27 research outputs found
Visual Attention of Anesthesia Providers in Simulated Anesthesia Emergencies Using Conventional Number-Based and Avatar-Based Patient Monitoring: Prospective Eye-Tracking Study
Background: Inadequate situational awareness accounts for two-thirds of preventable complications in anesthesia. An essential tool for situational awareness in the perioperative setting is the patient monitor. However, the conventional monitor has several weaknesses. Avatar-based patient monitoring may address these shortcomings and promote situation awareness, a prerequisite for good decision making.
Objective: The spatial distribution of visual attention is a fundamental process for achieving adequate situation awareness and thus a potential quantifiable surrogate for situation awareness. Moreover, measuring visual attention with a head-mounted eye-tracker may provide insights into usage and acceptance of the new avatar-based patient monitoring modality.
Methods: This prospective eye-tracking study compared anesthesia providers' visual attention on conventional and avatar-based patient monitors during simulated critical anesthesia events. We defined visual attention, measured as fixation count and dwell time, as our primary outcome. We correlated visual attention with the potential confounders: performance in managing simulated critical anesthesia events (task performance), work experience, and profession. We used mixed linear models to analyze the results.
Results: Fifty-two teams performed 156 simulations. After a manual quality check of the eye-tracking footage, we excluded 57 simulations due to technical problems and quality issues. Participants had a median of 198 (IQR 92.5-317.5) fixations on the patient monitor with a median dwell time of 30.2 (IQR 14.9-51.3) seconds. We found no significant difference in participants' visual attention when using avatar-based patient monitoring or conventional patient monitoring. However, we found that with each percentage point of better task performance, the number of fixations decreased by about 1.39 (coefficient -1.39; 95% CI -2.44 to -0.34; P=.02), and the dwell time diminished by 0.23 seconds (coefficient -0.23; 95% CI: -0.4 to -0.06; P=.01).
Conclusions: Using eye tracking, we found no significant difference in visual attention when anesthesia providers used avatar-based monitoring or conventional patient monitoring in simulated critical anesthesia events. However, we identified visual attention in conjunction with task performance as a surrogate for situational awareness.
Keywords: Anesthesia; avatar based model; eye-tracking technology; patient monitoring; patient simulation; perioperative; simulated anesthesia; situation awareness; task performance; visual attention
The determinants of capital structure in emerging capital markets : evidence from Serbia
This paper explores the determinants of the capital structure of Serbian firms listed on the regulated market using panel data. We model the leverage ratio as a function of firm-specific characteristics. The findings indicate the emerging character of Serbian corporate environment. We document that Serbian firms tend to have much lower debt ratio and that they rely more heavily on short-term than long-term debt compared to firms coming from other transitional economies. The study shows that there is a significant negative impact of liquidity, tangibility, profitability and cash gap on the two debt ratios. Leverage level is significantly positively affected by the income volatility and growth opportunities of Serbian firms. Our results are consistent with the findings of previous empirical studies realized in emerging and transition economies, indicating that Serbian companies follow the modified pecking order theory.peer-reviewe
Visual Attention of Anesthesia Providers in Simulated Anesthesia Emergencies Using Conventional Number-Based and Avatar-Based Patient Monitoring: Prospective Eye-Tracking Study
Background: Inadequate situational awareness accounts for two-thirds of preventable complications in anesthesia. An essential tool for situational awareness in the perioperative setting is the patient monitor. However, the conventional monitor has several weaknesses. Avatar-based patient monitoring may address these shortcomings and promote situation awareness, a prerequisite for good decision making.
Objective: The spatial distribution of visual attention is a fundamental process for achieving adequate situation awareness and thus a potential quantifiable surrogate for situation awareness. Moreover, measuring visual attention with a head-mounted eye-tracker may provide insights into usage and acceptance of the new avatar-based patient monitoring modality.
Methods: This prospective eye-tracking study compared anesthesia providers' visual attention on conventional and avatar-based patient monitors during simulated critical anesthesia events. We defined visual attention, measured as fixation count and dwell time, as our primary outcome. We correlated visual attention with the potential confounders: performance in managing simulated critical anesthesia events (task performance), work experience, and profession. We used mixed linear models to analyze the results.
Results: Fifty-two teams performed 156 simulations. After a manual quality check of the eye-tracking footage, we excluded 57 simulations due to technical problems and quality issues. Participants had a median of 198 (IQR 92.5-317.5) fixations on the patient monitor with a median dwell time of 30.2 (IQR 14.9-51.3) seconds. We found no significant difference in participants' visual attention when using avatar-based patient monitoring or conventional patient monitoring. However, we found that with each percentage point of better task performance, the number of fixations decreased by about 1.39 (coefficient -1.39; 95% CI -2.44 to -0.34; P=.02), and the dwell time diminished by 0.23 seconds (coefficient -0.23; 95% CI: -0.4 to -0.06; P=.01).
