An innovative mobile application to improve the efficiency of common procedures in the paediatric intensive care unit: a pilot study

Background/Aims Procedures performed in the paediatric intensive care unit require optimal efficiency. This study evaluated the feasibility of a mobile app for paediatric critical care trainees to help improve the efficiency of three common procedures: central line placement, arterial line insertion and chest tube insertion. Methods Data regarding frequency of forgotten items were collected during the pre-intervention stage. A mobile app was developed with a checklist to help users to gather all the correct equipment. Data regarding the number of forgotten items were collected from the app in the period following initial implementation (March–August 2019) and after a software update (August–October 2019). Results Once the mobile application was introduced, all 13 (100%) fellows and 2 (20%) of the 10 advanced practice registered nurses accessed the application's checklist to record their procedures. From March–August 2019, 19 users submitted post-completion assessments, of which four included records of forgotten items (21%). After a software update, from August–October 2019, there were eight post-procedure assessments submitted with zero forgotten items. After using the mobile application, over half (13/24) of users surveyed agreed that the mobile application was useful for helping select items. Conclusions A considerable decrease in the proportion of procedures with forgotten items was recorded after the implementation of the app and after the software update. However, there was also a decrease in use of the app during the study period, so more research is required into the use of mobile apps for this purpose.

DESIGNING DISTRIBUTED AUTOMATIC SOFTWARE UPDATE SYSTEM

This article offers the reader a practical guide to the design and development of a distributed client-server system designed to perform automatic software updates using the example of non-trivial functionality. For comparison, examples of existing systems and solutions used to perform software updates are given and justifications for their functional unsuitability in the given circumstances are provided.

Perfect Reconciliation in Quantum Key Distribution with Order-Two Frames

We present an error reconciliation method for Quantum Key Distribution (QKD) that corrects 100% of errors generated in regular binary frames transmitted over a noisy quantum channel regardless of the quantum channel error rate. In a previous investigation, we introduced a novel distillation QKD algorithm whose secret key rate descends linearly with respect to the channel error rate. Now, as the main achievement of this work, we demonstrate an improved algorithm capable of retaining almost all the secret information enclosed in the regular binary frames. Remarkably, this technique increases quadratically the secret key rate as a function of the double matching detection events and doubly quadratically in the number of the quantum pulses. Furthermore, this reconciliation method opens up the opportunity to use less attenuated quantum pulses, would allow greater QKD distances at drastically increased secret key rate. Since our method can be implemented as a software update, we hope that quantum key distribution technology would be fast deployed over global data networks in the quantum era.

Perfect Reconciliation in Quantum Key Distribution with Order-Two Frames

We present an error reconciliation method for Quantum Key Distribution (QKD) that corrects 100% of errors generated in regular binary frames transmitted over a noisy quantum channel regardless of the quantum channel error rate. In a previous investigation, we introduced a novel distillation QKD algorithm whose secret key rate descends linearly with respect to the channel error rate. Now, as the main achievement of this work, we demonstrate an improved algorithm capable of retaining almost all the secret information enclosed in the regular binary frames. Remarkably, this technique increases quadratically the secret key rate as a function of the double matching detection events and doubly quadratically in the number of the quantum pulses. Furthermore, this reconciliation method opens up the opportunity to use less attenuated quantum pulses, would allow greater QKD distances at drastically increased secret key rate. Since our method can be implemented as a software update, we hope that quantum key distribution technology would be fast deployed over global data networks in the quantum era.

Iceberg Load Software Update Using 2019 Iceberg Profile Dataset

The Iceberg Loads Software (ILS) was developed initially to determine design iceberg loads for the Hebron Gravity Base Structure (GBS). The ILS framework has since been adapted for assessing iceberg loads on other structures such as the West White Rose Platform, subsea protection structures, pipelines laid on the seabed and floating production structures (spars and FPSOs). When the ILS was developed, the available iceberg geometry dataset (collected in the 1980s) was relatively limited, which required certain assumptions (i.e., flat wall interaction) and parametrizations (i.e., length distribution, length/draft/mass relationships, eccentricity, etc.) in the formulation of the interaction model. Renewed iceberg profile collection began in 2012, with ongoing improvements in the data collection methodology such that, of the 200 iceberg profiles collected from 2012 onwards, 134 were collected in 2019. The profile data were collected using LiDAR for the iceberg sail and multibeam sonar for the keel. The ILS has been updated using the recent three dimensional (3D) profiles, and a comparison of original versus updated iceberg load distributions for a generic structure show a decrease in loads. Updated ILS loads are compared with another iceberg load analysis tool that directly incorporates iceberg profile data rather than relying on some of the assumptions and parametrizations used in the original ILS formulation. This comparison shows some differences, particularly for extreme loads, which are the subject of on-going investigation.

The Hazards Posed by Mesoscale Lightning Megaflashes

Lighting megaflashes extending over >100 km distances have been observed by the Geostationary Lightning Mappers (GLMs) on NOAA’s 16-series Geostationary Operational Environmental Satellites (GOES). The hazards posed by megaflashes are unclear, however, due to limitations in the GLM data. We address these by reprocessing GOES-16 GLM measurements from 1/1/2018 to 1/15/2020 and integrating them with Earth Networks Global Lightning Network (ENGLN) observations. 194,880 GLM megaflashes are verified as natural lightning by ENGLN. Of these, 127,479 flashes occurred following the October 2018 GLM software update that standardized GLM timing. Reprocessed GLM/ENGLN lightning maps from these post-update cases provide a comprehensive view of how individual megaflashes evolve.This megaflash dataset is used to generate statistics that describe their hazards. The average megaflash produces 5-7 CG strokes that are spread across 40-50% of the flash extent. As flash extent increases beyond 100 km, megaflashes become concentrated in key hotspot regions in North and South America while the number of CG and IC events per flash and the overall peak current increase. CGs in the larger megaflashes occur over 80% of the flash extent measured by GLM, while the majority contain regions where the megaflash is the only lightning activity in the preceding hour. These statistics demonstrate that there is no safe location below an electrified cloud that is producing megaflashes and current lightning safety guidance is not always sufficient to mitigate megaflash hazards.