Time-critical Situations Research Articles

Comments on the Proof of Adaptive Stochastic Set Cover Based on Adaptive Submodularity and Its Implications for the Group Identification Problem in “Group-Based Active Query Selection for Rapid Diagnosis in Time-Critical Situations”

We point out an issue with one of the results in Bellala et al. [1] that invokes a main result on adaptive stochastic minimum cost cover problem (Theorem 5.8) of Golovin and Krause. We construct an example that shows that the proof of Theorem 5.8 of Golovin and Krause is invalid, and therefore, the proof in Bellala et al. about the near-optimum performance of their algorithm is also invalid.

Subjektiver Kompetenzgewinn zur Durchführung eines Notfallkaiserschnitts mittels interdisziplinärem Simulationstraining

The emergency caesaran section is a gynecological emergency situation which is potentially life-threatening for mother and child. In the management of these time-critical situations human factors as well as the competence of the crisis resource management team have been shown to be important factors for success. The concept "simulation" has not been validated as a training tool for professional competence of multidisciplinary teams in the delivery suite. The aim of this study was, to assess the competence gain by subjective evaluation of the team members after taking part in an emergency caesarian section training which is integrable into the daily clinic setting. Method 36 members of a multidisciplinary team of a delivery suite took part in a 4-hourly "high-fidelity" simulation training "emergency caesarian section". Scenarios were created around the case setting of eclampsia with bradycardia of the child, uterus rupture, placenta abruption and cord prolapse. Each participant was involved in 2 scenarios as either a spectator or a team member. Using a questionnaire, the course performance and debriefing were evaluated and the subjective professional competence in Crisis Resource Management were recorded. Results In the collective of the trainee (over/equal 5 years), 25% had no experience in any cases of emergency caesarean in practice. On a scale of 1 to 6 (1=very good, 6=fail) the course was given an overall mark of 1.4 and a mark of 1.8 for its relevance to daily work. 6 months after the training, participants rated their competencies in prioritising necessary actions, following treatment plans, communicating among the team members as well as integrating new information as significantly improved. Conclusion The 4-hour simulation training can be easily integrated into everyday clinical practice. The participants marked the course scenarios as realistic and relevant for their clinical practice. The number of years of prior work experience is not significanty related with the experience in rare emergency situations. The interdisciplinary team training is a way to improve individual performance as well as to establish and practise interdisciplinary emergency concepts.

Willingness to click: Risk information seeking during imminent threats

Short messaging systems have the potential to deliver targeted messages to individuals needing critical safety information. However, their limited content may provide insufficient life‐saving information. One solution is to include a hyperlink that allows message recipients access to a web page. Research has not examined whether at‐risk individuals are willing to use this strategy in time critical situations. Using constructs from the risk information seeking and processing model, this study investigates how individuals perceive and make decisions to click on hyperlinks during crisis events. Findings suggest that the nature and timing of the crisis, risk judgement, and risk perceptions strongly influence decisions to click in crises. Suggestions are offered on ways to facilitate information seeking on short messaging systems during crises.

Effect of Robot Performance on Human–Robot Trust in Time-Critical Situations

Robots have the potential to save lives in high-risk situations, such as emergency evacuations. To realize this potential, we must understand how factors such as the robot's performance, the riskiness of the situation, and the evacuee's motivation influence his or her decision to follow a robot. In this paper, we developed a set of experiments that tasked individuals with navigating a virtual maze using different methods to simulate an evacuation. Participants chose whether or not to use the robot for guidance in each of two separate navigation rounds. The robot performed poorly in two of the three conditions. The participant's decision to use the robot and self-reported trust in the robot served as dependent measures. A 53% drop in self-reported trust was found when the robot performs poorly. Self-reports of trust were strongly correlated with the decision to use the robot for guidance ( $\phi ({90}) = + 0.745$ ). We conclude that a mistake made by a robot will cause a person to have a significantly lower level of trust in it in later interactions.

