Optimising safety, fidelity and usability of an Intelligent Clinical Support Tool (ICST) for acute hospital care: an Australian case Study using a multi-method Delphi process

This research focuses on a major health priority for Australia by addressing existing gaps in the implementation of nursing informatics solutions in healthcare. It serves to inform the successful deployment of IT solutions designed to support patient-centered, frontline acute healthcare delivery by multidisciplinary care teams. The outcomes can guide future evaluations of the contribution of IT solutions to the efficiency, safety and quality of care delivery in acute hospital settings.

Does bench model fidelity interfere in the acquisition of suture skills by novice medical students?

OBJETIVO: Embora vários modelos de bancada inanimados tenham sido descritos para o treinamento de habilidades de sutura, até o momento, não existe um método ideal para esse ensino e aprendizagem durante a formação médica. O objetivo foi avaliar se a fidelidade dos modelos de bancada interfere na aquisição de habilidades de sutura em estudantes de medicina iniciantes na prática cirúrgica. MÉTODOS: 36 estudantes de medicina sem exposição prévia a habilidades cirúrgicas foram randomizados em três grupos (n = 12): treinamento de suturas baseado em materiais didáticos (controle); treinamento de suturas em modelo de baixa-fidelidade (modelo de bancada de etileno vinil acetato); ou treinamento de suturas em modelo de alta-fidelidade (modelo de bancada de pele de pata de porco). Foram aplicados pré e pós-testes (realização de pontos simples e pontos subdérmicos invertidos em língua de boi). Três ferramentas (Global Rating Scale com avaliação cega, tamanho do efeito e autopercepção da confiança baseada em uma escala de Likert) foram utilizadas para mensurar todas as performances de sutura. RESULTADOS: A análise após o treinamento demonstrou que os estudantes que treinaram nos modelos tiveram um melhor (p < 0.0000) desempenho na avaliação pela Global Rating Scale, quando comparados com o controle, independente da fidelidade do modelo. A magnitude do efeito (treinamento) foi considerada grande (> 0.80) em todas as mensurações. Após o treinamento os alunos sentiram-se mais confiantes (p < 0.0000) para executarem os dois tipos de suturas. CONCLUSÃO: A aquisição de habilidades de suturas no modelo de baixa fidelidade foi semelhante à prática no modelo de alta fidelidade, sendo que a melhora no desempenho dos participantes que treinaram nesses dois modelos foi superior à aprendizagem baseada em materiais didáticos.

Sudden death of entanglement and teleportation fidelity loss via the Unruh effect

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Alternative fidelity measure between quantum states

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Quantitative fidelity of recent freshwater mollusk assemblages from the Touro Passo River, Rio Grande do Sul, Brazil

O presente estudo teve como objetivo apresentar uma das primeiras contribuições ao conhecimento sobre a fidelidade quantitativa de associações de moluscos recentes em rios subtropicais. Tanatocenoses e biocenoses foram estudadas em seções retilínea e meandrante tendendo a anastomosada, no curso médio do rio Touro Passo, um tributário de 4ª ordem do rio Uruguai, localizado no extremo oeste do Rio Grande do Sul. As amostragens foram realizadas por meio de quadrats de 5 m², cinco em cada seção, amostrando-se um total de 50 m². Também foram feitas amostragens em um ambiente lêntico, com comunicação intermitente com o Touro Passo, objetivando detectar a existência de transporte de comunidades lênticas para o interior do rio. Os resultados obtidos mostram que, apesar da freqüente oscilação do nível da água, a biocenose do Touro Passo apresenta uma alta fidelidade ecológica e sofre pouca influência de espécies de ambientes lênticos. A composição taxonômica e características de estrutura de comunidades, especialmente as espécies dominantes, refletem, ainda, diferenças ecológicas relacionadas às duas seções amostradas, como a maior complexidade de habitats da estação meandrante. Quanto à fidelidade quantitativa, 60% das espécies encontradas vivas também foram encontradas mortas e 47,3% das espécies encontradas mortas também foram encontras vivas em escala de rio. Porém, 72% dos exemplares coletados mortos são representantes de espécies encontradas vivas. Essa percentagem alta pode estar relacionada à boa correlação entre o ranking de dominância das associações vivas e mortas e, conseqüentemente, as espécies dominantes das tanatocenoses podem ser utilizadas para inferir características ecológicas das biocenoses. Todos os índices analisados variaram muito em escala local (quadrat) e seus valores são mais aproximados aos de outros, registrados em estudos prévios, apenas quando analisados em escala mais ampla (seção, área total).

