Wearable Proximity Sensors for Monitoring a Mass Casualty Incident Exercise: Feasibility Study.

BACKGROUND: Over the past several decades, naturally occurring and man-made mass casualty incidents (MCIs) have increased in frequency and number worldwide. To test the impact of such events on medical resources, simulations can provide a safe, controlled setting while replicating the chaotic environment typical of an actual disaster. A standardized method to collect and analyze data from mass casualty exercises is needed to assess preparedness and performance of the health care staff involved. OBJECTIVE: In this study, we aimed to assess the feasibility of using wearable proximity sensors to measure proximity events during an MCI simulation. In the first instance, our objective was to demonstrate how proximity sensors can collect spatial and temporal information about the interactions between medical staff and patients during an MCI exercise in a quasi-autonomous way. In addition, we assessed how the deployment of this technology could help improve future simulations by analyzing the flow of patients in the hospital. METHODS: Data were obtained and collected through the deployment of wearable proximity sensors during an MCI functional exercise. The scenario included 2 areas: the accident site and the Advanced Medical Post, and the exercise lasted 3 hours. A total of 238 participants were involved in the exercise and classified in categories according to their role: 14 medical doctors, 16 nurses, 134 victims, 47 Emergency Medical Services staff members, and 27 health care assistants and other hospital support staff. Each victim was assigned a score related to the severity of his/her injury. Each participant wore a proximity sensor, and in addition, 30 fixed devices were placed in the field hospital. RESULTS: The contact networks show a heterogeneous distribution of the cumulative time spent in proximity by the participants. We obtained contact matrices based on the cumulative time spent in proximity between the victims and rescuers. Our results showed that the time spent in proximity by the health care teams with the victims is related to the severity of the patient's injury. The analysis of patients' flow showed that the presence of patients in the rooms of the hospital is consistent with the triage code and diagnosis, and no obvious bottlenecks were found. CONCLUSIONS: Our study shows the feasibility of the use of wearable sensors for tracking close contacts among individuals during an MCI simulation. It represents, to our knowledge, the first example of unsupervised data collection-ie, without the need for the involvement of observers, which could compromise the realism of the exercise-of face-to-face contacts during an MCI exercise. Moreover, by permitting detailed data collection about the simulation, such as data related to the flow of patients in the hospital, such deployment provides highly relevant input for the improvement of MCI resource allocation and management.

Exposure to urban and rural contexts shapes smartphone usage behavior.

Smartphones have profoundly changed human life. Nevertheless, the factors that shape how we use our smartphones remain unclear, in part due to limited availability of usage-data. Here, we investigate the impact of a key environmental factor: users' exposure to urban and rural contexts. Our analysis is based on a global dataset describing mobile app usage and location for ∼500,000 individuals. We uncover strong and nontrivial patterns. First, we confirm that rural users tend to spend less time on their phone than their urban counterparts. We find, however, that individuals in rural areas tend to use their smartphones for activities such as gaming and social media. In cities, individuals preferentially use their phone for activities such as navigation and business. Are these effects (1) driven by differences between individuals who choose to live in urban vs. rural environments or do they (2) emerge because the environment itself affects online behavior? Using a quasi-experimental design based on individuals that move from the city to the countryside-or vice versa-we confirm hypothesis (2) and find that smartphone use changes according to users's environment. This work presents a quantitative step forward towards understanding how the interplay between environment and smartphones impacts human lives. As such, our findings could provide information to better regulate persuasive technologies embedded in smartphone apps. Further, our work opens the door to understanding new mechanisms leading to urban/rural divides in political and socioeconomic attitudes.

Deep Neural Networks for Optimal Team Composition.

Cooperation is a fundamental social mechanism, whose effects on human performance have been investigated in several environments. Online games are modern-days natural settings in which cooperation strongly affects human behavior. Every day, millions of players connect and play together in team-based games: the patterns of cooperation can either foster or hinder individual skill learning and performance. This work has three goals: (i) identifying teammates' influence on players' performance in the short and long term, (ii) designing a computational framework to recommend teammates to improve players' performance, and (iii) setting to demonstrate that such improvements can be predicted via deep learning. We leverage a large dataset from Dota 2, a popular Multiplayer Online Battle Arena game. We generate a directed co-play network, whose links' weights depict the effect of teammates on players' performance. Specifically, we propose a measure of network influence that captures skill transfer from player to player over time. We then use such framing to design a recommendation system to suggest new teammates based on a modified deep neural autoencoder and we demonstrate its state-of-the-art recommendation performance. We finally provide insights into skill transfer effects: our experimental results demonstrate that such dynamics can be predicted using deep neural networks.