A real-time man-in-loop threat evaluation and resource assignment in defense

Efficient weapon threat assignment reflects military proficiency and requires prompt decision while managing the available resources. An important problem which commanders/decision makers face is to optimally utilize the resources in complex and time constraints situations. Several solutions have been proposed in the literature. In this paper, an innovative approach is proposed for threat evaluation and weapon assignment (TEWA) by following 3-dimensional stable marriage algorithm (3-D SMA). This proposed model incorporates new parameters and constraints i.e. supply chain, inventory of resources and multiple threats-weapons assignments that outperforms the previous techniques. This suggested model is based on threat perception followed by an integration of parametric based automatic threat evaluation technique for further weapon scheduling and assignment problem keeping in view that the threat with greater threat index has higher priority to be intercepted and weapons’ kill probability. The experimental section shows that our proposed approach has greatly improved in comparison with other approaches. The results showed that the threat neutralization is improved up to 25% reducing the usage of ammunition till 31.1%. The damage of assets abridged to 28.5% in comparison with existing approaches. The proposed approach elucidates that TEWA is an efficient real-time threat perception and optimal multi-threat scheduling problem at weapons’ resolution. It is a three-stage process, where the first stage perceives the threat, the second stage works on threat evaluation and the final stage focuses on weapon scheduling and assignment problem. The addition of new parameters and constraints in the new proposed model makes it a unique approach in which more accurate results, in neutralizing the threats, are obtained with less use of ammunition and damage of assets that makes TEWA more effective and efficient tool for optimum decision making in time critical situations.

Clinicians\u2019 views and experiences of offering two alternative consent pathways for participation in a preterm intrapartum trial: a qualitative study

BackgroundThe Cord Pilot Trial compared alternative policies for timing of cord clamping at very preterm birth at eight UK hospitals. Preterm birth can be rapid and unexpected, allowing little time for the usual consent process. Therefore, in addition to the usual procedure for written consent, a two-stage pathway for consent for use when birth was imminent was developed. The aims of this study were to explore clinicians’ views and experiences of offering two consent pathways for recruitment to a randomised trial of timing of cord clamping at very preterm birth.MethodsThis was a qualitative study using semi-structured interviews. Clinicians from eight hospitals in the UK who had been involved in offering consent to the Cord Pilot Trial were invited to take part in an interview. Clinicians were interviewed in person or by telephone. Interviews were analysed using inductive systematic thematic analysis.ResultsSeventeen clinicians who had either offered usual written consent only (n = 6) or both the two-stage pathway (with oral assent before the birth and written consent after the birth) and usual written consent (n = 11) were interviewed. Six themes were identified: (1) team approach to offering participation; (2) consent form as a record; (3) consent and participation as a continual process; (4) different consent pathways for different trials; (5) balance between time, information, and understanding; and (6) validity of consent. Overall, clinicians were supportive of the two-stage consent pathway. Some clinicians felt that in time-critical situations oral assent presented an advantage over the usual written consent as they provided information on a “need to know” basis. However, there was some concern about how much information should be given for oral assent, and how this is understood by women when birth is imminent.ConclusionsThe two-stage pathway for consent developed for use in the Cord Pilot Trial when birth was imminent was acceptable to clinicians for comparable low-risk studies, although some concerns were raised about the practicalities of obtaining oral assent.Trial registrationISRCTN Registry, ISRCTN21456601. Registered on 28 February 2013.

Conditional Random Field (CRF)-Boosting: Constructing a Robust Online Hybrid Boosting Multiple Object Tracker Facilitated by CRF Learning.

Due to the reasonably acceptable performance of state-of-the-art object detectors, tracking-by-detection is a standard strategy for visual multi-object tracking (MOT). In particular, online MOT is more demanding due to its diverse applications in time-critical situations. A main issue of realizing online MOT is how to associate noisy object detection results on a new frame with previously being tracked objects. In this work, we propose a multi-object tracker method called CRF-boosting which utilizes a hybrid data association method based on online hybrid boosting facilitated by a conditional random field (CRF) for establishing online MOT. For data association, learned CRF is used to generate reliable low-level tracklets and then these are used as the input of the hybrid boosting. To do so, while existing data association methods based on boosting algorithms have the necessity of training data having ground truth information to improve robustness, CRF-boosting ensures sufficient robustness without such information due to the synergetic cascaded learning procedure. Further, a hierarchical feature association framework is adopted to further improve MOT accuracy. From experimental results on public datasets, we could conclude that the benefit of proposed hybrid approach compared to the other competitive MOT systems is noticeable.