Fidelity of molluscan assemblages from the touro passo formation (pleistocene-holocene), southern brazil: taphonomy as a tool for discovering natural baselines for freshwater communities

This study is the first assessment of mollusk fossil assemblages relative to the compositional fidelity of modern mollusk living and death assemblages. It also shows that the sedimentary record can provide information on the original, non-human-impacted, freshwater malacofauna biodiversity, based on Late Pleistocene shells. The fossil mollusk assemblage from the Touro Passo Formation (Pleistocene-Holocene) was compared to living and death assemblages of the Touro Passo River, southern Brazil, revealing little resemblance between fossil and live-dead species composition. Although the living and death assemblages agree closely in richness, species composition, and species relative abundances (both proportional and rank), the fossil assemblage differs significantly from both modern assemblages in most of these measures. The fossil assemblage is dominated by the native endemic corbiculid bivalve Cyanocyclas limosa and the gastropod Heleobia aff. bertoniana. These are absent in the living assemblages, and both living and death assemblages are dominated by the alien Asiatic corbiculid C. fluminea, which is absent in the fossil assemblage. The fossil assemblage also contains, overall, a higher proportional abundance of relatively thick-shelled species, suggesting a genuine bias against the thinner- and smaller-shelled species. Our results suggest that contemporary environmental changes, such as the introduction of some alien freshwater mollusk species, together with post-burial taphonomic processes, are the main factors leading to the poor fidelity of the fossil assemblage studied. Hence, the taxonomic composition of the Late Pleistocene mollusks from the Touro Passo Formation probably would show greater similarity to present-day assemblages wherever the mollusk biodiversity is not disturbed by human activities.

Assessment of color fidelity of several composite resins compared to their Vita Classical shade registration

This study compared the color fidelity of different composite resins with their registration in the Vita Classical Shade Guide. Using a prefabricated Teflon mold, 120 specimens were divided into four groups fn - 30), according to the resin tested. Three subgroups (a = 10) were prepared for each resin group; these subgroups tested enamel shade, dentin shade, and enamel and dentin shade. Three measurements were performed to verily whether the tooth shade matched that of the Vita Classical Shade Guide. The color was evaluated and the shade variations were calculated. The data were submitted to a three-way AN OVA test (time, color match, and composite type), followed by Tukey's test. It was concluded that all composite resins showed color differences in relation to the Vita Classical Shade Guide.

Geographical variation in mutualistic networks: similarity, turnover and partner fidelity

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Teaching elliptical excision skills to novice medical students: a randomized controlled study comparing low- and high-fidelity bench models

Background: The search for alternative and effective forms of training simulation is needed due to ethical and medico-legal aspects involved in training surgical skills on living patients, human cadavers and living animals. Aims : To evaluate if the bench model fidelity interferes in the acquisition of elliptical excision skills by novice medical students. Materials and Methods: Forty novice medical students were randomly assigned to 5 practice conditions with instructor-directed elliptical excision skills' training (n = 8): didactic materials (control); organic bench model (low-fidelity); ethylene-vinyl acetate bench model (low-fidelity); chicken legs' skin bench model (high-fidelity); or pig foot skin bench model (high-fidelity). Pre- and post-tests were applied. Global rating scale, effect size, and self-perceived confidence based on Likert scale were used to evaluate all elliptical excision performances. Results : The analysis showed that after training, the students practicing on bench models had better performance based on Global rating scale (all P < 0.0000) and felt more confident to perform elliptical excision skills (all P < 0.0000) when compared to the control. There was no significant difference (all P > 0.05) between the groups that trained on bench models. The magnitude of the effect (basic cutaneous surgery skills' training) was considered large (>0.80) in all measurements. Conclusion : The acquisition of elliptical excision skills after instructor-directed training on low-fidelity bench models was similar to the training on high-fidelity bench models; and there was a more substantial increase in elliptical excision performances of students that trained on all simulators compared to the learning on didactic materials.

