Flipped gaming-testing three simulation games

© 2018 IEEE. At the Inland Norway University of Applied Sciences 'flipped gaming' has been tested with two student groups (in 2017). This paper will present a newer version of the 'flipping' and also how a total of eight groups utilized tree different types of simulators to play the scenarios. The scenarios were developed by the student themselves as this was their mandatory assignment. The mandatory assignment was handed out in January. The assignment was about making a playable script for an incident, in addition to conduct the planning, execution and evaluation of a complete exercise in crisis management. They were given feedback once before the workshop where they presented and played the script. The tools that were used was Rayvn (https://rayvn.global/), Microsoft HoloLens (https://www.microsoft.com/nb-no/hololens) and a simulator based on a platform from Bohemia Interactive Solutions (https://bisimulations.com/)-the same platform as Virtual Battle Space 3 uses. Rayvn is an incident management tool, mainly for communication. The written messages can then be logged and stored for later reflections. Microsoft HoloLens is a tool for 3D vision, a tool that can show environments in 3D and allow the player to carry out operations using movements that are recorded and executed. This was a prototype. The game based simulator is computer based. The different views are 2D maps and 3D environments. The players use the keyboard and mouse to move the vehicles and avatars around. This in a 'disaster town', called 'Lyngvik', a very poor planned city centre with a large accident/crisis potential. The study is based on the previous study of the learning outcome from assignment that is based on student input. The mandatory assignment was to develop a playable scenario and they could choose in which of the three different simulation tools they were to play their scenario. Two by two, the groups are to play each other's scenario. They have received some supervision and the lecturers have remarked on that the students may lack insight in what a 'playable scenario' require. One of the groups operates as the exercise management staff(the ones that makes the incidents happen and 'play out') and the other group is the ones who man the different roles in handling the scenario e.g.,-different call out services. This group is also calledmain training audience (MTA). The students are in their 6th and last semester in their Bachelor in Crisis Management. The students have been subjected to diverse teaching methods, but this is the first time they have a simulation tool to work with in order to enhance their learning outcome. The preliminary reports from the reflections after the simulating are very positive. The students report on a learning outcome, both from making the scenarios and from simulating. There is also a final report to be written where the students are to reflect on their learning outcome from the simulation and the work on the assignment. The paper shows the results from the whole undertaking and presents further details from the different phases. We also present the theoretical backdrop and the methodological reasoning behind the data collection and analysis

China’s rising hydropower demand challenges water sector

Demand for hydropower is increasing, yet the water footprints (WFs) of reservoirs and hydropower, and their contributions to water scarcity, are poorly understood. Here, we calculate reservoir WFs (freshwater that evaporates from reservoirs) and hydropower WFs (the WF of hydroelectricity) in China based on data from 875 representative reservoirs (209 with power plants). In 2010, the reservoir WF totaled 27.9 × 109 m3 (Gm3), or 22% of China’s total water consumption. Ignoring the reservoir WF seriously underestimates human water appropriation. The reservoir WF associated with industrial, domestic and agricultural WFs caused water scarcity in 6 of the 10 major Chinese river basins from 2 to 12 months annually. The hydropower WF was 6.6 Gm3 yr−1 or 3.6 m3 of water to produce a GJ (109 J) of electricity. Hydropower is a water intensive energy carrier. As a response to global climate change, the Chinese government has promoted a further increase in hydropower energy by 70% by 2020 compared to 2012. This energy policy imposes pressure on available freshwater resources and increases water scarcity. The water-energy nexus requires strategic and coordinated implementations of hydropower development among geographical regions, as well as trade-off analysis between rising energy demand and water use sustainability

The roles of migratory and resident birds in local avian influenza infection dynamics