Online Analysis of Medical Time Series

Complex, often high-dimensional time series are observed in medical applications such as intensive care. We review statistical tools for intelligent alarm systems, which are helpful for guiding medical decision-making in time-critical situations. The procedures described can also be applied for decision support or in closed-loop controllers. Robust time series filters allow one to extract a signal in the form of a time-varying trend with little or no delay. Additional rules—based, for instance, on suitably designed statistical tests—can be incorporated to preserve or detect interesting patterns such as level shifts or trend changes. Statistical pattern detection is a useful preprocessing step for decision-support systems. Dimension reduction techniques allow the compression of the often high-dimensional time series into a few variables containing most of the information inherent in the observed data. Combining such techniques with tools for analyzing the relationships among the variables in the form of large partial correlations or similar trend behavior improves the interpretability of the extracted variables and provides information that is thus meaningful to physicians.

Learning and Treatment of Anaphylaxis by Laypeople: A Simulation Study Using Pupilar Technology.

An anaphylactic shock is a time-critical emergency situation. The decision-making during emergencies is an important responsibility but difficult to study. Eye-tracking technology allows us to identify visual patterns involved in the decision-making. The aim of this pilot study was to evaluate two training models for the recognition and treatment of anaphylaxis by laypeople, based on expert assessment and eye-tracking technology. A cross-sectional quasi-experimental simulation study was made to evaluate the identification and treatment of anaphylaxis. 50 subjects were randomly assigned to four groups: three groups watching different training videos with content supervised by sanitary personnel and one control group who received face-to-face training during paediatric practice. To evaluate the learning, a simulation scenario represented by an anaphylaxis' victim was designed. A device capturing eye movement as well as expert valuation was used to evaluate the performance. The subjects that underwent paediatric face-to-face training achieved better and faster recognition of the anaphylaxis. They also used the adrenaline injector with better precision and less mistakes, and they needed a smaller number of visual fixations to recognise the anaphylaxis and to make the decision to inject epinephrine. Analysing the different video formats, mixed results were obtained. Therefore, they should be tested to evaluate their usability before implementation.

Controllability of Partially Automated Driving functions – Does it matter whether drivers are allowed to take their hands off the steering wheel?

Different motor vehicle manufacturers have recently introduced assistance systems that are capable of both longitudinal and lateral vehicle control, while the driver still has to be able to take over the vehicle control at all times (so-called Partial Automation). While these systems usually allow hands-free driving only for short time periods (e.g., 10s), there has been little research whether allowing longer time periods of hands-off driving actually has a negative impact on driving safety in situations that the automation cannot handle alone. Altogether, two partially automated assistance systems, differing in the permitted hands-off intervals (Hands-off system vs. Hands-on system, n=20 participants per assistance condition, age 25–70years) were implemented in the driving simulation with a realistic take-over concept. The Hands-off system is defined by having a permitted hands-off interval of 120s, while the Hands-on system is defined by a permitted hands-off interval of 10s. Drivers’ reactions at a functional system limit were tested under conditions of high ecological validity: while driving in a traffic jam, participants unexpectedly encountered a time-critical situation, consisting of a vehicle at standstill that appeared suddenly and required immediate action. A visual-auditory take-over request was issued to the drivers. Regardless of the hands-off interval, all participants brought the vehicle to a safe stop. In spite of a stronger brake reaction with the Hands-on system, no significant differences between assistance levels were found in brake reaction times and the criticality of the situation. The reason for this may be that most of the drivers kept contact with the steering wheel, even in the Hands-off condition. Neither age nor prior experience with ACC was found to impact the results. The study thus demonstrates that permitting longer periods of hands-off driving does not necessarily lead to performance deficits of the driver in the case of take-over situations, if a comprehensive take-over concept is implemented.

Using Arden Syntax Medical Logic Modules to reduce overutilization of laboratory tests for detection of bacterial infections-Success or failure?