Seasonal home ranges and fidelity to breeding sites among ringed seals

Population structure and patterns of habitat use among ringed seals (Phoca hispida) are poorly known, in part because seasonal movements have not been adequately documented. We monitored the movements of 98 ringed seals in the Beaufort and Chukchi seas between 1990 and 2006 using three forms of telemetry. In the winter—spring period (when the seals were occupying shorefast ice), we used radio and ultra-sonic tags to track movements above and below the ice, respectively. We used satellite-linked transmitters in summer and fall (when the seals ranged away from their winter sites) to track at-sea movements. In the shorefast ice habitat, the home ranges of 27 adult males ranged from\1 to 13.9 km2 (median = 0.628) while the home ranges of 28 adult females ranged from \1 to 27.9 km2 (median = 0.652). The 3-dimensional volumes used by 9 seals tracked acoustically under the ice averaged 0.07 (SD = 0.04) km3 for subadults and adult males and 0.13 (SD = 0.04) km3 for adult females. Three of the radio-tracked seals and 9 tracked by satellite ranged up to 1,800 km from their winter/spring home ranges in summer but returned to the same small (1–2 km2) sites during the ice-bound months in the following year. The restricted movements of ringed seals during the ice-bound season— including the breeding season—limits their foraging activities for most of the year and may minimize gene flow within the species.

A macroscopic kinetic model for DNA polymerase elongation and high-fidelity nucleotide election

The enzymatically catalyzed template-directed extension of ssDNA/primer complex is an impor-tant reaction of extraordinary complexity. The DNA polymerase does not merely facilitate the insertion of dNMP, but it also performs rapid screening of substrates to ensure a high degree of fidelity. Several kinetic studies have determined rate constants and equilibrium constants for the elementary steps that make up the overall pathway. The information is used to develop a macro-scopic kinetic model, using an approach described by Ninio [Ninio J., 1987. Alternative to the steady-state method: derivation of reaction rates from first-passage times and pathway probabili-ties. Proc. Natl. Acad. Sci. U.S.A. 84, 663–667]. The principle idea of the Ninio approach is to track a single template/primer complex over time and to identify the expected behavior. The average time to insert a single nucleotide is a weighted sum of several terms, in-cluding the actual time to insert a nucleotide plus delays due to polymerase detachment from ei-ther the ternary (template-primer-polymerase) or quaternary (+nucleotide) complexes and time delays associated with the identification and ultimate rejection of an incorrect nucleotide from the binding site. The passage times of all events and their probability of occurrence are ex-pressed in terms of the rate constants of the elementary steps of the reaction pathway. The model accounts for variations in the average insertion time with different nucleotides as well as the in-fluence of G+C content of the sequence in the vicinity of the insertion site. Furthermore the model provides estimates of error frequencies. If nucleotide extension is recognized as a compe-tition between successful insertions and time delaying events, it can be described as a binomial process with a probability distribution. The distribution gives the probability to extend a primer/template complex with a certain number of base pairs and in general it maps annealed complexes into extension products.

Nonlocal dissipative tunneling for high-fidelity quantum-state transfer between distant parties

In this work, we propose the nonlocal tunneling mechanism for high-fidelity state transfer between distant parties. The nonlocal tunneling follows from the overlap between the distant sending and receiving wave functions, which is indirectlymediated by the off-resonant normal modes of a quantum channel. This channel is made up of a network of dissipative quantum systems exhibiting the same bosonic or fermionic statistical nature as the sender and receiver. We demonstrate that the incoherence arising from quantum channel nonidealities is almost completely circumvented by the tunneling mechanism, which thus affords a high-fidelity transfer process.

Fidelity and game-based technology in management education

This study explores educational technology and management education by analyzing fidelity in game-based management education interventions. A sample of 31 MBA students was selected to help answer the research question: To what extent do MBA students tend to recognize specific game-based academic experiences, in terms of fidelity, as relevant to their managerial performance? Two distinct game-based interventions (BG1 and BG2) with key differences in fidelity levels were explored: BG1 presented higher physical and functional fidelity levels and lower psychological fidelity levels. Hypotheses were tested with data from the participants, collected shortly after their experiences, related to the overall perceived quality of game-based interventions. The findings reveal a higher overall perception of quality towards BG1: (a) better for testing strategies, (b) offering better business and market models, (c) based on a pace that better stimulates learning, and (d) presenting a fidelity level that better supports real world performance. This study fosters the conclusion that MBA students tend to recognize, to a large extent, that specific game-based academic experiences are relevant and meaningful to their managerial development, mostly with heightened fidelity levels of adopted artifacts. Agents must be ready and motivated to explore the new, to try and err, and to learn collaboratively in order to perform.

Exploring symbiont fidelity among lichen symbioses and the common alga Trebouxia decolorans s.l.: differents levels of intrathalline photobiont diversity in Xanthoria parietina and Anaptychia ciliaris

Francesco Dal Grande (Biodiversity and Climate Research Centre (BiK-F), Senckenberg Gesellschaft fuer Naturforschung, Frankfurt am Main, Germany Goethe Universitat, Frankfurt am Main, Germany). Comunicación ofrecida por David Alors Rodríguez (Universidad Complutense de Madrid)