Computer-assisted Exercise Research Articles

Game-based training in critical infrastructure protection and resilience

Several institutions worldwide are reflecting on the relevance of training and exercises to critical infrastructure protection and resilience. This is witnessed, for instance, by Council Directive 2008/114/EC in the EU and the Homeland Security Exercise and Evaluation Program in the US. Contributing to the research actions in the field, the present article discusses methodological approaches, tools, techniques, and technologies relevant to this domain. In particular, we report on a recent training initiative elaborated by the authors and involving a game-based, modelling-and-simulation-backed, computer-assisted exercise for critical infrastructure expert audiences. This was developed taking advantage of JRC's Geospatial Risk and Resilience Assessment Platform (GRRASP) and critical infrastructure analysis methodologies integrated therein. The overarching objective was to enhance system thinking and raise awareness of resilience aspects while familiarizing participants with specific analysis tools and scientific models.

Training and exercises for Critical Infrastructure – A Hellenic computer-assisted exercise use case analysis

This paper aims to highlight the importance of emerging tools and technologies in the exercises and training of Critical Infrastructure (CI) operators. Computer-assisted exercises (CAX) may offer multiple advantages in designing and conducting exercises (e.g. cost-effectiveness, distance/remote learning), yet, customized platforms need to be designed and employed to meet the particular needs of CI protection. In this context, the paper analyses training and exercises of the Hellenic program for Critical Infrastructure Protection (CIP). A brief description of the current framework for the protection of CI in Greece encompassing the European directive is also presented. A CAX use case analysis is described with the pioneer implementation of the Joint Research Centre (JRC - E.2 Unit), Platform-based Operational System Events and Injects Distribution Online (POSEIDON) web-based IT platform, that was customised for the needs of the exercise under the code name EYZS-3, focusing on the transportation sector. Advanced training approaches, such as EYZS-3, seem to gain ground, as opposed to typical discussion-based exercises (tabletop), indicating valuable findings for future exploitation for planning training and exercises in CI protection.

Planning and Conducting Computer Assisted Exercises During a Pandemic

Abstract 2020 was a year that changed the world completely, forced everyone to think outside of the box and the effects, as well as the results, are still to be measured. While facing several countries’ lockdowns, planning and conducting a multinational computer assisted exercise (CAX) during a pandemic seemed nearly impossible. By taking extreme measures, developing a new architecture model for a CAX and relying on the training audience’s will to be trained, NATO managed to overcome all the constraints and successfully conducted the exercise Loyal Leda 2020. This paper will not only give details about the new CAX architecture concept that supported the execution phase of the exercise, but will also explain the exercise planning process (EPP) behind it.

Optimization of the Casualties' Treatment Process: Blended Military Experiment.

At the battalion level, NATO ROLE1 medical treatment command focuses on the provision of primary health care being the very first physician and higher medical equipment intervention for casualty treatments. ROLE1 has paramount importance in casualty reductions, representing a complex system in current operations. This study deals with an experiment on the optimization of ROLE1 according to the key parameters of the numbers of physicians, the number of ambulances and the distance between ROLE1 and the current battlefield. The very first step in this study is to design and implement a model of current battlefield casualties. The model uses friction data generated from an already executed computer assisted exercise (CAX) while employing a constructive simulation to produce offense and defense scenarios on the flow of casualties. The next step in the study is to design and implement a model representing the transportation to ROLE1, its structure and behavior. The deterministic model of ROLE1, employing a system dynamics simulation paradigm, uses the previously generated casualty flows as the inputs representing human decision-making processes through the recorder CAX events. A factorial experimental design for the ROLE1 model revealed the recommended variants of the ROLE1 structure for both offensive and defensive operations. The overall recommendation is for the internal structure of ROLE1 to have three ambulances and three physicians for any kind of current operation and any distance between ROLE1 and the current battlefield within the limit of 20 min. This study provides novelty in the methodology of casualty estimations involving human decision-making factors as well as the optimization of medical treatment processes through experimentation with the process model.

