Operations Center Research Articles

Towards Improved Heliosphere Sky Map Estimation with Theseus

The Interstellar Boundary Explorer (IBEX) satellite has been in orbit since 2008 and detects energy-resolved energetic neutral atoms (ENAs) originating from the heliosphere. Different regions of the heliosphere generate ENAs at different rates. It is of scientific interest to take the data collected by IBEX and estimate spatial maps of heliospheric ENA rates (referred to as sky maps) at higher resolutions than before. These sky maps will subsequently be used to discern between competing theories of heliosphere properties that are not currently possible. The data IBEX collects present challenges to sky map estimation. The two primary challenges are noisy and irregularly spaced data collection and the IBEX instrumentation’s point spread function. In essence, the data collected by IBEX are both noisy and biased for the underlying sky map of inferential interest. In this article, we present a two-stage sky map estimation procedure called Theseus. In Stage 1, Theseus estimates a blurred sky map from the noisy and irregularly spaced data using an ensemble approach that leverages projection pursuit regression and generalized additive models. In Stage 2, Theseus deblurs the sky map by deconvolving the PSF with the blurred map using regularization. Unblurred sky map uncertainties are computed via bootstrapping. We compare Theseus to a method closely related to the one operationally used today by the IBEX Science Operation Center (ISOC) on both simulated and real data. Theseus outperforms ISOC in nearly every considered metric on simulated data, indicating that Theseus is an improvement over the current state of the art.

Risk Stratified Treatment for Patients with Newly Diagnosed Juvenile Myelomonocytic Leukemia: A Phase 1/2 Non-Randomized Study of Trametinib and Azacitidine with or without Chemotherapy

Background: Juvenile myelomonocytic leukemia (JMML) is an aggressive myeloproliferative disorder of childhood. The biochemical hallmark of JMML is aberrant signaling through the Ras pathway caused by initiating mutations in NF1, NRAS, KRAS, RRAS, RRAS2, SH2B3, PTPN11,or CBL. While hematopoietic stem cell transplantation (HSCT) can be curative, 5-year event-free survival of children with JMML after HSCT is only ~50%. Recently, several studies have identified mutational burden and DNA methylation as predictive of clinical outcomes in patients with JMML. In the T2020-004 phase 1/2 clinical trial, we will define lower-risk patients as those with one somatic alteration and low DNA methylation and high-risk patients as those with more than one somatic alteration or intermediate/high DNA methylation. Trametinib is an orally bioavailable, reversible, highly selective allosteric inhibitor of MEK1/2 in the Ras/MAPK signaling pathway. Trametinib is FDA-approved for the treatment of adults with advanced melanoma with BRAF V600E or V600K mutations and in children with Ras-mutant solid tumors in combination with dabrafenib. Clinical investigation of trametinib monotherapy via the Children's Oncology Group ADVL1521 phase 2 trial (NCT03190915) showed efficacy in children with relapsed/refractory JMML. Phase 2 clinical trial evaluation of azacitidine in children with newly-diagnosed JMML was also efficacious and led to its FDA approval. In this trial, trametinib will be tested in combination with azacitidine in lower-risk patients and in combination with azacitidine and chemotherapy for high-risk patients. Study Design and Methods: This is a non-randomized, risk stratified, Phase 1/2 study for patients with newly-diagnosed JMML (NCT05849662) conducted via the Therapeutic Advances in Childhood Leukemia and Lymphoma (TACL) Consortium with safety and efficacy phases for both lower-risk and high-risk cohorts. Lower-risk patients will receive trametinib once-daily for 28 days in combination with azacitidine administered daily for five days per cycle. Lower-risk patients can receive up to 12 cycles and will proceed to HSCT only if they experience progressive disease or relapse. High-risk patients will receive trametinib administered once-daily for 28 days in combination with azacitidine, fludarabine, and cytarabine (aza/FLA) administered daily for five days per cycle. High-risk patients will receive up to two cycles of therapy before proceeding to HSCT off protocol. Key Eligibility: Patients aged 1 month to 21 years who meet World Health Organization criteria for JMML will be eligible. Objectives: The primary safety objectives are to determine the safety of combining trametinib with azacitidine for lower-risk patients and combining trametinib with aza/FLA for high-risk patients. The secondary efficacy objectives are to determine the event-free survival for lower-risk patients in the absence of HSCT and the molecular response rates pre-HSCT for high-risk patients. Sample Size and Statistical Design: A rolling 6 trial design will be used during Phase 1 of the study to determine the recommended phase II dose (RP2D) of trametinib for lower-risk and high-risk patients in combination with their respective therapies. Starting trametinib dose is 0.032mg/kg daily if less than 6 years of age, or 0.025mg/kg daily if 6 years or older, with one dose level de-escalation if indicated. Phase II of the study involves lower-risk and high-risk cohort expansions at the RP2D of trametinib. Target accrual is 22 patients in the lower-risk arm and 42 patients in the high-risk arm. The study is open to accrual at all TACL consortium sites. We acknowledge the TACL Consortium's scientific contribution to and participation in this study, including participating member institutions, investigators, research teams, and the TACL Operations Center. Novartis Pharmaceuticals Corporation provided the investigative drug in support of this trial. This study is supported by the National Institute of Health, National Cancer Institute (R37CA266550), the Pediatric Cancer Research Foundation, and the Cannonball Kids Cancer Foundation.

