We introduce the concept of Procedural Content Generation via Knowledge Transformation (PCG-KT), a new lens and framework for characterizing PCG methods and approaches in which content generation is enabled by the process of knowledge transformation—transforming knowledge derived from one domain in order to apply it in another. Our work is motivated by a substantial number of recent PCG works that focus on generating novel content via repurposing derived knowledge. Such works have involved, for example, performing transfer learning on models trained on one game's content to adapt to another game's content, as well as recombining different generative distributions to blend the content of two or more games. Such approaches arose in part due to limitations in PCG via Machine Learning (PCGML) such as producing generative models for games lacking training data and generating content for entirely new games. In this paper, we categorize such approaches under this new lens of PCG-KT by offering a definition and framework for describing such methods and surveying existing works using this framework. Finally, we conclude by highlighting open problems and directions for future research in this area.

Emergence agitation and delirium in children remain a common clinical challenge in the post-anesthetic care unit. Preoperative oral melatonin has been suggested as an effective preventive drug with a favorable safety profile. The oral bioavailability of melatonin, however, is low. Therefore, the MELA-PAED trial aims to investigate the efficacy and safety of intraoperative intravenous melatonin for the prevention of emergence agitation in pediatric surgical patients. MELA-PAED is a randomized, double-blind, parallel two-arm, multi-center, superiority trial comparing intravenous melatonin with placebo. Four hundred participants aged 1-6 years will be randomized 1:1 to either the intervention or placebo. The intervention consists of intravenous melatonin 0.15 mg/kg administered approximately 30 min before the end of surgery. Participants will be monitored in the post-anesthetic care unit (PACU), and the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery (PHBQ-AS) will be performed on days 1, 7, and 14 after the intervention. Serious Adverse Events (SAE) will be assessed up to 30 days after the intervention. The primary outcome is the incidence of emergence agitation, assessed dichotomously as any Watcha score >2 during the participant's stay in the post-anesthetic care unit. Secondary outcomes are opioid consumption in the post-anesthetic care unit and adverse events. Exploratory outcomes include SAEs, postoperative pain, postoperative nausea and vomiting, and time to awakening, to first oral intake, and to discharge readiness. The MELA-PAED trial investigates the efficacy of intravenous intraoperative melatonin for the prevention of emergence agitation in pediatric surgical patients. Results may provide further knowledge concerning the use of melatonin in pediatric perioperative care.

We explore AI-powered upscaling as a design assistance tool in the context of creating 2D game levels. Deep neural networks are used to upscale artificially downscaled patches of levels from the puzzle platformer game Lode Runner. The trained networks are incorporated into a web-based editor, where the user can create and edit levels at three different levels of resolution: 4x4, 8x8, and 16x16. An edit at any resolution instantly transfers to the other resolutions. As upscaling requires inventing features that might not be present at lower resolutions, we train neural networks to reproduce these features. We introduce a neural network architecture that is capable of not only learning upscaling but also giving higher priority to less frequent tiles. To investigate the potential of this tool and guide further development, we conduct a qualitative study with 3 designers to understand how they use it. Designers enjoyed co-designing with the tool, liked its underlying concept, and provided feedback for further improvement.

Generative Adversarial Networks (GANs) are a powerful indirect genotype-to-phenotype mapping for evolutionary search. Much previous work applying GANs to level generation focuses on fixed-size segments combined into a whole level, but individual segments may not fit together cohesively. In contrast, segments in human designed levels are often repeated, directly or with variation, and organized into patterns (the symmetric eagle in Level 1 of The Legend of Zelda, or repeated pipe motifs in Super Mario Bros). Such patterns can be produced with Compositional Pattern Producing Networks (CPPNs). CPPNs define latent vector GAN inputs as a function of geometry, organizing segments output by a GAN into complete levels. However, collections of latent vectors can also be evolved directly, producing more chaotic levels. We propose a hybrid approach that evolves CPPNs first, but allows latent vectors to evolve later, combining the benefits of both approaches. These approaches are evaluated in Super Mario Bros. and The Legend of Zelda. We previously demonstrated via a Quality-Diversity algorithm that CPPNs better cover the space of possible levels than directly evolved levels. Here, we show that the hybrid approach (1) covers areas that neither of the other methods can, and (2) achieves comparable or superior QD scores.

The term Procedural Content Generation (PCG) refers to the (semi-)automatic generation of game content by algorithmic means, and its methods are becoming increasingly popular in game-oriented research and industry. A special class of these methods, which is commonly known as search-based PCG, treats the given task as an optimisation problem. Such problems are predominantly tackled by evolutionary algorithms.We will demonstrate in this paper that obtaining more information about the defined optimisation problem can substantially improve our understanding of how to approach the generation of content. To do so, we present and discuss three efficient analysis tools, namely diagonal walks, the estimation of high-level properties, as well as problem similarity measures. We discuss the purpose of each of the considered methods in the context of PCG and provide guidelines for the interpretation of the results received. This way we aim to provide methods for the comparison of PCG approaches and eventually, increase the quality and practicality of generated content in industry.