Main Events List/Main Incidents List Development Process for Computer Assisted Exercises

Abstract In order to train commanders in the decision making process we cannot rely only on simulation systems. It takes more than war-gaming to be able to train higher-headquarters and a proven solution to achieve that is by using computer assisted exercises (CAX). The higher the headquarters that needs to be trained, the more complicated the systems’ architecture becomes, for both functional area services and simulation systems together with their auxiliary tools. It takes subject matter experts in different domains and up to 18 months to plan a computer assisted exercise. Every stage of the exercise planning process involves using different systems and building their databases. In order for the commanders to be successfully trained in the decision making process, they need to face operational dilemmas. The Main Events List/Main Incidents List (MEL/MIL) planning team’s job during the exercise planning phase is to develop the major events, incidents and injects which will trigger the operational dilemmas and will force the commanders to make decisions in dynamic and fast-paced environments. The MEL/MIL plays a key role in ensuring a successful execution phase of an exercise and this study explains in detail the complex 8 month process of building the MEL/MIL database.

Interoperability and data flow between JTLS-GO simulation system and LOGFAS logistic system during CAX (Computer Assisted Exercise) exercises

The purpose of this article is to present the results of the research concerning the possibility of interoperability between the JTLS-GO military simulation system and the LOGFAS military logistic system during Computer Assisted Exercises. The JTLS-GO system is the primary simulation system used in the Polish Armed Forced (PAF) while LOGFAS is the main logistics tool within NATO. Preparing CAXs requires extensive work in terms of building a database of military units, command and logistic structure, combat systems and supply categories. The main goal is to prepare as realistic an environment as possible enabling commanders and staff to use real IT command support systems (C4I) along with real procedures to produce orders for virtual sub-units according to the principle: “train as you plan to fight”. The main benefit of CAXs is minimal cost – a real training audience uses virtual troops in a virtual world using real procedures and decision-making processes. Logistic support is one of the most important areas implemented during such exercises, and the LOGFAS system is the main tool supporting the planning and implementation of logistical support during operations.

Application of geographic information systems in Computer Assisted Exercise (CAX)

Application of geographic information systems in Computer Assisted Exercise (CAX)

What type of computer-assisted exercise supports young less skilled spellers in resolving problems in open and closed syllable words?

Dutch bisyllabic words containing open and closed syllables are particularly difficult to spell for children. What kind of support in spelling exercises improves the spelling of these words the most? Two extensions of a commonly used dictation exercise were tested: less skilled spellers in grade 2 (n = 50; 7 years and 10 months) either received explicit syllabic segmentation cues or received spelling cues by means of a visual preview. Comparisons between pre-, post-, and retention tests of spelling skill showed that extra syllabic cues did not show a significant improvement beyond normal spelling dictation and that visual preview was most effective as compared to the other types of training. The findings suggest that word-specific knowledge can effectively be improved by exposure to the correct letter pattern during exercises in spelling and seems to result in lasting improvement of word-specific orthographic representations, at least for 5 weeks.

Visual versus Computerized Analysis of Upsloping ST Segment Depression in the Exercise Electrocardiogram

A slowly upsloping ST segment depression is an abnormal, and a rapidly upsloping ST segment depression is a normal exercise ECG response. We investigated the agreement of expert physicians on the visual classification of the ST segment depression, and compared the (majority) vote with the computer-generated ST slope. A total of 206 exercise ECG leads with an amplitude of the ST segment depression ≥0.15 mV and a ST segment slope ≥0.5 mVs^–1 were evaluated. All three interpreters agreed in 68 cases, two agreed in 123 cases, and all disagreed in 15 cases. Intraobserver agreement was 61%. The ST segment slope was significantly (p < 0.001) greater in leads generally interpreted as rapidly upsloping (n = 38; 2.1 ± 0.8 mVs^–1), than in those interpreted as slowly upsloping (n 121; 1.3 ± 0.6 mVs^–1) or horizontal (n = 32; 1.1 ± 0.4 mVs^–1), although there was some overlap. Thus, standardization of the computer-assisted exercise ECG interpretation should be continued.

Computer-assisted exercise ECG analysis: real-time scheduling within MS-DOS on PCs

Computer analysis and monitoring of exercise electrocardiograms (ECG) have been advantageously applied for a long time. Recently, the availability of personal computers (PCs) has also had a significant impact in this field. PCs have been used in the development of a software package for on-line exercise ECG analysis. This paper reveals the core of the application, i.e. a built-in real-time executive. A three-phase design approach is described: first, recognition of the tasks and their structure; second, evaluation of the task time complexities; and third, allocation of the tasks and implementation in C++ in the MS-DOS environment. The performance of the real-time multitasking environment is finally studied for the worst-case situation using a prototype PC installation.

