A Video Analysis of Intra- and Inter-professional Leadership Behaviours Within “The Burns Suite”: Identifying Key Leadership Models

Objective Leadership is particularly important in complex highly interprofessional health care contexts involving a number of staff, some from the same specialty (intraprofessional), and others from different specialties (interprofessional). The authors recently published the concept of “The Burns Suite” (TBS) as a novel simulation tool to deliver interprofessional and teamwork training. It is unclear which leadership behaviors are the most important in an interprofessional burns resuscitation scenario, and whether they can be modeled on to current leadership theory. The purpose of this study was to perform a comprehensive video analysis of leadership behaviors within TBS. Methods A total of 3 burns resuscitation simulations within TBS were recorded. The video analysis was grounded-theory inspired. Using predefined criteria, actions/interactions deemed as leadership behaviors were identified. Using an inductive iterative process, 8 main leadership behaviors were identified. Cohen’s κ coefficient was used to measure inter-rater agreement and calculated as κ = 0.7 (substantial agreement). Each video was watched 4 times, focusing on 1 of the 4 team members per viewing (senior surgeon, senior nurse, trainee surgeon, and trainee nurse). The frequency and types of leadership behavior of each of the 4 team members were recorded. Statistical significance to assess any differences was assessed using analysis of variance, whereby a p < 0.05 was taken to be significant. Leadership behaviors were triangulated with verbal cues and actions from the videos. Results All 3 scenarios were successfully completed. The mean scenario length was 22 minutes. A total of 362 leadership behaviors were recorded from the 12 participants. The most evident leadership behaviors of all team members were adhering to guidelines (which effectively equates to following Advanced Trauma and Life Support/Emergency Management of Severe Burns resuscitation guidelines and hence “maintaining standards”), followed by making decisions. Although in terms of total frequency the senior surgeon engaged in more leadership behaviors compared with the entire team, statistically there was no significant difference between all 4 members within the 8 leadership categories. This analysis highlights that “distributed leadership” was predominant, whereby leadership was “distributed” or “shared” among team members. The leadership behaviors within TBS also seemed to fall in line with the “direction, alignment, and commitment” ontology. Conclusions Effective leadership is essential for successful functioning of work teams and accomplishment of task goals. As the resuscitation of a patient with major burns is a dynamic event, team leaders require flexibility in their leadership behaviors to effectively adapt to changing situations. Understanding leadership behaviors of different team members within an authentic simulation can identify important behaviors required to optimize nontechnical skills in a major resuscitation. Furthermore, attempting to map these behaviors on to leadership models can help further our understanding of leadership theory. Collectively this can aid the development of refined simulation scenarios for team members, and can be extrapolated into other areas of simulation-based team training and interprofessional education.

Monitoring sandy shores morphologies by DGPS: a practical tool to generate digital elevation models

The highly dynamic nature of some sandy shores with continuous morphological changes require the development of efficient and accurate methodological strategies for coastal hazard assessment and morphodynamic characterisation. During the past decades, the general methodological approach for the establishment of coastal monitoring programmes was based on photogrammetry or classical geodetic techniques. With the advent of new geodetic techniques, space-based and airborne-based, new methodologies were introduced in coastal monitoring programmes. This paper describes the development of a monitoring prototype that is based on the use of global positioning system (GPS). The prototype has a GPS multiantenna mounted on a fast surveying platform, a land vehicle appropriate for driving in the sand (four-wheel quad). This system was conceived to perform a network of shore profiles in sandy shores stretches (subaerial beach) that extend for several kilometres from which high-precision digital elevation models can be generated. An analysis of the accuracy and precision of some differential GPS kinematic methodologies is presented. The development of an adequate survey methodology is the first step in morphodynamic shore characterisation or in coastal hazard assessment. The sample method and the computational interpolation procedures are important steps for producing reliable three-dimensional surface maps that are real as possible. The quality of several interpolation methods used to generate grids was tested in areas where there were data gaps. The results obtained allow us to conclude that with the developed survey methodology, it is possible to Survey sandy shores stretches, under spatial scales of kilometers, with a vertical accuracy of greater than 0.10 m in the final digital elevation models.