Results from the Phase 1 Portion of a Trial of Oral Ixazomib Combined with Chemotherapy in Relapsed/Refractory Acute Lymphoblastic Leukemia or Lymphoma in Children, Adolescents and Young Adults: A Report from the Therapeutic Advances in Childhood Leukemia and Lymphoma (TACL) Consortium

ACKNOWLEDGEMENT Proteasome inhibitors potentiate anti-tumor effects of standard cytotoxic chemotherapy in childhood leukemia. Ixazomib is an oral proteasome inhibitor that has a shorter proteasome dissociation half-life than bortezomib, which leads to a higher tumor-to-blood ratio inhibition. We performed a phase 1 trial to determine the dose limiting toxicities (DLT), Recommended Phase 2 Dose (RP2D) of ixazomib in pediatric patients with relapsed/refractory acute lymphoblastic leukemia (ALL) or lymphoma (LL). Patients ≤ 21 years of age with relapsed or refractory ALL (with ≥ 5% detectable disease in the marrow) or LL were eligible. Ixazomib was combined with 28-day blocks of well-established, relapsed ALL backbone chemotherapy. Block 1 contained vincristine (1.5 mg/m 2/dose IV Days 1, 8, 15, 22), dexamethasone (5 mg/m 2/dose IV or oral twice daily Days 1-14), PEG-asparaginase (2500 IU/m 2/dose IV Days 2, 15) and daunorubicin (60 mg/m 2/dose IV Day 1) (VXLD). An optional Block 2 contained vincristine (1.5 mg/m 2/dose IV Day 1), dexamethasone (3 mg/m 2/dose oral twice daily Days 1-5), methotrexate (1000 mg/m 2/dose IV over 36 hours Day 8), PEG-asparaginase (2500 IU/m 2/dose IV Day 9), cyclophosphamide (440 mg/m 2/dose IV Days 15-19) and etoposide (100 mg/m 2/dose IV Days 15-19). An additional optional Maintenance Block contained vincristine (1.5 mg/m 2/dose IV Day 1), prednisone (20 mg/m 2/dose oral twice daily Days 1-5), mercaptopurine (75 mg/m 2/dose oral daily) and methotrexate (20 mg/m 2/dose oral weekly). Intrathecal therapy was given throughout with agents and dosing based on the patient's CNS disease status upon study entry. Ixazomib was given orally and tested at two dose levels (DL) (DL1: 1.6 mg/m 2/dose; DL2: 2 mg/m 2/dose) using a 3+3 design and was given during Block 1 on Days 1, 4, 8 and 11; during Block 2 on Days 1, 4, 8, 15 and 18 and during Maintenance on Days 1, 8 and 15. DLTs during Block 1 only were utilized to make DL escalation decisions and determine the RP2D. Patients without Down Syndrome (DS) entered Cohort A, used to determine the P2RD. Patients with DS were eligible for a 1 DL lagging descriptive-only Cohort B. Ten patients were treated; nine in Cohort A (n = 3 at DL1 and n = 6 at DL2) and one in Cohort B (DL1). Median age (range) at study entry was 10.5 years (5 - 20 years). Nine patients had B-ALL and one had T-ALL. Most were heavily pretreated with a median (range) of 3.4 (1 - 7) previous remission attempts with six having had prior immunotherapy and three patients having had at least one prior hematopoietic stem cell transplant. After Block 1, two patients received Block 2 and one received Maintenance. In Block 1 of Cohort A, non-hematological Grade 3/4 adverse events (AE) possibly, probably or definitely related to ixazomib or the backbone chemotherapy were limited and included neutropenic fever (n = 7), increased AST (n = 3), increased ALT (n = 2) and hypokalemia (n = 2). Two septic events occurred (n = 1 in Cohort A (Grade 3) and n = 1 in Cohort B (Grade 4)). Block 2 and Maintenance AEs were not significantly different than those seen in Block 1. No deaths or DLTs occurred. Response assessment showed that at DL1 two of three patients had a Complete Remission (CR) both of whom were Minimal Residual Disease (MRD) negative (-) and at DL2 three of six patients had a CR, two of whom were MRD- and two patients had a CR with incomplete count recovery (CRi). The overall response rate (CR + CRi) was 78% (7 of 9 patients). With a minimum of 20 months of follow-up six of nine patients in Cohort A and the single patient in Cohort B are still alive. All three deceased patients died of disease progression. Ixazomib can be combined with standard chemotherapy with an acceptable safety profile and an encouraging early efficacy signal in pediatric relapsed ALL including those with DS. The RP2D of Ixazomib combined with chemotherapy is 2 mg/m 2/dose, which is being used in the ongoing phase 2/expansion cohort of the study. We acknowledge the TACL Consortium's scientific contribution to and participation in this study, including participating member institutions, investigators, research teams, and the TACL Operations Center. Takeda Pharmaceuticals Company provided the investigative drug and funding in support of this trial.