Bacterial infections frequently cause prolonged intensive care unit (ICU) stays. Repeated measurements of the procalcitonin (PCT) biomarker are typically used for early detection and follow up of bacterial infections and sepsis, but those PCT measurements are costly. To avoid overutilization, we developed and evaluated a clinical decision support system (CDSS) in Arden Syntax which computes necessary and preventable PCT orders. The CDSS implements a rule set based on the latest PCT value, the time period since this measurement, and the PCT trend scenario. We assessed the CDSS effects on the daily rate of ordered PCT tests within a prospective study having two ON and two OFF phases in a surgical ICU. In addition, we performed interviews with the participating physicians to investigate their experience with the CDSS advice. Prior to the deployment of the CDSS, 22% of the performed PCT tests were potentially preventable according to the rule set. During the first ON phase the daily rate of ordered PCT tests per patient decreased significantly from 0.807 to 0.662. In subsequent OFF, ON and OFF phases, however, PCT utilization reached again daily rates of 0.733, 0.803, and 0.792, respectively. The interviews demonstrated that the physicians were aware of the problem of PCT overutilization, which they primarily attributed to acute time constraints. The responders assumed that the majority of preventable measurements are indiscriminately ordered for patients during longer ICU stays. We observed an 18% reduction of PCT tests within the first four weeks of CDSS support in the investigated ICU. This reduction may have been influenced by raised awareness of the overutilization problem; the extent of this influence cannot be determined in our study design. No reduction of PCT tests could be observed during the second ON phase. The physician interviews indicated that time critical ICU situations can prevent extensive reflection about the necessity of individual tests. In order to achieve an enduring effect on PCT utilization, we will have to proceed to electronic order entry.

Developing interactive geospatial holograms for spatial decision-making

Spatial decision-making in time-critical situations requires effective and usable two-dimensional and three-dimensional (3D) cartographic products. Holographic displays allow decision makers to work with auto-stereoscopic maps without the hassle of interacting with complex user interfaces or additional vision hardware. Holographic production processes have advanced greatly in a short period and now support timely and full integration of digital 3D models in geospatial holograms. George Mason University’s and Zebra Imaging’s research on interactive holographic motion displays showcases the leadership in moving cartography and geovisualization research in the US forward. In close cooperation with academic researchers, decision makers, and domain experts, the usability and usefulness of these cartographic products is tested and design guidelines for effective geospatial holograms are being developed.

Performance Analysis of Various Routing Protocols with Preference to Border Nodes in VANET Environment

Vehicular Ad-hoc Networks (VANETs) where vehicles are described as the moving nodes, is a subclass of Mobile Adhoc Networks (MANETs) in which moving nodes has the potential of self-organization without need of fixed infrastructures. VANET provides road safety, traffic control management and spreading the important information to drivers of the moving vehicles in highly mobile environments. Various safety and non-safety applications provided in timecritical situations, high node density and varying mobility distinguishes VANETs from other wireless networks. Routing protocols for MANETs are not suitable in VANETs but position based routing protocols are much suitable. In this paper, we describe the essentials of VANETs and elaborate various routing protocols mostly position based routing protocols with preference to border nodes and compare the existing protocols by considering some simulation criteria characterized by network size, number of nodes and time to simulate the network using the NS2 simulator and evaluated the performance of routing protocols and compute the results in terms of packet delivery ratio, end to end delay, throughput and describe which protocol gives the better results.

A Practical Approach for Digital Forensic Triage

In order to uncover truths to serve justice, case-related data collected from a digital investigation requires substantial resources to analyze, especially in time-critical situations. At present, however, digital forensics has not evolved to meet this ever-increasing demand. Digital forensic triage is a promising solution, as it is designed to maximize the use of resources according to a system of priorities, and hence the efficiency and effectiveness of forensic examinations can be increased. Nevertheless, the lack of concrete methods limits efforts to implement triage. This paper presents a practical approach that is designed to build a prioritizing solution. In this work a new process model is derived based on the presented approach, and it is particularly suited to scenarios where forensic examiners do not have enough time and resources to conduct a full examination and analysis. An example is described to demonstrate how this approach can be used to meet the requirements of network forensic investigations.