Enhancing the numerical performance of fire field models (CMS Paper)

This paper describes two new techniques designed to enhance the performance of fire field modelling software. The two techniques are "group solvers" and automated dynamic control of the solution process, both of which are currently under development within the SMARTFIRE Computational Fluid Dynamics environment. The "group solver" is a derivation of common solver techniques used to obtain numerical solutions to the algebraic equations associated with fire field modelling. The purpose of "group solvers" is to reduce the computational overheads associated with traditional numerical solvers typically used in fire field modelling applications. In an example, discussed in this paper, the group solver is shown to provide a 37% saving in computational time compared with a traditional solver. The second technique is the automated dynamic control of the solution process, which is achieved through the use of artificial intelligence techniques. This is designed to improve the convergence capabilities of the software while further decreasing the computational overheads. The technique automatically controls solver relaxation using an integrated production rule engine with a blackboard to monitor and implement the required control changes during solution processing. Initial results for a two-dimensional fire simulation are presented that demonstrate the potential for considerable savings in simulation run-times when compared with control sets from various sources. Furthermore, the results demonstrate the potential for enhanced solution reliability due to obtaining acceptable convergence within each time step, unlike some of the comparison simulations.

Shipping noise in a dynamic sea: a case study of grey seals in the Celtic Sea

Shipping noise is a threat to marine wildlife. Grey seals are benthic foragers, and thus experience acoustic noise throughout the water column, which makes them a good model species for a case study of the potential impacts of shipping noise. We used ship track data from the Celtic Sea, seal track data and a coupled ocean-acoustic modelling system to assess the noise exposure of grey seals along their tracks. It was found that the animals experience step changes in sound levels up to ~20dB at a frequency of 125Hz, and ~10dB on average over 10-1000Hz when they dive through the thermocline, particularly during summer. Our results showed large seasonal differences in the noise level experienced by the seals. These results reveal the actual noise exposure by the animals and could help in marine spatial planning.

Dynamic Link Inclusion in Online PDF Journals

Two complementary de facto standards for the publication of electronic documents are HTML on theWorldWideWeb and Adobe s PDF (Portable Document Format) language for use with Acrobat viewers. Both these formats provide support for hypertext features to be embedded within documents. We present a method, which allows links and other hypertext material to be kept in an abstract form in separate link databases. The links can then be interpreted or compiled at any stage and applied, in the correct format to some specific representation such as HTML or PDF. This approach is of great value in keeping hyperlinks relevant, up-to-date and in a form which is independent of the finally delivered electronic document format. Four models are discussed for allowing publishers to insert links into documents at a late stage. The techniques discussed have been implemented using a combination of Acrobat plug-ins, Web servers and Web browsers.

Multi-Scale Dynamic Study of Secondary Impact During Drop Testing of Surface Mount Packages

This dissertation focuses on design challenges caused by secondary impacts to printed wiring assemblies (PWAs) within hand-held electronics due to accidental drop or impact loading. The continuing increase of functionality, miniaturization and affordability has resulted in a decrease in the size and weight of handheld electronic products. As a result, PWAs have become thinner and the clearances between surrounding structures have decreased. The resulting increase in flexibility of the PWAs in combination with the reduced clearances requires new design rules to minimize and survive possible internal collisions impacts between PWAs and surrounding structures. Such collisions are being termed ‘secondary impact’ in this study. The effect of secondary impact on board-level drop reliability of printed wiring boards (PWBs) assembled with MEMS microphone components, is investigated using a combination of testing, response and stress analysis, and damage modeling. The response analysis is conducted using a combination of numerical finite element modeling and simplified analytic models for additional parametric sensitivity studies.

Development and Application of Predictive Models for Survival, Growth, and Death of Enteric Pathogens in Leafy Greens Supply Chain

Leafy greens are essential part of a healthy diet. Because of their health benefits, production and consumption of leafy greens has increased considerably in the U.S. in the last few decades. However, leafy greens are also associated with a large number of foodborne disease outbreaks in the last few years. The overall goal of this dissertation was to use the current knowledge of predictive models and available data to understand the growth, survival, and death of enteric pathogens in leafy greens at pre- and post-harvest levels. Temperature plays a major role in the growth and death of bacteria in foods. A growth-death model was developed for Salmonella and Listeria monocytogenes in leafy greens for varying temperature conditions typically encountered during supply chain. The developed growth-death models were validated using experimental dynamic time-temperature profiles available in the literature. Furthermore, these growth-death models for Salmonella and Listeria monocytogenes and a similar model for E. coli O157:H7 were used to predict the growth of these pathogens in leafy greens during transportation without temperature control. Refrigeration of leafy greens meets the purposes of increasing their shelf-life and mitigating the bacterial growth, but at the same time, storage of foods at lower temperature increases the storage cost. Nonlinear programming was used to optimize the storage temperature of leafy greens during supply chain while minimizing the storage cost and maintaining the desired levels of sensory quality and microbial safety. Most of the outbreaks associated with consumption of leafy greens contaminated with E. coli O157:H7 have occurred during July-November in the U.S. A dynamic system model consisting of subsystems and inputs (soil, irrigation, cattle, wildlife, and rainfall) simulating a farm in a major leafy greens producing area in California was developed. The model was simulated incorporating the events of planting, irrigation, harvesting, ground preparation for the new crop, contamination of soil and plants, and survival of E. coli O157:H7. The predictions of this system model are in agreement with the seasonality of outbreaks. This dissertation utilized the growth, survival, and death models of enteric pathogens in leafy greens during production and supply chain.