Migratory birds are an increasing focus of interest when it comes to infection dynamics and the spread of avian influenza viruses (AIV ). However, we lack detailed understanding of migratory birds’ contribution to local AIV prevalence levels and their downstream socio‐economic costs and threats. To explain the potential differential roles of migratory and resident birds in local AIV infection dynamics, we used a susceptible‐infectious‐recovered (SIR ) model. We investigated five (mutually non‐ exclusive) mechanisms potentially driving observed prevalence patterns: (1) a pronounced birth pulse (e.g. the synchronised annual influx of immunologically naïve individuals), (2) short‐term immunity, (3) increase in susceptible migrants, (4) differential susceptibility to infection (i.e. transmission rate) for migrants and residents, and (5) replacement of migrants during peak migration. SIR models describing all possible combinations of the five mechanisms were fitted to individual AIV infection data from a detailed longitudinal surveillance study in the partially migratory mallard duck (Anas platyrhynchos ). During autumn and winter, the local resident mallard community also held migratory mallards that exhibited distinct AIV infection dynamics. Replacement of migratory birds during peak migration in autumn was found to be the most important mechanism driving the variation in local AIV infection patterns. This suggests that a constant influx of migratory birds, likely immunological naïve to locally circulating AIV strains, is required to predict the observed temporal prevalence patterns and the distinct differences in prevalence between residents and migrants. Synthesis and applications . Our analysis reveals a key mechanism that could explain the amplifying role of migratory birds in local avian influenza virus infection dynamics; the constant flow and replacement of migratory birds during peak migration. Apart from monitoring efforts, in order to achieve adequate disease management and control in wildlife—with knock‐on effects for livestock and humans,—we conclude that it is crucial, in future surveillance studies, to record host demographical parameters such as population density, timing of birth and turnover of migrants

A Current Mode Detector Array for Gamma-Ray Asymmetry Measurements

We have built a CsI(Tl) gamma-ray detector array for the NPDGamma experiment to search for a small parity-violating directional asymmetry in the angular distribution of 2.2 MeV gamma-rays from the capture of polarized cold neutrons by protons with a sensitivity of several ppb. The weak pion-nucleon coupling constant can be determined from this asymmetry. The small size of the asymmetry requires a high cold neutron flux, control of systematic errors at the ppb level, and the use of current mode gamma-ray detection with vacuum photo diodes and low-noise solid-state preamplifiers. The average detector photoelectron yield was determined to be 1300 photoelectrons per MeV. The RMS width seen in the measurement is therefore dominated by the fluctuations in the number of gamma rays absorbed in the detector (counting statistics) rather than the intrinsic detector noise. The detectors were tested for noise performance, sensitivity to magnetic fields, pedestal stability and cosmic background. False asymmetries due to gain changes and electronic pickup in the detector system were measured to be consistent with zero to an accuracy of $10^{-9}$ in a few hours. We report on the design, operating criteria, and the results of measurements performed to test the detector array.Comment: 33 pages, 20 figures, 2 table

BLR1 and FCGR1A transcripts in peripheral blood associate with the extent of intrathoracic tuberculosis in children and predict treatment outcome

Biomarkers reflecting the extent of Mycobacterium tuberculosis-induced pathology and normalization during anti-tuberculosis treatment (ATT) would considerably facilitate trials of new treatment regimens and the identification of patients with treatment failure. Therefore, in a cohort of 99 Indian children with intrathoracic tuberculosis (TB), we performed blood transcriptome kinetic analysis during ATT to explore 1) the association between transcriptional biomarkers in whole blood (WB) and the extent of TB disease at diagnosis and treatment outcomes at 2 and 6 months, and 2) the potential of the biomarkers to predict treatment response at 2 and 6 months. We present the first data on the association between transcriptional biomarkers and the extent of TB disease as well as outcome of ATT in children: Expression of three genes down-regulated on ATT (FCGR1A, FPR1 and MMP9) exhibited a positive correlation with the extent of TB disease, whereas expression of eight up-regulated genes (BCL, BLR1, CASP8, CD3E, CD4, CD19, IL7R and TGFBR2) exhibited a negative correlation with the extent of disease. Baseline levels of these transcripts displayed an individual capacity >70% to predict the six-month treatment outcome. In particular, BLR1 and FCGR1A seem to have a potential in monitoring and perhaps tailoring future antituberculosis therapy

Human hippocampal neurogenesis drops sharply in children to undetectable levels in adults.

New neurons continue to be generated in the subgranular zone of the dentate gyrus of the adult mammalian hippocampus. This process has been linked to learning and memory, stress and exercise, and is thought to be altered in neurological disease. In humans, some studies have suggested that hundreds of new neurons are added to the adult dentate gyrus every day, whereas other studies find many fewer putative new neurons. Despite these discrepancies, it is generally believed that the adult human hippocampus continues to generate new neurons. Here we show that a defined population of progenitor cells does not coalesce in the subgranular zone during human fetal or postnatal development. We also find that the number of proliferating progenitors and young neurons in the dentate gyrus declines sharply during the first year of life and only a few isolated young neurons are observed by 7 and 13 years of age. In adult patients with epilepsy and healthy adults (18-77 years; n = 17 post-mortem samples from controls; n = 12 surgical resection samples from patients with epilepsy), young neurons were not detected in the dentate gyrus. In the monkey (Macaca mulatta) hippocampus, proliferation of neurons in the subgranular zone was found in early postnatal life, but this diminished during juvenile development as neurogenesis decreased. We conclude that recruitment of young neurons to the primate hippocampus decreases rapidly during the first years of life, and that neurogenesis in the dentate gyrus does not continue, or is extremely rare, in adult humans. The early decline in hippocampal neurogenesis raises questions about how the function of the dentate gyrus differs between humans and other species in which adult hippocampal neurogenesis is preserved

