Keeping it real! Enhancing realism in standardised patient OSCE stations

Background: Objective structured clinical examinations (OSCEs) are a
commonly used method of assessing clinical competency in healthcare education. They can providean opportunity to observe candidates interacting with patients.
There are many challenges in using real patients in OSCEs, and increasingly standardised patients are being used as a preference. However, by using standardised patients there is a risk of making the encounter arti?cial and removed from actual clinical practice.
Context: Efforts made in terms of cognitive, auditory, visual, tactile, psychological and emotional cues can minimise the differences between a simulated
and real clinical scenario. However, a number of factors, including feasibility, cost and usability, need to be considered if such techniques are to be practicable
within an OSCE framework.
Innovation: This article describes a series of techniques that have been used in our institution to enhance the realism of a standardised patient encounter in an
OSCE. Efforts in preparing standardised patient roles, and how they portray these roles, will be considered. A wide variety of equipment can also be used in
combination with a patient and the surrounding environment, which can further enhance the authenticity of the simulated scenario.
Implications: By enhancing the realism in simulated patient OSCE encounters, there is potential to trigger more authentic conscious responses from candidates and implicit reactions that the candidates themselves may be less
aware of. Furthermore, using such techniques may allow faculty members to select scenarios that were previously not thought possible in an OSCE

Massive MIMO Systems with Hardware-Constrained Base Stations

Massive multiple-input multiple-output (MIMO) systems are cellular networks where the base stations (BSs) are equipped with unconventionally many antennas. Such large antenna arrays offer huge spatial degrees-of-freedom for transmission optimization; in particular, great signal gains, resilience to imperfect channel knowledge, and small inter-user interference are all achievable without extensive inter-cell coordination. The key to cost-efficient deployment of large arrays is the use of hardware-constrained base stations with low-cost antenna elements, as compared to today's expensive and power-hungry BSs. Low-cost transceivers are prone to hardware imperfections, but it has been conjectured that the excessive degrees-of-freedom of massive MIMO would bring robustness to such imperfections. We herein prove this claim for an uplink channel with multiplicative phase-drift, additive distortion noise, and noise amplification. Specifically, we derive a closed-form scaling law that shows how fast the imperfections increase with the number of antennas.

Hydrological modelling of Maranhão and Pracana Basins, a first approach

Modelling the hydrology of hydrographic basins has shown itself as a useful tool in environment management. The hydrological models can be used for multiple purposes: estimate runoff from sequences of rainfall, access stream water quality, quantify the diffuse pollution that reaches water masses such as estuaries, rivers and lakes, etc. This study has as final objective to simulate and analyse the flow, sediment transport and water quality as a function of landuse and soil type in the basins of Maranhão and Pracana. The modelling system used is SWAT, Soil Water Assessment Tool. In this first phase of the study the hydrodynamic calibration of the model was performed using measurements of average daily flows in five stations. The model compares well with the measurements; the annual average flows are similar and the majority of the measured flow peaks coincide with the model peaks.

Alessandro Baricco littérature, musique, peinture, cinéma, etc.

Dans l'oeuvre contemporaine d'Alessandro Baricco, des références de toutes sortes attirent l'attention de ceux et celles qui s'intéressent aux récits et romans de l'écrivain italien. De cette esthétique néo-baroque, c'est la rencontre avec d'autres formes d'art qui nous a ici interpelée. Autant sur le plan formel que thématique, les références à la musique, à la peinture et au cinéma, entre autres, offrent de remarquables exemples d'intermédialité. Cette diversité de disciplines convoquées dans le texte de Châteaux de la colère (1995), Soie (1997), Océan mer (1998), City (2001) et Novecento : pianiste (1997), constitue l'originalité forte de l'oeuvre de Baricco. Ces formes artistiques produisent une ambiance qui plonge le lecteur dans le domaine de l'art et accorde à l'auteur la possibilité de déployer avec une grande maîtrise de moyens et d'effets son style unique. Les renvois intermédiatiques relevant principalement des personnages soutiennent les propos de Baricco au sujet de l'art : ils permettent d'établir l'importance qu'accorde ce dernier au métalangage artistique et à la création sous toutes ses formes. Par là, il devient possible de mieux comprendre sa propre oeuvre littéraire qui valorise, au détriment de la prétention réaliste, une fantaisie ludique qui relève du spectaculaire. Le premier chapitre présente les procédés formels au service de la musicalité dans l'écriture de Baricco et les personnages de musiciens - ou en lien avec la musique - qui évoquent cette forme artistique privilégiée. Dans le deuxième chapitre, il est question des moyens techniques qui permettent aux textes de Baricco de rappeler l'art pictural ainsi que des personnages qui, par le truchement de la peinture, tiennent un discours sur la création artistique. Dans le troisième et dernier chapitre, nous nous intéressons à la structure romanesque qui, par diverses stratégies formelles, imite le scénario. Les personnages qui renvoient à l'art dramatique sont aussi abordés, de façon à tenir compte de la vision artistique qu'ils mettent en place. Enfin, la conclusion nous permet, à la lumière des informations recueillies, de relever les effets entrainés i.e. [entraînés] par ces jeux intermédiatiques. Celle-ci est aussi pour nous l'occasion de dégager, en son caractère unitaire, la vision artistique à l'oeuvre chez Baricco.