Evaluation of a Telemergency Service for Older People Living at Home: A Cross-Sectional Study

Personal Emergency Response Systems (PERSs) are fall-detection devices supporting users in any situation. No previous studies have investigated the differences in events and the use of PERS between users financially supported by public authorities (public users) and those who privately afford the PERS cost (private users). More than two years of data collected by the Telemergency Operation Centre (TOC) were downloaded. All users who sent at least one real alert to request support were included. No differences were found for falls (37, 16.7% vs. 95, 13.4%) and medical problems (46, 20.7% vs. 122, 17.2%). The dispatch of an ambulance was necessary for all medical problems, while for falls, this was only in half of cases. Public users significantly asked more for service demand, while private users asked for support calls. The TOC staff directly managed most of the service demands (398, 97.3%) and support calls. PERS could be a valid instrument for promoting independent living and helping manage chronic conditions in older adults. The results suggest that PERSs might improve in-home care services, facilitating the connection to in-home services.

Semi-Supervised Alert Filtering for Network Security

Network-based intrusion detection systems play a pivotal role in cybersecurity, but they generate a significant number of alerts. This leads to alert fatigue, a phenomenon where security analysts may miss true alerts hidden among false ones. To address alert fatigue, practical detection systems enable administrators to divide alerts into multiple groups by the alert name and the related Internet Protocol (IP) address. Then, some groups are deliberately ignored to conserve human resources for further analysis. However, the drawback of this approach is that the filtering basis is so coarse-grained that some true alerts are also ignored, which may cause critical security issues. In this paper, we present a new semi-supervised and fine-grained filtering method that uses not only alert names and IP addresses but also semi-supervised clustering results from the alerts. We evaluate our scheme with both a private dataset from a security operations center and a public dataset from the Internet. The experimental results demonstrate that the new filtering scheme achieves higher accuracy and saves more human resources compared to the current state-of-the-art method.

Future evolutions of EUSST collision avoidance service

Over the last few years, both the space debris population and the number of active satellites in orbit has dramatically increased. The risk of collision for satellite missions is a problem to an increasing extent targeted thoroughly by all agents involved in space situational awareness (SSA) & spacecraft operations. In the frame of the European Union Space Surveillance and Tracking (EU SST), the CA service is provided on a hot redundancy scheme involving the French and Spanish Operations Centres (FR-SSA Centre and S3TOC, respectively), to more than 50 organizations and 390 satellites at the time of writing.Given the dynamic space environment, EU SST CA service must evolve continuously to face the increase of the number of registered users and spacecraft, the diversity of users’ needs and the increasing number of close approaches.