Sparse L<sub>p</sub>-Norm Based ICP for 3D Registration

In order to uncover truths to serve justice, case-related data collected from a digital investigation requires substantial resources to analyze, especially in time-critical situations. At present, however, digital forensics has not evolved to meet this ever-increasing demand. Digital forensic triage is a promising solution, as it is designed to maximize the use of resources according to a system of priorities, and hence the efficiency and effectiveness of forensic examinations can be increased. Nevertheless, the lack of concrete methods limits efforts to implement triage. This paper presents a practical approach that is designed to build a prioritizing solution. In this work a newprocess model is derived based on the presented approach, and it is particularly suited to scenarios where forensic examiners do not have enough time and resources to conduct a full examination and analysis. An example is described to demonstrate how this approach can be used to meet the requirements of network forensic investigations.

Designing a Decision Support System for Disaster Management and Recovery

Returning to basic function and then to normalcy is important after a disaster. This level of resilience allows businesses to reopen, social and emergency services to act quickly and effectively in aiding citizens, and returns a feeling of safety and comfort to those affected. Unfortunately, those tasked with responding and managing the disaster are often overwhelmed and their decision-making taxed, causing the response itself to be inefficient. One way to aid disaster response teams is the introduction of a decision support system (DSS) to support decision making capabilities in time-critical situations. The purpose of this research was to create a framework for disaster recovery and a prototype DSS to aid both command center workers and those in the field. Our goal was to help make response easier and more efficient, as well as evaluate our prototype design for usability.

Intranasal medications in pediatric emergency medicine.

Intranasal medication administration in the emergency care of children has been reported for at least 20 years and is gaining popularity because of ease of administration, rapid onset of action, and relatively little pain to the patient. The ability to avoid a needle stick is often attractive to practitioners, in addition to children and their parents. In time-critical situations for which emergent administration of medication is needed, the intranasal route may be associated with more rapid medication administration. This article reviews the use of intranasal medications in the emergency care of children. Particular attention will be paid to anatomy and its impact on drug delivery, pharmacodynamics, medications currently administered by this route, delivery devices available, tips for use, and future directions.

Multi-operator wireless mesh networks secured by an all-encompassing security architecture

Wireless Mesh Networks (WMNs) consist of a wirelessly connected infrastructure of Mesh Routers (MRs) connected to the Internet via Mesh Gateways. Previous proposals on WMN security mainly focus on mesh networks operated by a single operator and rarely support mobility of Mesh Clients (MCs) with the help of secure roaming and handover procedures. While these approaches protect the communication of MCs against external attackers, they do not take internal attackers into account. In our previous work, we proposed a security architecture for single-operator WMNs, extended this architecture to the multi-operator case to support roaming between operators and secure infrastructure sharing and proposed secure handover procedures within the domain of a single operator. In this paper, we merge the different aspects of our prior proposals together to form a comprehensive security architecture for multi-operator WMNs. Our solution is based on open standards and explicitly addresses internal attackers. In addition, we propose pro-active handover services between different operators and show how dedicated MRs can take over authentication services in time-critical situations such as handover procedures.

Error prevention through management of complications in urology: standard operating procedures from commercial aviation as a model

Patient safety and risk/complication management rank among the current megatrends in modern medicine, which has undoubtedly become more complex. In time-critical, error-prone and difficult situations, which often occur repeatedly in everyday clinical practice, guidelines are inappropriate for acting rapidly and intelligently. With the establishment and consistent use of standard operating procedures like in commercial aviation, a possible strategic approach is available. These medical aids to decision-making - quick reference cards - are short, optimized instructions that enable a standardized procedure in case of medical claims.

Measuring Cognitive Load Using Linguistic Features: Implications for Usability Evaluation and Adaptive Interaction Design

An intelligent adaptable system, aware of a user’s experienced cognitive load, may help improve performance in complex, time-critical situations by dynamically deploying more appropriate output strategies to reduce cognitive load. However, measuring a user’s cognitive load robustly, in real-time is not a trivial task. Many research studies have attempted to assess users’ cognitive load using different measurements, but these are often unsuitable for deployment in real-life applications due to high intrusiveness. Relatively novel linguistic behavioral features as potential indices of user’s cognitive load is proposed. These features may be collected implicitly and nonintrusively supporting real-time assessment of users’ cognitive load and accordingly allowing adaptive usability evaluation and interaction. Results from a laboratory experiment show significantly different linguistic patterns under different task complexities and cognitive load levels. Implications of the research for adaptive interaction are also discussed, that is, how the cognitive load measurement-based approach could be used for user interface evaluation and interaction design improvement.