Usefulness of bevantolol for chronic, stable angina pectoris

An objective assessment of the efficacy of bevantolol was performed in 21 patients with chronic, stable angina using computer-assisted exercise testing and ambulatory ST-segment monitoring. Given once daily, 200 mg of bevantolol was compared with 200 mg of bevantolol given twice daily and with placebo, using a double-blind crossover technique. The mean exercise time with placebo was 7.4 ± 0.6 minutes; this increased to 10.6 ± 0.9 minutes (p < 0.001) with once-daily bevantolol and to 9.4 ± 0.9 minutes (p < 0.001) with twice-daily bevantolol. The mean heart rate at rest was 80 ± 3 beats/min with placebo; it decreased to 63 ± 2 beats/min (p < 0.001) with once-daily bevantolol and to 66 ± 2 beats/min (p < 0.001) with twice-daily bevantolol. The maximum exercise heart rate of 118 ± 6 beats/min with placebo was reduced to 99 ± 4 beats/min (p < 0.001) on once-daily and 101 ± 4 beats/min (p < 0.001) on twice-daily bevantolol. There was a corresponding decrease in the rate-pressure product. The corrected maximum ST-segment depression was reduced from 0.3 ± 0.06 mm min −1 with placebo to 0.2 ± 0.03 mm min −1 (p < 0.02) with once-daily and 0.2 ± 0.04 mm min −1 (p < 0.05) with twice-daily bevantolol. The mean hourly ambulatory heart rate was significantly reduced for 21 hours with once-daily and 22 hours with twicedaily bevantolol. The lowest mean minimum heart rate was 55 beats/min during twice-daily treatment. The mean number of episodes of ST depression over 24 hours in lead CM 5 was decreased from 6.89 ± 1.7 with placebo to 2.50 ± 0.6 (p < 0.001) with once-daily and to 3.72 ± 1.3 (p < 0.001) with twice-daily bevantolol. Three patients were withdrawn during the once-daily bevantolol regimen due to adverse experiences, and another patient was admitted for coronary artery bypass surgery after 25 days. No patient withdrew during the twice-daily treatment regimen. Bevantolol appears to be an effective antianginal agent in patients with chronic stable angina and may be equally well administered once or twice daily.

Double-blind, randomized, placebo-controlled study of molsidomine in patients with stable effort angina receiving beta-blocker therapy with atenolol

A randomized, double-blind, placebo-controlled trial was performed in 12 patients with chronic and stable effort angina to study the antianginal and anti-ischemic actions of a single dose of molsidomine in addition to long-term therapy with a long-acting beta-adrenergic blocker (100 mg of atenolol daily). Efficacy was assessed by meas of objective endpoints obtained by computer-assisted exercise testing. The mean exercise time to produce angina improved significantly from 330 ± 38 seconds (mean ± SEM) in patients after administration of atenolol and placebo to 420 ± 36 seconds after administration of atenolol and molsidomine. Similar significant improvements were seen in ST segment changes at an identical exercise duration, in maximal heart rate, and in maximal exercise duration. The increased anginal threshold and the reduced ischemic changes were not explained by changes in the rate-pressure product at submaximal levels. Thus molsidomine showed antianginal and anti-ischemic efficacy in the treatment of stable effort angina additional to the effect of long-term therapy with beta-adrenergic blockers.

Randomized double-blind comparison of verapamil and nifedipine in chronic stable angina

A randomized double-blind crossover trial was performed in 32 patients with chronic stable angina to compare the antianginal actions of verapamil (120 mg 3 times daily) and nifedipine (20 mg 3 times daily). Efficacy was assessed using objective end points obtained by computer-assisted exercise testing and 24 hour ambulatory monitoring for S-T segment shift. Twenty-eight patients completed the trial. The mean exercise time to produce angina improved from 5.7 ± 0.3 minutes (mean ± standard error of the mean) in patients on placebo, to 7.9 ± 0.5 minutes in those on nifedipine and 10.0 ± 0.7 minutes in those on verapamil. Similar improvement was seen in all other objective variables. Generally, verapamil produced mild bradycardia and nifedipine mild tachycardia. Four patients complained of palpitations and angina after ingestion of nifedipine and were identified by ambulatory monitoring to have tachycardia and persistent S-T depression. These opposite effects on heart rate may explain the differences in efficacy between these 2 potent calcium ion antagonists.