Conclusions: Using eye tracking, we found no significant difference in visual attention when anesthesia providers used avatar-based monitoring or conventional patient monitoring in simulated critical anesthesia events. However, we identified visual attention in conjunction with task performance as a surrogate for situational awareness.
Keywords: Anesthesia; avatar based model; eye-tracking technology; patient monitoring; patient simulation; perioperative; simulated anesthesia; situation awareness; task performance; visual attention
Acrokeratosis paraneoplastica (Bazex syndrome)n
Acrokeratosis paraneoplastica of Bazex is rare condition, characterized
with scaly hyperkeratotic psoriasiform plaques on acral parts of body
(helices, nose, and malar and acral surfaces), and in later stages
propagation to the limbs and trunk.This syndrome is distinct marker for
different neoplastic conditions, predominantly squamous cell carcinoma
of the upper aerodigestive tract with possible cervical lymph node
metastases.In this paper we present 56 years old male patient, with
hyperkeratotic plaques on the skin of his palms, soles, ear lobes and
apex of the nose. Detailed examination found tumorous swelling on the
left side of his neck. Histopathologic examination revealed solid
anaplastic metastatic tumor. Patient died before primary tumor could be
found. Bazex syndrome can appear before the diagnosis of internal
malignancies, and thus is important for dermatologists to recognize it
in favor of early diagnosis of specific malignant process
FOREIGN DIRECT INVESTMENTS IN SERBIA – STATE AND PERSPECTIVES
The last decade of the twentieth century was very successful for a number of ex socialist countries of Central Europe. That was the decade of prosperity, progress, and getting closer to the modern and developed European countries. This region (Slovenia, Poland, Czech Republic, Hungary, and Slovakia) comprises group of countries in transition, which are in the front line in the process oh transformation of their economic systems, implementation of economic reforms and attracting private foreign investments, first of all, foreign direct investment. In contrast to these countries, in the area of former Yugoslavia, the early 1990s were the years of complete disintegration, marked by economic sanctions, huge human causalities, and vast destructions. The dramatic political
situation Serbia was in, caused heavy consequences on its social-economic development.
The result is that Serbia today is one of the least developed countries in Europe. Position
of Serbian economy drastically aggravated in the area of international capital flow.
In this paper we analyze one form of international capital flow that can start up the
Serbian economy – foreign direct investment. In the period to come, the development of our country will mostly depend on the value of foreign investments. Without direct foreign investments and conditions of low domestic savings, limited opportunities for crediting, lack of management knowledge, modern technology and export routes, there is not going to be any economic development in Serbia. In that sense, the most prominent is the need to affirm our competitory advantages and to remove the existing limitations for foreign investments so that conditions for foreign investors to realize in the fastest way their ideas for investments are created
EFFECT OF THE HEMODIALYSIS DURATION, AGE AND GENDER ON THE EMERGENCE OF THE RENAL OSTEODYSTROPHY SYMPTOMS
The study comprises 185 patients who are at the hemodialysis (HD) in the hemodialysis center of the Clinic for Nephrology of the Clinical Center Nis. The factors analyzed in the hemodialytic patients are: duration of the hemodialysis according to which the patients were divided into two groups (shorter and longer than 5 years), age on the basis of which the patients were divided into three groups (younger than 30, subjects of 30 to 60 years of age and older than 60) and gender. In all 185 hemodialytic patients the most frequent symptoms of renal osteodystrophy were examined on the basis of visualization and the use of verbal symptoms score (VSS). For the statistical processing, the student t-test and the Mantzel Haencel tests were used while the differences at the levels p < 0.01 and p<0.05 were taken as statistically significant and were shown in diagrams and tables. The results of the research showed that of a significantly higher frequency and intensity of pain in the bones, muscles and joints as well as the emergence of spontaneous fractures and/or skeletal deformations in the group which is on the HD for more than 5 years, while the emergence of itching, fatigue and wearisome walking were insignificant with respect to the group which was on the HD for less than 5 years. The impact of gender upon the emergence of subjective symptoms of renal osteodystrophy did not show any significance, while the influence of old age showed statistical significance for the emergence of pain in the bones, muscles and joints in addition to spontaneous fractures and/or skeletal deformations in the group of examinees of 30 to 60 years of age and older than 60