Extracting the multi-timescale activity patterns of online financial markets.

Online financial markets can be represented as complex systems where trading dynamics can be captured and characterized at different resolutions and time scales. In this work, we develop a methodology based on non-negative tensor factorization (NTF) aimed at extracting and revealing the multi-timescale trading dynamics governing online financial systems. We demonstrate the advantage of our strategy first using synthetic data, and then on real-world data capturing all interbank transactions (over a million) occurred in an Italian online financial market (e-MID) between 2001 and 2015. Our results demonstrate how NTF can uncover hidden activity patterns that characterize groups of banks exhibiting different trading strategies (normal vs. early vs. flash trading, etc.). We further illustrate how our methodology can reveal "crisis modalities" in trading triggered by endogenous and exogenous system shocks: as an example, we reveal and characterize trading anomalies in the midst of the 2008 financial crisis.

Estimating the outcome of spreading processes on networks with incomplete information: A dimensionality reduction approach.

Recent advances in data collection have facilitated the access to time-resolved human proximity data that can conveniently be represented as temporal networks of contacts between individuals. While the structural and dynamical information revealed by this type of data is fundamental to investigate how information or diseases propagate in a population, data often suffer from incompleteness, which possibly leads to biased estimations in data-driven models. A major challenge is thus to estimate the outcome of spreading processes occurring on temporal networks built from partial information. To cope with this problem, we devise an approach based on non-negative tensor factorization, a dimensionality reduction technique from multilinear algebra. The key idea is to learn a low-dimensional representation of the temporal network built from partial information and to use it to construct a surrogate network similar to the complete original network. To test our method, we consider several human-proximity networks, on which we perform resampling experiments to simulate a loss of data. Using our approach on the resulting partial networks, we build a surrogate version of the complete network for each. We then compare the outcome of a spreading process on the complete networks (nonaltered by a loss of data) and on the surrogate networks. We observe that the epidemic sizes obtained using the surrogate networks are in good agreement with those measured on the complete networks. Finally, we propose an extension of our framework that can leverage additional data, when available, to improve the surrogate network when the data loss is particularly large.

Individual performance in team-based online games.

Complex real-world challenges are often solved through teamwork. Of special interest are ad hoc teams assembled to complete some task. Many popular multiplayer online battle arena (MOBA) video-games adopt this team formation strategy and thus provide a natural environment to study ad hoc teams. Our work examines data from a popular MOBA game, League of Legends, to understand the evolution of individual performance within ad hoc teams. Our analysis of player performance in successive matches of a gaming session demonstrates that a player's success deteriorates over the course of the session, but this effect is mitigated by the player's experience. We also find no significant long-term improvement in the individual performance of most players. Modelling the short-term performance dynamics allows us to accurately predict when players choose to continue to play or end the session. Our findings suggest possible directions for individualized incentives aimed at steering the player's behaviour and improving team performance.

Rac signal adaptation controls neutrophil mobilization from the bone marrow.

Mobilization of neutrophils from the bone marrow determines neutrophil blood counts and thus is medically important. Balanced neutrophil mobilization from the bone marrow depends on the retention-promoting chemokine CXCL12 and its receptor CXCR4 and the egression-promoting chemokine CXCL2 and its receptor CXCR2. Both pathways activate the small guanosine triphosphatase Rac, leaving the role of this signaling event in neutrophil retention and egression ambiguous. On the assumption that active Rac determines persistent directional cell migration, we generated a mathematical model to link chemokine-mediated Rac modulation to neutrophil egression time. Our computer simulation indicated that, in the bone marrow, where the retention signal predominated, egression time strictly depended on the time it took Rac to return to its basal activity (namely, adaptation). This prediction was validated in mice lacking the Rac inhibitor ArhGAP15. Neutrophils in these mice showed prolonged Rac adaptation and cell-autonomous retention in the bone marrow. Our model thus demonstrates that mobilization in the presence of two spatially defined opposing chemotactic cues strictly depends on inhibitors shaping the time course of signal adaptation. Furthermore, our findings might help to find new modes of intervention to treat conditions characterized by excessively low or high circulating neutrophils.