Addressing the challenges of ECMO simulation

This document is the Accepted Manuscript. The final, definitive version of this paper has been published in Perfusion, May 2018, published by SAGE Publishing, All rights reserved.Introduction/Aim: The patient’s condition and high-risk nature of extracorporeal membrane oxygenation (ECMO) therapy force clinical services to ensure clinicians are properly trained and always ready to deal effectively with critical situations. Simulation-based education (SBE), from the simplest approaches to the most immersive modalities, helps promote optimum individual and team performance. The risks of SBE are negative learning, inauthenticity in learning and over-reliance on the participants’ suspension of disbelief. This is especially relevant to ECMO SBE as circuit/patient interactions are difficult to fully simulate without confusing circuit alterations. Methods: Our efforts concentrate on making ECMO simulation easier and more realistic in order to reduce the current gap there is between SBE and real ECMO patient care. Issues to be overcome include controlling the circuit pressures, system failures, patient issues, blood colour and cost factors. Key to our developments are the hospital-university collaboration and research funding. Results: A prototype ECMO simulator has been developed that allows for realistic ECMO SBE. The system emulates the ECMO machine interface with remotely controllable pressure parameters, haemorrhaging, line chattering, air bubble noise and simulated blood colour change. Conclusion: The prototype simulator allows the simulation of common ECMO emergencies through innovative solutions that enhance the fidelity of ECMO SBE and reduce the requirement for suspension of disbelief from participants. Future developments will encompass the patient cannulation aspect.Peer reviewe

INTEROPERABILITY FOR MODELING AND SIMULATION IN MARITIME EXTENDED FRAMEWORK

This thesis reports on the most relevant researches performed during the years of the Ph.D. at the Genova University and within the Simulation Team. The researches have been performed according to M&S well known recognized standards. The studies performed on interoperable simulation cover all the environments of the Extended Maritime Framework, namely Sea Surface, Underwater, Air, Coast & Land, Space and Cyber Space. The applications cover both the civil and defence domain. The aim is to demonstrate the potential of M&S applications for the Extended Maritime Framework, applied to innovative unmanned vehicles as well as to traditional assets, human personnel included. A variety of techniques and methodology have been fruitfully applied in the researches, ranging from interoperable simulation, discrete event simulation, stochastic simulation, artificial intelligence, decision support system and even human behaviour modelling

From Social Simulation to Integrative System Design

As the recent financial crisis showed, today there is a strong need to gain "ecological perspective" of all relevant interactions in socio-economic-techno-environmental systems. For this, we suggested to set-up a network of Centers for integrative systems design, which shall be able to run all potentially relevant scenarios, identify causality chains, explore feedback and cascading effects for a number of model variants, and determine the reliability of their implications (given the validity of the underlying models). They will be able to detect possible negative side effect of policy decisions, before they occur. The Centers belonging to this network of Integrative Systems Design Centers would be focused on a particular field, but they would be part of an attempt to eventually cover all relevant areas of society and economy and integrate them within a "Living Earth Simulator". The results of all research activities of such Centers would be turned into informative input for political Decision Arenas. For example, Crisis Observatories (for financial instabilities, shortages of resources, environmental change, conflict, spreading of diseases, etc.) would be connected with such Decision Arenas for the purpose of visualization, in order to make complex interdependencies understandable to scientists, decision-makers, and the general public.Comment: 34 pages, Visioneer White Paper, see http://www.visioneer.ethz.c

Games for a new climate: experiencing the complexity of future risks

This repository item contains a single issue of the Pardee Center Task Force Reports, a publication series that began publishing in 2009 by the Boston University Frederick S. Pardee Center for the Study of the Longer-Range Future.This report is a product of the Pardee Center Task Force on Games for a New Climate, which met at Pardee House at Boston University in March 2012. The 12-member Task Force was convened on behalf of the Pardee Center by Visiting Research Fellow Pablo Suarez in collaboration with the Red Cross/Red Crescent Climate Centre to “explore the potential of participatory, game-based processes for accelerating learning, fostering dialogue, and promoting action through real-world decisions affecting the longer-range future, with an emphasis on humanitarian and development work, particularly involving climate risk management.” Compiled and edited by Janot Mendler de Suarez, Pablo Suarez and Carina Bachofen, the report includes contributions from all of the Task Force members and provides a detailed exploration of the current and potential ways in which games can be used to help a variety of stakeholders – including subsistence farmers, humanitarian workers, scientists, policymakers, and donors – to both understand and experience the difficulty and risks involved related to decision-making in a complex and uncertain future. The dozen Task Force experts who contributed to the report represent academic institutions, humanitarian organization, other non-governmental organizations, and game design firms with backgrounds ranging from climate modeling and anthropology to community-level disaster management and national and global policymaking as well as game design.Red Cross/Red Crescent Climate Centr