Preventing Animals Interference using Intelligence Camera and RFID System

Animals’ interference into operation centers has become major headaches for some companies. Although it is a trivial case, the animals’ interference has disrupted major operations of the company. The article takes case of an Indonesian utility company, PN, that has challenges to distribute electricity to nationwide, especially in the rural areas, mountain, and forest areas, and thousand islands. Those areas are surrounded by animal presences that might trespass and interference into distribution sites such as transmission lines and transformers. The common presence of animals’ interference was found such as snakes, birds, and squirrels have created blackouts in some areas. The article proposes the use of intelligence cameras and RFID systems, along with preventive devices to assist animal trespassing in the distribution area. The article takes pilot of project in Payakumbuh area that is in West Sumatera, that has high animal interferences to the distribution system. Since the last decade, PN has promoted digital transformation in all her business units. The use of digital technology is expected to provide solution reference for animal interfere cases around Indonesia area, considering that each area in Indonesia has an un

Integrating Battlefield Documentation into Virtual Reality Medical Simulation Training: Virtual Battlefield Assisted Trauma Distributed Observation Kit (BATDOK).

Clinical documentation is an essential component of the provision of medical care, enabling continuity of information across provider and site handoffs. This is particularly important in the combat casualty care setting when a single casualty may be treated by four or more or five completely disparate teams across the roles of care. The Battlefield Assisted Trauma Distributed Observation Kit (BATDOK) is a digital battlefield clinical documentation system developed by the Air Force Research Laboratory to address this need. To support the deployment of this tool, we integrated BATDOK into a commercially available virtual reality (VR) medical simulation platform used by the U.S. Air Force and Defense Health Agency personnel in order to provide an immersive simulation training experience which included battlefield documentation. A multidisciplinary team consisting of medical educators, VR simulation engineers, emergency physicians and pararescuemen, and BATDOK developers first developed a specification for a virtual BATDOK capability, including a detailed listing of learning objectives, critical interfaces and task plans, and sensor integrations. These specifications were then implemented into the commercially available Virtual Advancement of Learning for Operational Readiness VR Medical Simulation System and underwent developmental testing and evaluation during pararescueman training exercises at the Air Force Special Operations Command Special Operations Center for Medical Integration and Development. The BATDOK capability was successfully implemented within the VR Medical Simulation System. The capability consisted of a virtual tablet with replicated interfaces and capabilities based on the developed specifications. These capabilities included integrated point-of-care ultrasound capability, multi-patient management, vitals sign monitoring with sensor pairing and continuous monitoring, mechanism of injury documentation (including injury pattern documentation), intervention logging (including tourniquets, dressing, airways, lines, tubes and drains, splints, fluids, and medications), and event logging. The capability was found to be operational and in alignment with learning objectives and user acceptance goals.

The district operation centres in one of the largest local health authorities in Italy to manage COVID-19 surveillance and homecare: first implementation and results of a survey addressed to general practitioners

BackgroundCOVID-19 pandemic represented a shock for healthcare systems. Italy was one of the first country to deal with a huge number of patients to be diagnosed, isolated, and treated with scarce evidence-based guidelines and resources. Several organizational and structural changes were needed to face the pandemic at local level. The article aims at studying the perceived impact of the newly implemented District Operation Centres (DOCs) of Local Health Authority (LHA) Roma 1 in managing active surveillance and home care of COVID-19 patients and their close contacts in cooperation with general practitioners (GPs).MethodsA questionnaire, developed according to Delphi methodology, was validated by 7 experts and administered to a randomized sample of GPs and family paediatricians (FPs). All medical doctors selected received a phone interview between December 2020 and January 2021. The questionnaire investigated general characteristics of the sample, relations with DOC and its usefulness, and potential developments. A descriptive analysis was performed and inferential statistical tests were used to assess differences.ResultsIn April 2020 the LHA Roma 1 implemented one DOCs in each local health district. 215 medical doctors were interviewed, reaching the sample target for health districts (80% CL and 10% MOE) and the whole LHA (90% CL and 5% MOE). Several aspects in the management of COVID-19 cases and close contacts of COVID-19 cases, and of the support of DOCs to GPs/FPs were investigated. More than 55% of the GPs and FPs interviewed found the DOCs useful and more than 78% would recommend a service DOC-like to other LHAs. The medical professionals interviewed would use DOCs in the future as support in treating vulnerable patients, utilizing digital health tools, enlisting specialist doctors, establishing networks, and facilitating professional counselling by nurses.ConclusionsThis study is an attempt to evaluate an organizational change happened during COVID-19 pandemic. DOCs were created to support GPs and FPs as a link between primary healthcare and public health. Although several difficulties were disclosed, DOCs’ experience can help to overcome the fragmentation of the systems and the duality between primary care and public health and make the system more resilient.