Evolution feature oriented model driven product line engineering approach for synergistic and dynamic service evolution in clouds: A04BPEL3.0 proposal.

Model Driven based approach for Service Evolution in Clouds will mainly focus on the reusable evolution patterns' advantage to solve evolution problems. During the process, evolution pattern will be driven by MDA models to pattern aspects. Weaving the aspects into service based process by using Aspect-Oriented extended BPEL engine at runtime will be the dynamic feature of the evolution.

Dynamic instabilities in scalar neural field equations with space-dependent delays

In this paper we consider a class of scalar integral equations with a form of space-dependent delay. These non-local models arise naturally when modelling neural tissue with active axons and passive dendrites. Such systems are known to support a dynamic (oscillatory) Turing instability of the homogeneous steady state. In this paper we develop a weakly nonlinear analysis of the travelling and standing waves that form beyond the point of instability. The appropriate amplitude equations are found to be the coupled mean-field Ginzburg-Landau equations describing a Turing-Hopf bifurcation with modulation group velocity of O(1). Importantly we are able to obtain the coefficients of terms in the amplitude equations in terms of integral transforms of the spatio-temporal kernels defining the neural field equation of interest. Indeed our results cover not only models with axonal or dendritic delays but those which are described by a more general distribution of delayed spatio-temporal interactions. We illustrate the predictive power of this form of analysis with comparison against direct numerical simulations, paying particular attention to the competition between standing and travelling waves and the onset of Benjamin-Feir instabilities.

Increased CSF Aβ during the very early phase of cerebral Aβ deposition in mouse models

Abnormalities in brains of Alzheimer's disease (AD) patients are thought to start long before the first clinical symptoms emerge. The identification of affected individuals at this 'preclinical AD' stage relies on biomarkers such as decreased levels of the amyloid-β peptide (Aβ) in the cerebrospinal fluid (CSF) and positive amyloid positron emission tomography scans. However, there is little information on the longitudinal dynamics of CSF biomarkers, especially in the earliest disease stages when therapeutic interventions are likely most effective. To this end, we have studied CSF Aβ changes in three Aβ precursor protein transgenic mouse models, focusing our analysis on the initial Aβ deposition, which differs significantly among the models studied. Remarkably, while we confirmed the CSF Aβ decrease during the extended course of brain Aβ deposition, a 20-30% increase in CSF Aβ40 and Aβ42 was found around the time of the first Aβ plaque appearance in all models. The biphasic nature of this observed biomarker changes stresses the need for longitudinal biomarker studies in the clinical setting and the search for new 'preclinical AD' biomarkers at even earlier disease stages, by using both mice and human samples. Ultimately, our findings may open new perspectives in identifying subjects at risk for AD significantly earlier, and in improving the stratification of patients for preventive treatment strategies.

Dynamic model development of adiabatic compressed air energy storage

The share of variable renewable energy in electricity generation has seen exponential growth during the recent decades, and due to the heightened pursuit of environmental targets, the trend is to continue with increased pace. The two most important resources, wind and insolation both bear the burden of intermittency, creating a need for regulation and posing a threat to grid stability. One possibility to deal with the imbalance between demand and generation is to store electricity temporarily, which was addressed in this thesis by implementing a dynamic model of adiabatic compressed air energy storage (CAES) with Apros dynamic simulation software. Based on literature review, the existing models due to their simplifications were found insufficient for studying transient situations, and despite of its importance, the investigation of part load operation has not yet been possible with satisfactory precision. As a key result of the thesis, the cycle efficiency at design point was simulated to be 58.7%, which correlated well with literature information, and was validated through analytical calculations. The performance at part load was validated against models shown in literature, showing good correlation. By introducing wind resource and electricity demand data to the model, grid operation of CAES was studied. In order to enable the dynamic operation, start-up and shutdown sequences were approximated in dynamic environment, as far as is known, the first time, and a user component for compressor variable guide vanes (VGV) was implemented. Even in the current state, the modularly designed model offers a framework for numerous studies. The validity of the model is limited by the accuracy of VGV correlations at part load, and in addition the implementation of heat losses to the thermal energy storage is necessary to enable longer simulations. More extended use of forecasts is one of the important targets of development, if the system operation is to be optimised in future.