PurposeThe purpose of this paper is to investigate the collaboration between researchers and practitioners on developing standards and guidelines for Facilities Management (FM).Design/methodology/approachThis paper is based on a longitudinal case study on research on FM value adding and its impact on FM standardization and development of a FM Value Guide. The sources used are literature and documents on FM value adding and standardization, published and planned FM standards, the FM Value Guide, internal documents and participant observations and experiences. All authors of this paper have both research and practical background. Two of them have been – and one still is – actively involved in developing European and international FM standards, and all three have been involved in developing the FM Value Guide. The research methodology can be characterized as retrospective action research.FindingsThe literature review shows that even though there are many references to standards in research papers, particularly in relation to definitions of concepts, there are only few studies on how research influences standardization and how researchers collaborate with practitioners on developing standards and guidelines. This paper presents a case study showing how research can contribute to standardization and development of guidelines in collaboration with practitioners and makes suggestions on how such collaboration can be improved.Practical implicationsThe results of this paper provide understanding and inspiration for how researchers and practitioners can collaborate in the development of standards and guidelines.Originality/valueTo the best of the authors’ knowledge, this paper is the first study on collaboration between researchers and practitioners on developing FM standards and guidelines.

IntroductionThis study describes deaths among Danish soldiers in international operations 2002–2018. Having been part of UN and later NATO forces in ex-Yugoslavia, in 2002 the first Danish contingent took part in the International Security Assistance Force mission in Afghanistan as well as Iraq. The changing role of the Danish military in international operations meant casualties, in numbers that had not yet been experienced, and necessitated a review of our procedures for handling fatalities in the military.MethodsThe study is a retrospective review of autopsy reports, Military Police reports and medical reports, and the purpose is to examine all Danish fatalities in international operations in 2002–2018 to identify potential areas of improving treatment and protection and to review the contribution of the autopsies. The mechanism of injury, the fatal injuries and causes of death and the time of death within the chain of evacuation were identified. Casualties dying at any time from site of injury until definitive care were included.ResultsA total of 53 soldiers died from injuries during international operations in the years 2002–2018. The majority of these (43) died from combat injuries and 10 from accidents. Four of the victims with combat injuries were not autopsied. The majority (36) of the combat deaths were caused by blast/explosions (improvised explosive devices, rocket propelled grenades, fragments), while 7 were caused by bullets. 39 combat victims died instantly on the site or at the arrival to the field hospital, 4 were treated in field hospital and 2 of these were transported back to Denmark.ConclusionsMost combat fatalities result from fragmentation and blast injury. Forensic autopsies provide valuable information regarding injuries, weaponry, the efficiency of protective equipment and the quality of medical intervention in military fatalities and are recommended in all military fatalities in order to prevent avoidable casualties in the future.

There is a significantly higher number of people experiencing severe levels of suicidal thoughts compared to that of suicidal deaths and suicide attempts. In suicide prevention research, there is a shift towards greater emphasis on people's experiences of living with suicidal thoughts. This can expand the existing evidence base, which is dominated by a biomedical approach. The aim of this review was to summarise and disseminate existing research on the lived experiences of living with suicidal thoughts. A scoping review by Arksey & O'Malley consisting of six stages: (1) formulating the research question, (2) identifying relevant studies, (3) selecting studies, (4) mapping data, (5) summarising the results and (6) consulting stakeholders. PubMed, PsycINFO and CINAHL were searched for studies in English, Danish, Swedish and Norwegian. Peer-reviewed articles examining people's experiences of living with suicidal thoughts using qualitative methods were included. The search was supplemented with a citation pearl search in the Web of Science database. Twenty-eight studies were included. The findings were organised under two thematic headings: (a) the significance of social connections and (b) a loss of the personal self. There is a need for further qualitative research of people's experiences of living with suicidal thoughts from an everyday life perspective. Awareness about social connections and attachment in mental health prevention and governance is crucial. Trauma-informed care could be a useful approach to prevent suicidal thoughts as the review found that many participants had traumatic experiences in both childhood and adulthood. As part of the treatment of suicidal thoughts, it might be useful to have a focus on narrative and communicative methods and their clinical application.

To evaluate interventions to promote physical activity, valid outcome measures are important. This study evaluated the validity and reliability of the ActivPAL3™ and the SENS motion® activity monitors with regard to the number of steps taken, walking, and sedentary behavior in hospitalized patients (n = 36) (older medical patients (+65 years) (n = 12), older patients (+65) with acute hip fracture (n = 12), and patients (+18) who underwent acute high-risk abdominal surgery (n = 12)). Both monitors showed good (≥60%) percentage agreement with direct observation for standing and no. of steps (all gait speeds) and high agreement (≥80%) for lying. For walking, ActivPAL3™ showed moderate percentage agreement, whereas SENS motion® reached high percentage agreement. The relative reliability was moderate for sedentary behavior for both monitors. The ActivPAL3™ showed poor (walking) to moderate (steps) reliability for walking and steps, whereas SENS motion® showed moderate reliability for both activities. For slow walkers, the relative reliability was moderate for SENS motion® and poor for ActivPAL3™. This trial is registered with the ClinicalTrials.gov identifier NCT04120740.