Experiences, attitudes and barriers towards research amongst junior faculty of Pakistani medical universities

<p>Abstract</p> <p>Background</p> <p>The developing world has had limited quality research and in Pakistan, research is still in its infancy. We conducted a study to assess the proportion of junior faculty involved in research to highlight their attitude towards research, and identify the factors associated with their research involvement.</p> <p>Methods</p> <p>A cross-sectional study was conducted in four medical universities/teaching hospitals in Pakistan, representing private and public sectors. A pre-tested, self-administered questionnaire was used to collect information from 176 junior faculty members of studied universities/hospitals. Logistic regression analysis was used to identify factors related to attitudes and barriers in research among those currently involved in research with those who were not.</p> <p>Results</p> <p>Overall, 41.5% of study subjects were currently involved in research. A highly significant factor associated with current research involvement was research training during the post-graduate period (p < 0.001). Other factors associated with current involvement in research were male gender, working in the public sector and previous involvement in research. Overall, a large majority (85.2%) of doctors considered research helpful in their profession and had a positive attitude towards research; nevertheless this positive attitude was more frequently reported by doctors who were currently involved in research compared to those who were not (OR = 4.69; 95% CI = 1.54-14.26). Similarly, a large proportion (83.5%) of doctors considered research difficult to conduct; higher by doctors who were not presently involved in research (OR = 2.74; 95% CI = 1.20-6.22)</p> <p>Conclusion</p> <p>Less than half of the study participants were currently involved in research. Research output may improve if identified barriers are rectified. Further studies are recommended in this area.</p

The effect of TCM acupuncture on hot flushes among menopausal women (ACUFLASH) study: A study protocol of an ongoing multi-centre randomised controlled clinical trial

BACKGROUND: After menopause, 10–20% of all women have nearly intolerable hot flushes. Long term use of hormone replacement therapy involves a health risk, and many women seek alternative strategies to relieve climacteric complaints. Acupuncture is one of the most frequently used complementary therapies in Norway. We designed a study to evaluate whether Traditional Chinese Medicine acupuncture-care together with self-care is more effective than self-care alone to relieve climacteric complaints. METHODS/DESIGN: The study is a multi-centre pragmatic randomised controlled trial with two parallel arms. Participants are postmenopausal women who document ≥7 flushes/24 hours and who are not using hormone replacement therapy or other medication that may influence flushes. According to power calculations 200 women are needed to detect a 50% reduction in flushes, and altogether 286 women will be recruited to allow for a 30% dropout rate. The treatment group receives 10 sessions of Traditional Chinese Medicine acupuncture-care and self-care; the control group will engage in self-care only. A team of experienced Traditional Chinese Medicine acupuncturists give acupuncture treatments. DISCUSSION: The study tests acupuncture as a complete treatment package including the therapeutic relationship and expectation. The intervention period lasts for 12 weeks, with follow up at 6 and 12 months. Primary endpoint is change in daily hot flush frequency in the two groups from baseline to 12 weeks; secondary endpoint is health related quality of life, assessed by the Women's Health Questionnaire. We also collect data on Traditional Chinese Medicine diagnoses, and we examine treatment experiences using a qualitative approach. Finally we measure biological variables, to examine potential mechanisms for the effect of acupuncture. The study is funded by The Research Council of Norway

Editorial: Observational studies in ADHD: the effects of switching to modified-release methylphenidate preparations on clinical outcomes and adherence

Patients with ADHD may have better adherence to treatment with modified-release methylphenidate (MPH-MR) formulations, which are taken once daily, compared with immediate-release (IR) formulations, which need to be taken several times a day. Data on long-term outcomes such as adherence may be lacking from randomised controlled trials as these are usually only short-term. Observational studies, if performed and reported appropriately, can provide valuable long-term data on such outcomes, as well as additional information on effectiveness and efficiency, from a real-life setting. By reviewing previous observational studies that have investigated switching treatment from MPH-IR to MPH-MR, results from a new, naturalistic observational study, the OBSEER study, are put into context. We conclude that, based on observational trial data, switching from MPH-IR to MPH-MR is a valid clinical approach, with the potential for improved clinical outcome and treatment adherence