Realistic simulation in nursing education: Testing two scenario‐based models

Aim: To evaluate students' self- perceived pedagogical outcomes when using a digital scenario- based tool compared to traditional scenarios printed on paper. Design: This study used a within- subjects experiment. Method: A digital platform for scenario development was developed, focusing on patients' regaining independence and returning home after an acute event. Students participated in two simulation activities, differing only in the type of scenario used and completed a questionnaire to evaluate their learning experience. Results: Students considered that the new scenario template provided a clearer understanding of the situation under analysis, allowing them to recognize the focuses of attention to be prioritized when formulating the intervention plan. No Patient or Public Contribution: A digital platform for a standardized process of scenario writing to help realistic simulation in nursing education is a novelty in this study and will likely contribute to substantial learning gains.info:eu-repo/semantics/publishedVersio

Non-Linearities, Model Uncertainty, and Macro Stress Testing

A distinguishing feature of macro stress testing exercises is the use of macroeconomic models in scenario design and implementation. It is widely agreed that scenarios should be based on "rare but plausible" events that have either resulted in vulnerabilities in the past or could do so in the future. This requirement, however, raises a number of difficult statistical and methodological problems. Economic models, as well as the statistical models of the relationships among economic variables, generally focus on capturing the average rather than the extreme behaviour, and frequently rely on the assumption of linearity. In this paper we show that these models are particularly ill-suited for stress-testing as they do not adequately capture past behaviour in extreme events, nor do they generate plausible responses to shocks under stress. Whereas one might argue that the use of these models is still preferable to no having no models, since they at least impose the consistency restrictions on the paths generated under the scenario, failing to deal with a large extent of uncertainty of these paths may lead to results that are non-informative, and potentially misleading. The paper illustrates both of these problems by a series of examples, but our conclusions have broader implications for the types of models that would be useful in these exercises.Financial stability

Adaptive Mean Value Function Based Quality Assessment of Software Reliable Growth Models

Software growth models aims for reliability of the application over a period of time. Assessment of such models is of great interest since many faults arises with the models during the operation over a span of time. In this paper a adaptive mean value function based testing and estimation of the parameters were discussed. The proposed approach is also compared against the conventional testing approaches and found that the proposed method able to detect the fault under different scenario and proves to give better performance under a constrained environment. Keywords: Software reliability, Growth models, testing analysis, Fault detection and correction

Clinical and economic impact of current ALK rearrangement testing in Spain compared with a hypothetical no-testing scenario

Background: Currently biomarkers play an essential role in diagnosis, treatment, and management of cancer. In non-small cell lung cancer (NSCLC) determination of biomarkers such as ALK, EGFR, ROS1 or PD-L1 is mandatory for an adequate treatment decision. The aim of this study is to determine the clinical and economic impact of current anaplastic lymphoma kinase testing scenario in Spain. Methods: A joint model, composed by decision-tree and Markov models, was developed to estimate the long-term health outcomes and costs of NSCLC patients, by comparing the current testing scenario for ALK in Spain vs a hypothetical no-testing. The current distribution of testing strategies for ALK determination and their sensitivity and specificity data were obtained from the literature. Treatment allocation based on the molecular testing result were defined by a panel of Spanish experts. To assess long-term effects of each treatment, 3-states Markov models were developed, where progression-free survival and overall survival curves were extrapolated using exponential models. Medical direct costs (expressed in €, 2019) were included. A lifetime horizon was used and a discount rate of 3% was applied for both costs and health effects. Several sensitivity analyses, both deterministic and probabilistic, were performed in order test the robustness of the analysis. Results: We estimated a target population of 7628 NSCLC patients, including those with non-squamous histology and those with squamous carcinomas who were never smokers. Over the lifetime horizon, the current ALK testing scenario produced additional 5060 and 3906 life-years and quality-adjusted life-years (QALY), respectively, compared with the no-testing scenario. Total direct costs were increased up to € 51,319,053 for testing scenario. The incremental cost-effectiveness ratio was 10,142 €/QALY. The sensitivity analyses carried out confirmed the robustness of the base-case results, being the treatment allocation and the test accuracy (sensitivity and specificity data) the key drivers of the model. Conclusions: ALK testing in advanced NSCLC patients, non-squamous and never-smoker squamous, provides more than 3000 QALYs in Spain over a lifetime horizon. Comparing this gain in health outcomes with the incremental costs, the resulting incremental cost-effectiveness ratio reinforces that testing non-squamous and never-smoker squamous NSCLC is a cost-effective strategy in Spain

Review of local non-Gaussianity from multi-field inflation

We review models which generate a large non-Gaussianity of the local form. We first briefly consider three models which generate the non-Gaussianity either at or after the end of inflation; the curvaton scenario, modulated (p)reheating and an inhomogeneous end of inflation. We then focus on ways of generating the non-Gaussianity during inflation. We derive general conditions which a product or sum separable potential must satisfy in order to generate a large local bispectrum during slow-roll inflation. As an application we consider two-field hybrid inflation. We then derive a formalism not based on slow roll which can be applied to models in which the slow-roll parameters become large before inflation ends. An exactly soluble two-field model is given in which this happens. Finally we also consider further non-Gaussian observables; a scale dependence of f_NL and the trispectrum.Comment: 22 pages, 2 figures. Invited review for the special issue "Testing the Gaussianity and Statistical Isotropy of the Universe" for Advances in Astronomy. v2: Numerous references and comments adde

Model testing of radioactive contamination Cs-137 of soils and bottom sediments in the Romachka river (Tomsk region, Russia)

This paper presents results of testing models for the radioactive contamination of river water and bottom sediments by 137Cs. The scenario for the model testing is based on data from the Romashka River, which was contaminated as a result of accidents at the Siberian Chemical Combine (Russia, Region of Tomsk). The input data include the following: estimates of inventories of 137Cs in the floodplain of the downstream part of Romashka River; the estimated annual runoff of 137Cs from the downstream part of Romachka River; data on the precipitation, hydrological and hydrochemical characteristics of the river. The endpoints of the scenario are model predictions of the activity concentrations of 137Cs in water and bottom sediments along the Romachka River in 2012-2013. Calculations for the Romashka scenario were performed by the Institute of radioprotection and nuclear safety (model CASTEAUR and HAMSTER. As a whole, the radionuclide predictions for137Cs for all considered models. At the same time the CASTEAUR model estimate the activity concentrations of 137Cs and in water more precisely than in bottom sediments