, this trend is reversed in developing economies including China and India (Anderson & Gilbride, 2003).

Expert performance in sport and the dynamics of talent development

Research on expertise, talent identification and development has tended to be mono-disciplinary, typically adopting adopting neurogenetic deterministic or environmentalist positions, with an over-riding focus on operational issues. In this paper the validity of dualist positions on sport expertise is evaluated. It is argued that, to advance understanding of expertise and talent development, a shift towards a multi-disciplinary and integrative science focus is necessary, along with the development of a comprehensive multi-disciplinary theoretical rationale. Here we elucidate dynamical systems theory as a multi-disciplinary theoretical rationale for capturing how multiple interacting constraints can shape the development of expert performers. This approach suggests that talent development programmes should eschew the notion of common optimal performance models, emphasise the individual nature of pathways to expertise, and identify the range of interacting constraints that impinge on performance potential of individual athletes, rather than evaluating current performance on physical tests referenced to group norms.

On model typing

Where object-oriented languages deal with objects as described by classes, model-driven development uses models, as graphs of interconnected objects, described by metamodels. A number of new languages have been and continue to be developed for this model- based paradigm, both for model transformation and for general programming using models. Many of these use single-object approaches to typing, derived from solutions found in object-oriented systems, while others use metamodels as model types, but without a clear notion of polymorphism. Both of these approaches lead to brittle and overly restrictive reuse characteristics. In this paper we propose a simple extension to object-oriented typing to better cater for a model-oriented context, including a simple strategy for typing models as a collection of interconnected objects. We suggest extensions to existing type system formalisms to support these concepts and their manipulation. Using a simple example we show how this extended approach permits more flexible reuse, while preserving type safety.

Contexts, hybrids and network governance : a comparison of three case-studies in infrastructure governance

While hybrid governance arrangements have been a major element of organisational architecture for some time, the contemporary operating environment has brought to the fore new conditions and expectations for the governance of entities that span conventional public sector departments, private firms and community organisations or groups. These conditions have resulted in a broader array of mixed governance configurations including Public Private Partnerships, alliances, and formal and informal collaborations. In some such arrangements, market based or ‘complete’ contractual relationships have been introduced to replace or supplement existing traditional ‘hierarchical’ and/or newer relational ‘network-oriented’ institutional associations. While there has been a greater reliance on collaborative or relational contracts as an underpinning institutional model, other modes of hierarchy and market may remain in operation. The success of these emergent hybrid forms has been mixed. There are examples of hybrids that have been well adopted, achieving the desired goals of efficiency, effectiveness and financial accountability; while others have experienced implementation problems which have undermined their results. This paper postulates that the cultural and institutional context within which hybrids operate may contribute to the implementation processes employed and the level of success attained. The paper explores hybrid arrangements through three cases of the use of inter-organisational arrangements in three different national contexts. Distilling the various elements of hybrids and the impact of institutional context will provide important insights for those charged with the responsibility for the formation and key infrastructure and public value development.

Biceps brachii muscle oxygenation in electrical muscle stimulation

The purpose of this study was to compare between electrical muscle stimulation (EMS) and maximal voluntary (VOL) isometric contractions of the elbow flexors for changes in biceps brachii muscle oxygenation (tissue oxygenation index, TOI) and haemodynamics (total haemoglobin volume, tHb = oxygenated-Hb + deoxygenated-Hb) determined by near-infrared spectroscopy (NIRS). The biceps brachii muscle of 10 healthy men (23–39 years) was electrically stimulated at high frequency (75 Hz) via surface electrodes to evoke 50 intermittent (4-s contraction, 15-s relaxation) isometric contractions at maximum tolerated current level (EMS session). The contralateral arm performed 50 intermittent (4-s contraction, 15-s relaxation) maximal voluntary isometric contractions (VOL session) in a counterbalanced order separated by 2–3 weeks. Results indicated that although the torque produced during EMS was approximately 50% of VOL (P<0Æ05), there was no significant difference in the changes in TOI amplitude or TOI slope between EMS and VOL over the 50 contractions. However, the TOI amplitude divided by peak torque was approximately 50% lower for EMS than VOL (P<0Æ05), which indicates EMS was less efficient than VOL. This seems likely because of the difference in the muscles involved in the force production between conditions. Mean decrease in tHb amplitude during the contraction phases was significantly (P<0Æ05) greater for EMS than VOL from the 10th contraction onwards, suggesting that the muscle blood volume was lower in EMS than VOL. It is concluded that local oxygen demand of the biceps brachii sampled by NIRS is similar between VOL and EMS.

Soundness of workflow nets with reset arcs

Petri nets are often used to model and analyze workflows. Many workflow languages have been mapped onto Petri nets in order to provide formal semantics or to verify correctness properties. Typically, the so-called Workflow nets are used to model and analyze workflows and variants of the classical soundness property are used as a correctness notion. Since many workflow languages have cancelation features, a mapping to workflow nets is not always possible. Therefore, it is interesting to consider workflow nets with reset arcs. Unfortunately, soundness is undecidable for workflow nets with reset arcs. In this paper, we provide a proof and insights into the theoretical limits of workflow verification.

The development of fast bowling experts in Australian cricket

In this paper, we highlight key concepts from dynamical systems theory and complexity sciences to exemplify constraints on talent development in a sample of elite cricketers. Eleven international fast bowlers who cumulatively had taken more than 2,400 test wickets in over 600 international test matches were interviewed using an in-depth, open-ended, and semi-structured approach. Qualitative data were analysed to identify key components in fast bowling expertise development. Results revealed that, contrary to traditional perspectives, the athletes progressed through unique, nonlinear trajectories of development, which appears to be a commonality in the experts' developmental pathways. During development, individual experts encountered unique constraints on the acquisition of expertise in cricket fast bowling, resulting in unique performance adaptations. Specifically, data illustrated experts' ability to continually adapt behaviours under multifaceted ecological constraints.

Soundness of workflow nets: classification, decidability, and analysis

Workflow nets, a particular class of Petri nets, have become one of the standard ways to model and analyze workflows. Typically, they are used as an abstraction of the workflow that is used to check the so-called soundness property. This property guarantees the absence of livelocks, deadlocks, and other anomalies that can be detected without domain knowledge. Several authors have proposed alternative notions of soundness and have suggested to use more expressive languages, e.g., models with cancellations or priorities. This paper provides an overview of the different notions of soundness and investigates these in the presence of different extensions of workflow nets.We will show that the eight soundness notions described in the literature are decidable for workflow nets. However, most extensions will make all of these notions undecidable. These new results show the theoretical limits of workflow verification. Moreover, we discuss some of the analysis approaches described in the literature.

How do our 'quicks' generate pace? A cross sectional analysis of the Cricket Australia pace pathway

Technique and physical contributions to ball delivery speed in fast bowling have been popular research topics in sports science. However, a common limiting factor of this work is the level of expertise of participants and lack of within bowler investigations (Salter et al., 2007). The relationship between technique, anthropometry and ball speed has not been comprehensively investigated among elite fast bowlers. The purpose of this study was to examine the relationship between technique, anthropometric variables and ball speed using both within- and betweenbowler analyses in a cross section of the Cricket Australia high performance pace pathway.