Escalation: Explorative studies of high-risk situations from the theoretical perspectives of complexity and joint cognitive systems

The main aim of the research is to explore different aspects of organisational resilience in escalating situations, with an investigation of both theoretical and practical implications. From the platform of an explorative approach, this study makes use of naturalistic research in the domain of health care and experimental simulation studies, in order to establish a broad theoretical framework vis-à-vis the processes of escalation. Rather than treating notions of crisis as processes taking place outside the organisation, the thesis outlines a view of escalation as an inherent part of organisational reproduction and structure, rooted in historical relations of power and professional identities. The thesis goes on to look at pragmatic implications in areas such as the establishment of efficient coordination structures in escalating situations, and team performance assessment

Human behaviour modelling in complex socio-technical systems : an agent based approach

For many years we have been striving to understand human behaviour and our interactions with our socio-technological environment. By advancing our knowledge in this area, we have helped the design of new or improved work processes and technologies. Historically, much of the work in analysing social interactions has been conducted within the social sciences. However, computer simulation has brought an extra tool in trying to understand and model human behaviours. Using an agent based approach this presentation describes my work in constructing computational models of human behaviour for informing design through simulation. With examples from projects in two main application areas of crisis and emergency management, and energy management I describe how my work addresses some main issues in agent based social simulation. The first concerns the process by which we develop these models. The second lies in the nature of socio-technical systems. Human societies are a perfect example of a complex system exhibiting characteristics of self-organisation, adaptability and showing emergent phenomena such as cooperation and robustness. I describe how complex systems theory may be applied to improve our understanding of socio-technical systems, and how our micro level interactions lead to emergent mutual awareness for problem-solving. From agent based simulation systems I show how context awareness may be modelled. Looking forward to the future, I discuss how the increasing prevalence of artificial agents in our society will cause us to re-examine the new types of interactions and cooperative behaviours that will emerge.Depuis de nombreuses années, nous nous sommes efforcés de comprendre le comportement humain et nos interactions avec l'environnement sociotechnique. Grâce à l'avancée de nos connaissances dans ce domaine, nous avons contribué à la conception de technologies et de processus de travail nouveaux ou améliorés. Historiquement, une part importante du travail d'analyse des interactions sociales fut entreprise au sein des sciences sociales. Cependant, la simulation informatique a apporté un nouvel outil pour tenter de comprendre et de modéliser les comportements humains. En utilisant une approche à base d'agents, cette présentation décrit mon travail sur la construction de modèles informatiques du comportement humain pour guider la conception par la simulation. A l'aide d'exemples issus de projets des deux domaines d'application que sont la gestion des crises et de l'urgence et la gestion de l'énergie, je décris comment mon travail aborde certains problèmes centraux à la simulation sociale à base d'agents. Le premier concerne le processus par lequel nous développons ces modèles. Le second problème provient de la nature des systèmes sociotechniques. Les sociétés humaines constituent un exemple parfait de système complexe possédant des caractéristiques d'auto-organisation et d'adaptabilité, et affichant des phénomènes émergents tels que la coopération et la robustesse. Je décris comment la théorie des systèmes complexes peut être appliquée pour améliorer notre compréhension des systèmes sociotechniques, et comment nos interactions au niveau microscopique mènent à l'émergence d'une conscience mutuelle pour la résolution de problèmes. A partir de systèmes de simulation à base d'agents, je montre comment la conscience du contexte peut être modélisée. En terme de perspectives, j'expliquerai comment la hausse de la prévalence des agents artificiels dans notre société nous forcera à considérer de nouveaux types d'interactions et de comportements coopératifs