Urban transformations and rail stations system - the study case of Naples

The aim of this study is to give an interpretation of the urban transformations connected to rail transit system investments; in particular the main research goal is to analyze and give a methodological support for the urban transformation phenomena government in the rail transit stations areas. The article proposes an empirical studies comparative analysis and an application in the Naples urban area, in which a new rail transit network has been developed. In particular the socio-economic transit impacts on the urban system are measured and interpretated with the support of a GIS; therefore an application of the node-place interpretative model (Bertolini 1999) is proposed in order to support transit–land use planning processes in the stations areas.

On the choice of posittioning and cluster size for fixed relay stations in a LTE network

The long term evolution (LTE) is one of the latest standards in the mobile communications market. To achieve its performance, LTE networks use several techniques, such as multi-carrier technique, multiple-input-multiple-output and cooperative communications. Inside cooperative communications, this paper focuses on the fixed relaying technique, presenting a way for determining the best position to deploy the relay station (RS), from a set of empirical good solutions, and also to quantify the associated performance gain using different cluster size configurations. The best RS position was obtained through realistic simulations, which set it as the middle of the cell's circumference arc. Additionally, it also confirmed that network's performance is improved when the number of RSs is increased. It was possible to conclude that, for each deployed RS, the percentage of area served by an RS increases about 10 %. Furthermore, the mean data rate in the cell has been increased by approximately 60 % through the use of RSs. Finally, a given scenario with a larger number of RSs, can experience the same performance as an equivalent scenario without RSs, but with higher reuse distance. This conduces to a compromise solution between RS installation and cluster size, in order to maximize capacity, as well as performance.

Measurements of environmental background radiation in the surrounding area of a coal-fired power plant

Certain materials used and produced in a wide range of non-nuclear industries contain enhanced activity concentrations of natural radionuclides. In particular, electricity production from coal is one of the major sources of increased exposure to man from enhanced naturally occurring materials. Over the past decades there has been some discussion about the elevated natural background radiation in the area near coal-fired power plants due to high uranium and thorium content present in coal. This work describes the methodology developed to assess the radiological impact due to natural radiation background increasing levels, potentially originated by a coal-fired power plant’s operation. Gamma radiation measurements have been done with two different instruments: a scintillometer (SPP2 NF, Saphymo) and a gamma ray spectrometer with energy discrimination (Falcon 5000, Canberra). A total of 40 relevant sampling points were established at locations within 20 km from the power plant: 15 urban and 25 suburban measured stations. The highest values were measured at the sampling points near to the power plant and those located in the area within the 6 and 20 km from the stacks. This may be explained by the presence of a huge coal pile (1.3 million tons) located near the stacks contributing to the dispersion of unburned coal and, on the other hand, the height of the stacks (225 m) which may influence ash’s dispersion up to a distance of 20 km. In situ gamma radiation measurements with energy discrimination identified natural emitting nuclides as well as their decay products (212Pb, 214Pb, 226Ra 232Th, 228Ac, 234Th 234Pa, 235U, etc.). This work has been primarily done to in order to assess the impact of a coal-fired power plant operation on the background radiation level in the surrounding area. According to the results, an increase or at least an influence has been identified both qualitatively and quantitatively.

Migração de ligações Wi-Fi não seguras para ligações seguras, após autenticação em captive portal

Atualmente a popularidade das comunicações Wi-Fi tem crescido, os utilizadores acedem a partir de vários dispositivos como telemóveis, tablets, computadores portáteis sendo estes utilizados por qualquer pessoa nos mais variados locais. Com esta utilização massiva por parte dos utilizadores surgiram os hotspots Wi-Fi públicos (em aeroportos, estações de comboios, etc) que permitem a ligação de clientes recorrendo a ligações wireless não seguras (ou abertas). Tais hotspots utilizam, após a ligação de um cliente, um captive portal que captura o tráfego IP com origem no cliente e o redireciona para uma página Web de entrada. A página Web permite ao cliente comprar tempo de acesso à Internet ou, caso já seja um cliente da empresa, autenticar-se para ter acesso à Internet. A necessidade da ligação aberta assenta na possibilidade do operador do hotspot vender acesso à Internet a utilizadores não conhecidos (caso contrário teria de fornecerlhes uma senha previamente). No entanto, fornecer um acesso à Internet wireless sem qualquer tipo de segurança ao nível físico permite que qualquer outro utilizador consiga obter informação sobre a navegação Web dos utilizadores ligados (ex.: escuta de pedidos DNS). Nesta tese pretende-se apresentar uma solução que estenda um dos atuais mecanismos de autenticação Wi-Fi (WPA, WPA2) para que permita, após autenticação em captive portal, a migração de uma ligação aberta para uma ligação segura.