Human performance measures for cyber security operations centers

Human performance metrics and measures are important to Security Operations Centers (SOCs). Metrics are used by SOC managers to assess analysts’ performance. However, existing metrics for analysts tend to focus solely on task performance. Researchers and practitioners may value ideas on other dimensions by which the performance of an analyst can be measured. As studies on performance metrics for analysts continue to evolve, this paper provides timely insights and recommendations for researchers and practitioners on different dimensions by which the performance of an analyst can be measured. This paper identifies and presents various dimensions by which analysts’ performance could be measured. Beyond the identification of the different dimensions, this paper provides examples of measurable constructs under each suggested dimension in the context of a SOC.

Efficacy of the Allosteric MEK Inhibitor Trametinib in Relapsed and Refractory Juvenile Myelomonocytic Leukemia: A Report from the Children's Oncology Group

Background: Juvenile myelomonocytic leukemia (JMML) is an aggressive myeloproliferative neoplasm of infants and toddlers. Upfront therapies typically include high-dose cytarabine or azacitidine, but the only definitive treatment is hematopoietic stem cell transplantation (HSCT). While HSCT cures ~50% of patients, the prognosis is dismal for those who relapse. In the absence of a second HSCT, patients who relapse have a 2-year overall survival of ~10%. JMML is initiated by germline and somatic driver mutations in NF1, KRAS, NRAS, PTPN11, and CBL. These mutations converge on Ras signaling, leading to elevated levels of active Ras-GTP in specific cell lineages. Genetically engineered mouse (GEM) models accurately model key molecular, biologic, and biochemical features of JMML. Preclinical trials of the allosteric MEK inhibitors in Kras and Nf1 mutant mice demonstrated dramatic phenotypic responses with reduction in white blood cell counts, resolution of splenomegaly, and reversion to normal erythropoiesis. Based on the promising efficacy signal in GEM models, we evaluated trametinib, an orally bioavailable allosteric inhibitor of MEK1/2, in a prospective clinical trial in children with relapsed or refractory JMML to determine the overall response rate to trametinib. Results: Ten infants and children with JMML (median age 23.6 months) were enrolled and all were evaluable for safety and efficacy. Patients received age-adjusted dosing of trametinib for 28-day cycles and could remain on study for up to 12 cycles in the absence of disease progression or toxicity. A clonal Ras pathway mutation was confirmed in the blood and/or bone marrow of all patients. The objective response rate was 50% (two complete and three partial clinical responses). Four patients proceeded to HSCT after receiving protocol therapy and remain alive in complete remission with undetectable levels of the Ras pathway mutation identified at enrollment. Three additional patients completed 12 cycles of trametinib and continue to receive off-protocol therapy 6-24 months later with no change in the variant allele frequency of the underlying Ras pathway mutation. The remaining three patients had progressive disease with two demonstrating molecular evolution by the end of cycle 2. Paired pre- and post-trametinib RNASeq and proteomic analyses confirmed on-target biochemical effects of trametinib with down-regulation of both Ras/MAPK pathway related gene expression and MEK1/2 kinase activity, respectively. To gain deeper insight into how trametinib might affect distinct populations of hematopoietic cells, we generated single cell RNASeq data before and after treatment. The most prominent finding was a reduction in the proportions of classical and non-classical monocytes and broad downregulation of immune-related pathways in all cell populations. However, the downregulation of MAPK signaling genes was confined to specific cell types including, macrophages, classical monocytes, and granulocyte-monocyte progenitors, which uniquely displayed downregulated KRAS-related signatures following treatment. High DNA methylation and the presence of >1 mutation at enrollment correlated with lack of response to trametinib. Conclusions: We conducted an open label, phase 2 trial of trametinib in children with relapsed or refractory JMML. This is the first completed study of a MEK inhibitor in any hematologic malignancy in children. The trial met its primary objective and demonstrated a 50% objective response rate with 70% of patients bridging to a successful HSCT or completing the maximum 12 cycles permitted on study. The three patients who completed 12 cycles continue to receive trametinib off study for as long as 2 years. Although limited by a small number of patients, the long-term survival, and correlative molecular analyses from this trial raise provocative questions about whether certain patients with JMML might be spared the long-term adverse health risks of genotoxic HSCT conditioning regimens based on favorable molecular characteristics at diagnosis. This hypothesis will now be tested in a national, risk-stratified therapeutic trial (NCT05849662) of trametinib in combination with azacitidine in newly diagnosed patients. The authors would like to acknowledge funding and support from: NCTN Operations Center Grant (U10CA180886), NCTN Statistics & Data Center Grant (U10CA180899), and the St. Baldrick's Foundation.