Quantification of the effects of architectural traits on dry mass production and light interception of tomato canopy under different temperature regimes using a dynamic functional-structural plant model

There is increasing interest in evaluating the environmental effects on crop architectural traits and yield improvement. However, crop models describing the dynamic changes in canopy structure with environmental conditions and the complex interactions between canopy structure, light interception, and dry mass production are only gradually emerging. Using tomato (Solanum lycopersicum L.) as a model crop, a dynamic functional-structural plant model (FSPM) was constructed, parameterized, and evaluated to analyse the effects of temperature on architectural traits, which strongly influence canopy light interception and shoot dry mass. The FSPM predicted the organ growth, organ size, and shoot dry mass over time with high accuracy (>85%). Analyses of this FSPM showed that, in comparison with the reference canopy, shoot dry mass may be affected by leaf angle by as much as 20%, leaf curvature by up to 7%, the leaf length: width ratio by up to 5%, internode length by up to 9%, and curvature ratios and leaf arrangement by up to 6%. Tomato canopies at low temperature had higher canopy density and were more clumped due to higher leaf area and shorter internodes. Interestingly, dry mass production and light interception of the clumped canopy were more sensitive to changes in architectural traits. The complex interactions between architectural traits, canopy light interception, dry mass production, and environmental conditions can be studied by the dynamic FSPM, which may serve as a tool for designing a canopy structure which is 'ideal' in a given environment.

Explaining dinophysis cf. acuminata abundance in Antifer (Normandy, France) using dynamic linear regression

Classical regression analysis can be used to model time series. However, the assumption that model parameters are constant over time is not necessarily adapted to the data. In phytoplankton ecology, the relevance of time-varying parameter values has been shown using a dynamic linear regression model (DLRM). DLRMs, belonging to the class of Bayesian dynamic models, assume the existence of a non-observable time series of model parameters, which are estimated on-line, i.e. after each observation. The aim of this paper was to show how DLRM results could be used to explain variation of a time series of phytoplankton abundance. We applied DLRM to daily concentrations of Dinophysis cf. acuminata, determined in Antifer harbour (French coast of the English Channel), along with physical and chemical covariates (e.g. wind velocity, nutrient concentrations). A single model was built using 1989 and 1990 data, and then applied separately to each year. Equivalent static regression models were investigated for the purpose of comparison. Results showed that most of the Dinophysis cf. acuminata concentration variability was explained by the configuration of the sampling site, the wind regime and tide residual flow. Moreover, the relationships of these factors with the concentration of the microalga varied with time, a fact that could not be detected with static regression. Application of dynamic models to phytoplankton time series, especially in a monitoring context, is discussed.

An identification procedure of multi-input Wiener models for the distortion analysis of nonlinear circuits

In this contribution, a system identification procedure of a two-input Wiener model suitable for the analysis of the disturbance behavior of integrated nonlinear circuits is presented. The identified block model is comprised of two linear dynamic and one static nonlinear block, which are determined using an parameterized approach. In order to characterize the linear blocks, an correlation analysis using a white noise input in combination with a model reduction scheme is adopted. After having characterized the linear blocks, from the output spectrum under single tone excitation at each input a linear set of equations will be set up, whose solution gives the coefficients of the nonlinear block. By this data based black box approach, the distortion behavior of a nonlinear circuit under the influence of an interfering signal at an arbitrary input port can be determined. Such an interfering signal can be, for example, an electromagnetic interference signal which conductively couples into the port of consideration. © 2011 Author(s).

Investigating the peculiar emission from the new VHE gamma-ray source H1722+119

The MAGIC (Major Atmospheric Gamma-ray Imaging Cherenkov) telescopes observed the BL Lac object H1722+119 (redshift unknown) for six consecutive nights between 2013 May 17 and 22, for a total of 12.5 h. The observations were triggered by high activity in the optical band measured by the KVA (Kungliga Vetenskapsakademien) telescope. The source was for the first time detected in the very high energy (VHE, E > 100 GeV) γ-ray band with a statistical significance of 5.9 σ. The integral flux above 150 GeV is estimated to be (2.0 ± 0.5) per cent of the Crab Nebula flux. We used contemporaneous high energy (HE, 100MeV < E < 100 GeV) γ-ray observations from Fermi-LAT (Large Area Telescope) to estimate the redshift of the source. Within the framework of the current extragalactic background light models, we estimate the redshift to be z = 0.34±0.15. Additionally, we used contemporaneous X-ray to radio data collected by the instruments on board the Swift satellite, the KVA, and the OVRO (Owens Valley Radio Observatory) telescope to study multifrequency characteristics of the source. We found no significant temporal variability of the flux in the HE and VHE bands. The flux in the optical and radio wavebands, on the other hand, did vary with different patterns. The spectral energy distribution (SED) of H1722+119 shows surprising behaviour in the ∼ 3×1014 −1018 Hz frequency range. It can be modelled using an inhomogeneous helical jet synchrotron self-Compton model.