Doing the right thing at the right time: Assessing responses to patient deterioration in electronic simulation scenarios using course-of-action analysis

International studies indicate that the recognition and management of deteriorating patients in hospitals are poor and that patient assessment is often inadequate. Face-to-face simulation programs have been shown to have an impact on educational and clinical outcomes; however, little is known about performance in contemporary healthcare e-simulation approaches. Using data from an open-access Web-based patient deterioration program (FIRSTACTWeb), the performance of 367 Australian nursing students in identification of treatment priorities and clinical actions was analyzed using a military model of Course of Action Simulation Analysis. Participants' performance in the whole program demonstrated a significant improvement in knowledge and skills (P ≤ .001) with high levels of participant satisfaction. Course of Action Simulation Analysis modeling identified three key participant groupings within which only 18% took the "best course of action" (the right actions and timing), with most (70%) completing the right actions but in the wrong order. The remaining 12% produced incomplete assessments and actions in an incorrect sequence. Contemporary approaches such as e-simulation do enhance educational outcomes. Measurement of performance when combined with Course of Action Simulation Analysis becomes a useful tool in the description of outcomes, an understanding of decision making, and the prediction of future events.

Analysis of the current distribution in an aluminum electrolysis cell with copper collector-bar cathode assembly

Understanding the magneto-hydrodynamic forces generated due to the external magnetic field and current density distribution within the cell (current in cell linings) is important in the optimization of cell dynamics. It is well documented that these factors play a crucial role in establishing the metal-pad stability of the cell. Conventional cells use the cathode-collector-bar assembly to carry the current through molten aluminium, the cathode and the steel collector-bar to nearest external bus. The electrical conductivity of the steel is so poor relative to the molten aluminium that the outer third of the collector bar carries the maximum load, which in turn increases the horizontal components of the current within the cell. Previous studies have modelled improvement in the cell instability through external magnetic compensation by redistributing current in the cathode busbar. Very little to date has been published on work to improve the current distribution within the cell. In this work, the current distribution in an aluminium electrolysis cell with copper collector-bar was predicted using finite element modelling. A 2D cross-section of a commercial cell was used under steady conditions of electrical fields in anode, electrolyte, molten aluminium and copper cathode-assembly. Different shapes and sizes of the cathode assembly are also considered to optimise the distribution of current throughout the cathode lining. The findings indicated that the copper-bar of similar size to steel could save voltage up to 150 mV. There is a reduction of more than 70% in peak current density value due to the copper inserts. The predicted trends of current distribution show a good agreement with previously published data.

Invisible walls: Do psychological barriers really exist in stock index levels?

We investigate whether the levels of a stock market index contain any evidence of a behavioural bias depending on the proximity of the index level to 'psychological barriers'. These are certain index levels (usually in multiples of 100) at which the market tends to stick before breaking out either up or down. Extant behavioural finance literature has attributed this to investors' subjective perception of 'something special' about certain index levels where in fact no rational economic basis exists for such a perception. We carry out an empirical analysis of the NASDAQ Composite index and find that barrier effects are indeed present in that stock index. We employ simulation analysis to validate of our obtained results.

Power analysis and simulation of a vehicle under combined loads

This paper presents an analytical model of fuel consumption (AMFC) to coordinate the driving power and manage the overall fuel consumption for an internal combustion engine vehicle. The model calculates the different loads applied on the vehicle including road-slope, road-friction, wind-drag, accessories, and mechanical losses. Also, it solves the combustion equation of the engine under different working conditions including various fuel compositions, excess airs and air inlet temperatures. Then it determines the contribution of each load to signify the energy distribution and power flows of the vehicle. Unlike the conventional models in which the vehicle speed needs to be given as an input, the developed model can predict the vehicle speed and acceleration under different working conditions by allowing the speed to vary within a predefined range only. Furthermore, the model indicates the ways to minimises the vehicles' fuel consumption under various driving conditions. The results show that the model has the potential to assist in the vehicle energy management.

Parameter sensitivity analysis of surface plasmon resonance biosensor through numerical simulation

Surface based analytical tools have gained more importance for rapid, sensitive and label-free monitoring of molecular recognition events. Surface plasmon resonance (SPR) has played a prominent role in real time monitoring of surface binding events. SPR is increasing its significance especially for the study of ultrathin dielectric layer. This paper investigates the role of thin films of gold, silver and aluminium for protein detection in SPR biosensors. It is shown that the sensitivity, which is indicated by the shift of plasmon dip, is not linearly related to the thickness of protein but quadratic over a specific range. The approach involves a plot of a reflectivity curve as a function of the angle of incidence.

A full body musculoskeletal model based on flexible multibody simulation approach utilised in bone strain analysis during human locomotion

Load-induced strains applied to bone can stimulate its development and adaptation. In order to quantify the incident strains within the skeleton, in vivo implementation of strain gauges on the surfaces of bone is typically used. However, in vivo strain measurements require invasive methodology that is challenging and limited to certain regions of superficial bones only such as the anterior surface of the tibia. Based on our previous study [Al Nazer et al. (2008) J Biomech. 41:1036–1043], an alternative numerical approach to analyse in vivo strains based on the flexible multibody simulation approach was proposed. The purpose of this study was to extend the idea of using the flexible multibody approach in the analysis of bone strains during physical activity through integrating the magnetic resonance imaging (MRI) technique within the framework. In order to investigate the reliability and validity of the proposed approach, a three-dimensional full body musculoskeletal model with a flexible tibia was used as a demonstration example. The model was used in a forward dynamics simulation in order to predict the tibial strains during walking on a level exercise. The flexible tibial model was developed using the actual geometry of human tibia, which was obtained from three-dimensional reconstruction of MRI. Motion capture data obtained from walking at constant velocity were used to drive the model during the inverse dynamics simulation in order to teach the muscles to reproduce the motion in the forward dynamics simulation. Based on the agreement between the literature-based in vivo strain measurements and the simulated strain results, it can be concluded that the flexible multibody approach enables reasonable predictions of bone strain in response to dynamic loading. The information obtained from the present approach can be useful in clinical applications including devising exercises to prevent bone fragility or to accelerate fracture healing.

A generalised data analysis approach for baggage handling systems simulation

Airport baggage handling systems are a critical infrastructure component within major airports, and essential to ensure smooth luggage transfer while preventing dangerous material being loaded onto aircraft. This paper proposes a standard set of measures to assess the expected performance of a baggage handling system through discrete event simulation. These evaluation methods also have application in the study of general network systems. Results from the application of these methods reveal operational characteristics of the studied BHS, in terms of metrics such as peak throughput, in-system time and system recovery time.

Simulation and analysis of a sub-wavelength grating based multilayer surface plasmon resonance biosensor

This paper presents a subwavelength grating based multilayer surface plasmon resonance biosensor (SPRB) which includes a periodic array of subwavelength grating on top of a layer of graphene sheet in the biosensor. The proposed biosensor is named grating-graphene SPRB (GG-SPRB). The aim of the proposed multilayer structure is to improve the sensitivity of the SPRB through monitoring of the biomolecular interactions of DNA hybridization. Significant sensitivity improvement is obtained for the GG-SPRB compared with the conventional SPRB. The result of the numerical investigation of the GG-SPRB is presented and compared with a theoretically developed multilayer matrix formalism, and a good agreement has been observed. In addition, an optimization of the grating dimensions including volume factor, grating depth, grating angle, grating period, and grating geometry (e.g., rectangular, sinusoidal and triangular) is presented. The outcome of the investigation presented in this paper identifies desired functioning conditions corresponding to the best design parameters for the GG-SPRB.