An ILP approach for tactical flight rescheduling during airport access mode disruptions

AbstractAirport access mode disruptions, such as a subway shutdown, threaten the whole passenger door‐to‐door journey. When such a disruptive event occurs, knowledge of passengers' delays would help the airport operation centre to decide if a departure flight should be delayed. This paper proposes a tactical flight rescheduling at an airport to minimise the number of stranded passengers while considering operational constraints. An integer linear programming formulation of the problem is presented. Constraints such as terminal capacities, maximal runway throughput, minimum turnaround time or minimum transfer time for connecting passengers are considered. An exact and heuristic resolution is proposed and compared to a study case around Paris‐Charles de Gaulle airport. The new schedule satisfies the operational constraints and reduces up to 60% of the number of stranded passengers with moderate deviation from the initial planning.

Coordination strategies and concept of operations implemented during activation of public health emergency operations center for COVID-19 response in Pakistan

Public health emergency management systems encountered difficulties in developing countries, especially in Pakistan. The COVID-19 pandemic was extremely challenging for different agencies/departments in Pakistan. Health emergency management depends on a well-established public health emergency operations center that could generate a coordinated response to emergencies. We conducted an assessment of public health emergency response coordination implemented during the COVID-19 at strategic level. This was mix-method qualitative study. Primary data was collected by using a structured questionnaire, and secondary data was collected by desk review. The agencies engaged in pandemic response at the national level in Pakistan were included in the assessment. The overall score of the emergency response coordination system during COVID-19 was 49% for all agencies. We found that agencies faced challenges in leadership, legislation, and financing issues during the pandemic response (44%). None of the agencies had a fully developed framework for joint planning and response system for health emergencies. Roles and responsibilities attached to designated agencies in response were relatively clear (55%) for most of the agencies. Effective public health emergency response is based on multi-departmental coordination, resource mobilization, and clear roles for each agency. Pakistan must proactively address these challenges for pandemic response in future.

Knowledge management used in technology operations for innovations and value creation

Knowledge Management (KM) facilitates organizations with critical business decisions for competitive advantage. However, organizational leaders and technology teams still struggle with understanding how KM strategies and practices can help the company with innovations and business value additions. Therefore, this qualitative descriptive case study was performed in 2021 to examine KM’s capability maturity in creating business value and innovation for a large financial institution in Texas, headquartered in Virginia. The population sample consisted of one director, two Technology Operations Center Managers (TOCMs), and 10 power users (non-managers). The problem addressed by this study was understanding and describing the KM capability maturity and its relationship with leadership’s perceptions of KM value to determine how different features have impacted value creation and innovation. The two guiding research questions were: 1) How do KM administrators and senior leadership understand and describe KM related to creating business value and innovation in financial technology operations? 2) Why do TOCMs and power users understand and use KM the way they do? The conceptual framework was KM, business value, and innovation. Tools like Capability Maturity Models of Knowledge Management (CMM of KM) helped the researchers and TOC participants assess their current level of KM use and areas for improvement. Data collection was completed through a qualitative questionnaire after eligibility checks against company intranet profiles. Data analysis used NVivo 1.5 coding to identify themes from the TOCM participants’ perspectives to compare with archival and historical data. This study’s results contributed to the existing body of knowledge about KM from a technology operations perspective, including gaps in alignment and communication.

Readiness of public schools before reopening during COVID-19 pandemic: School-based cross-sectional survey in southern Ethiopia.

School closures in response to the COVID-19 impacted children's education, protection, and wellbeing. After understanding these impacts and that children were not super spreaders, countries including Ethiopia decided to reopen schools with specified preconditions. But when deciding to reopen schools, the benefits and risks across education, public health and socio-economic factors have to be evaluated. However, there was information gap on status of schools as per preconditions. Hence, this study was designed to investigate status of schools in Southern Ethiopia. School based cross-sectional study was conducted in October 2020 in Southern Ethiopia. Sample of 430 schools were included. National school reopening guideline was used to develop checklist for assessment. Data was collected by public health experts at regional emergency operation center. Descriptive analysis was performed to summarize data. A total of 430 schools were included. More than two thirds, 298 (69.3%), of schools were from rural areas while 132 (30.7%) were from urban settings. The general infection prevention and water, sanitation and hygiene (IPC-WASH) status of schools were poor and COVID-19 specific preparations were inadequate to meet national preconditions to reopen schools during the pandemic. Total score from 24 items observed ranged from 3 to 22 points with mean score of 11.75 (SD±4.02). No school scored 100% and only 41 (9.5%) scored above 75% while 216 (50.2%%) scored below half point that is 12 items. Both the basic and COVID-19 specific IPC-WASH status of schools were inadequate to implement national school reopening preconditions and general standards. Some of strategies planned to accommodate teaching process and preconditions maximized inequalities in education. Although COVID-19 impact lessened due to vaccination and other factors, it is rational to consider fulfilling water and basic sanitation facilities to schools to prevent communicable diseases of public health importance.

Tidal and Wave Renewable Energy: In Support of Marines during Expeditionary Advanced Base Operations

This study proposes an improved method of military logistics focused on tidal and wave renewable energy that reduces vulnerabilities tied to required resupplies and extends U.S. Marine Corps endurance in forward, austere expeditionary advanced base operations environments, ultimately creating options to persist within an adversary’s weapons engagement zone. Currently, one major problem surrounding traditional military operations is an overreliance on fuel, which results in increased consumption and financial costs, as well as the risk to force and risk to mission associated with logistical resupplies. In this article, both descriptive and explanatory qualitative research methods facilitate an understanding of military logistical problems and then explore current commercial logistical solutions for potential future military applications. The results highlight the ability of tidal energy converters to provide efficient and cost-saving renewable energy solutions at military bases and stations. Further results emphasize wave energy converters as viable renewable energy solutions to support the Marine littoral regiment with 2.8 megawatts of power (reducing consumption by 30 percent), combat operations centers, and light and ultralight hybrid tactical vehicles by cutting the tether of required resupplies, limiting fuel costs, and ultimately reducing the risk to force and risk to mission.

Self-Aware Cybersecurity Architecture for Autonomous Vehicles: Security through System-Level Accountability.

The inherent dynamism of recent technological advancements in intelligent vehicles has seen multitudes of noteworthy security concerns regarding interactions and data. As future mobility embraces the concept of vehicles-to-everything, it exacerbates security complexities and challenges concerning dynamism, adaptiveness, and self-awareness. It calls for a transition from security measures relying on static approaches and implementations. Therefore, to address this transition, this work proposes a hierarchical self-aware security architecture that effectively establishes accountability at the system level and further illustrates why such a proposed security architecture is relevant to intelligent vehicles. The article provides (1) a comprehensive understanding of the self-aware security concept, with emphasis on its hierarchical security architecture that enables system-level accountability, and (2) a deep dive into each layer supported by algorithms and a security-specific in-vehicle black box with external virtual security operation center (VSOC) interactions. In contrast to the present in-vehicle security measures, this architecture introduces characteristics and properties that enact self-awareness through system-level accountability. It implements hierarchical layers that enable real-time monitoring, analysis, decision-making, and in-vehicle and remote site integration regarding security-related decisions and activities.

Kinematic Modeling and Stable Control Law Designing for Four Mecanum Wheeled Mobile Robot Platform Based on Lyapunov Stability Criterion

Transportation in warehouses and production workshops is a matter of urgency today. Most warehouses arrange routes for circulation along the shelves, transportation vehicles will move on this road to perform the task of exporting or importing goods. Routes will be arranged to move in one direction because vehicles do not have enough space to turn around in cramped warehouses. This causes many difficulties in planning the trajectory for transportation vehicles, especially self-propelled vehicles. In order to have an appropriate transportation plan, it is necessary to solve many problems, including: reasonable transport equipment, sufficient number of devices, optimal route layout, algorithm of operation center for Positioning and Navigation of transportation equipment,... This study proposes a method for transportation using an omnidirectional automated guided vehicle (AGV). The AGV's omnidirectional mobility is supported by the mecanum wheels. This study consists of two parts, the first part focuses on kinematic modeling for mecanum wheels and extends to robot’s platform using four mecanum wheels. Part two proposes a diagram to calculate the errors of the robot compared to a reference tracking line, design a control law based on the Lyapunov stability criterion. The stability of the control law is verified and confirmed by simulation on MATLAB environment.

Identifying patients at imminent risk of out-of-hospital cardiac arrest during the Emergency Medical call: The views of call-takers

IntroductionThere is little research on the triage of patients who are not yet in cardiac arrest when the emergency call is initiated, but who deteriorate and suffer a cardiac arrest during the prehospital phase of care. The aim of this study was to investigate Emergency Operation Centre staff views on ways to improve the early identification of patients who are at imminent risk of cardiac arrest, and the barriers to achieving this. MethodsA qualitative interview and focus group study was conducted in two large Emergency Medical Services in England, United Kingdom. Twelve semi-structured interviews and one focus group were completed with Emergency Operations Centre staff. Data were analysed using reflexive thematic analysis. ResultsThree main themes were identified: The dispatch protocol and call-taker audit; Identifying and responding to deteriorating patients; Education, knowledge and skills. Barriers to recognising patients at imminent risk of cardiac arrest include a restrictive dispatch protocol, limited opportunity to monitor a patient, compliance auditing and inadequate education. Clinician support is not always optimal, and a lack of patient outcome feedback restricts dispatcher learning and development. Suggested remedies include improvements in training and education (call-takers and the public), software, clinical support and patient outcome feedback. ConclusionsEmergency Operation Centre staff identified a multitude of ways to improve the identification of patients who are at imminent risk of out-of-hospital cardiac arrest during the Emergency Medical Service call. Suggested areas for improvement include education, triage software, clinical support redesign and patient outcome feedback.

Boosting Holistic Cybersecurity Awareness with Outsourced Wide-Scope CyberSOC: A Generalization from a Spanish Public Organization Study

Public sector organizations are facing an escalating challenge with the increasing volume and complexity of cyberattacks, which disrupt essential public services and jeopardize citizen data and privacy. Effective cybersecurity management has become an urgent necessity. To combat these threats comprehensively, the active involvement of all functional areas is crucial, necessitating a heightened holistic cybersecurity awareness among tactical and operational teams responsible for implementing security measures. Public entities face various challenges in maintaining this awareness, including difficulties in building a skilled cybersecurity workforce, coordinating mixed internal and external teams, and adapting to the outsourcing trend, which includes cybersecurity operations centers (CyberSOCs). Our research began with an extensive literature analysis to expand our insights derived from previous works, followed by a Spanish case study in collaboration with a digitization-focused public organization. The study revealed common features shared by public organizations globally. Collaborating with this public entity, we developed strategies tailored to its characteristics and transferrable to other public organizations. As a result, we propose the “Wide-Scope CyberSOC” as an innovative outsourced solution to enhance holistic awareness among the cross-functional cybersecurity team and facilitate comprehensive cybersecurity adoption within public organizations. We have also documented essential requirements for public entities when contracting Wide-Scope CyberSOC services to ensure alignment with their specific needs, accompanied by a management framework for seamless operation.