Minimum data set harmonization in the management of cross-border Multi Casualty Incidents. Modified Delphi (VALKYRIES-H2020 project).

INTRODUCTION: There is a need to develop harmonized procedures and a Minimum Data Set (MDS) for cross-border Multi Casualty Incidents (MCI) in medical emergency scenarios to ensure appropriate management of such incidents, regardless of place, language and internal processes of the institutions involved. That information should be capable of real-time communication to the command-and-control chain. It is crucial that the models adopted are interoperable between countries so that the rights of patients to cross-border healthcare are fully respected. OBJECTIVE: To optimize management of cross-border Multi Casualty Incidents through a Minimum Data Set collected and communicated in real time to the chain of command and control for each incident. To determine the degree of agreement among experts. METHOD: We used the modified Delphi method supplemented with the Utstein technique to reach consensus among experts. In the first phase, the minimum requirements of the project, the profile of the experts who were to participate, the basic requirements of each variable chosen and the way of collecting the data were defined by providing bibliography on the subject. In the second phase, the preliminary variables were grouped into 6 clusters, the objectives, the characteristics of the variables and the logistics of the work were approved. Several meetings were held to reach a consensus to choose the MDS variables using a Modified Delphi technique. Each expert had to score each variable from 1 to 10. Non-voting variables were eliminated, and the round of voting ended. In the third phase, the Utstein Style was applied to discuss each group of variables and choose the ones with the highest consensus. After several rounds of discussion, it was agreed to eliminate the variables with a score of less than 5 points. In phase four, the researchers submitted the variables to the external experts for final assessment and validation before their use in the simulations. Data were analysed with SPSS Statistics (IBM, version 2) software. RESULTS: Six data entities with 31 sub-entities were defined, generating 127 items representing the final MDS regarded as essential for incident management. The level of consensus for the choice of items was very high and was highest for the category 'Incident' with an overall kappa of 0.7401 (95% CI 0.1265-0.5812, p 0.000), a good level of consensus in the Landis and Koch model. The items with the greatest degree of consensus at ten were those relating to location, type of incident, date, time and identification of the incident. All items met the criteria set, such as digital collection and real-time transmission to the chain of command and control. CONCLUSIONS: This study documents the development of a MDS through consensus with a high degree of agreement among a group of experts of different nationalities working in different fields. All items in the MDS were digitally collected and forwarded in real time to the chain of command and control. This tool has demonstrated its validity in four large cross-border simulations involving more than eight countries and their emergency services.

Opportunities for standardization in emergency scenarios in the European Union.

OBJECTIVE: Despite current standardization actions towards the unification between European Union (EU) countries, there is still much work to do. In this context, this paper aims to offer a comprehensive analysis of the limitations of the EU concerning emergency situations, specifically in cross-border, cross-hierarchical, and cross-sectorial emergencies, as well as the analysis of emergent opportunities for improvement. The final goal of this analysis is to serve as an initial step for pre-standardizing these opportunities. MATERIALS AND METHODS: This work, performed in the context of the EU H2020 VALKYRIES project, first analyzed existing gaps from three dimensions: technological, procedural, collaboration, and training. Each gap was obtained from the literature, professional experience within VALKYRIES, or a consultation process on EU emergency agencies. This research subsequently obtained a list of opportunities from these limitations, aggregating those opportunities with similarities to ease their study. Then, this work prioritized the opportunities based on their feasibility and positive impact, performing an additional consultation process to EU emergencies for validation. Finally, this investigation provided a roadmap for pre-standardization for the five top-ranked opportunities per dimension. RESULTS: This paper presents a set of 303 gaps and 255 opportunities across technological, procedural, collaboration, and training dimensions. After clustering the opportunities, this work provides a final set of 82 meta opportunities for improving emergency actions in the EU, prioritized based on their feasibility for adoption and positive impact. Finally, this work documents the roadmaps for three top-ranked opportunities for conciseness. CONCLUSION: This publication highlights the limitations and opportunities in the EU concerning emergency agencies and, more specifically, those existing in cross-border and multi-casualty incidents. This work concludes that there is still room for improvement despite the current measures toward harmonization and standardization.

Breaching Subjects' Thoughts Privacy: A Study with Visual Stimuli and Brain-Computer Interfaces.

Brain-computer interfaces (BCIs) started being used in clinical scenarios, reaching nowadays new fields such as entertainment or learning. Using BCIs, neuronal activity can be monitored for various purposes, with the study of the central nervous system response to certain stimuli being one of them, being the case of evoked potentials. However, due to the sensitivity of these data, the transmissions must be protected, with blockchain being an interesting approach to ensure the integrity of the data. This work focuses on the visual sense, and its relationship with the P300 evoked potential, where several open challenges related to the privacy of subjects' information and thoughts appear when using BCI. The first and most important challenge is whether it would be possible to extract sensitive information from evoked potentials. This aspect becomes even more challenging and dangerous if the stimuli are generated when the subject is not aware or conscious that they have occurred. There is an important gap in this regard in the literature, with only one work existing dealing with subliminal stimuli and BCI and having an unclear methodology and experiment setup. As a contribution of this paper, a series of experiments, five in total, have been created to study the impact of visual stimuli on the brain tangibly. These experiments have been applied to a heterogeneous group of ten subjects. The experiments show familiar visual stimuli and gradually reduce the sampling time of known images, from supraliminal to subliminal. The study showed that supraliminal visual stimuli produced P300 potentials about 50% of the time on average across all subjects. Reducing the sample time between images degraded the attack, while the impact of subliminal stimuli was not confirmed. Additionally, younger subjects generally presented a shorter response latency. This work corroborates that subjects' sensitive data can be extracted using visual stimuli and P300.

Twitter social bots: The 2019 Spanish general election data.

The term social bots refer to software-controlled accounts that actively participate in the social platforms to influence public opinion toward desired directions. To this extent, this data descriptor presents a Twitter dataset collected from October 4th to November 11th, 2019, within the context of the Spanish general election. Starting from 46 hashtags, the collection contains almost eight hundred thousand users involved in political discussions, with a total of 5.8 million tweets. The proposed data descriptor is related to the research article available at [1]. Its main objectives are: i) to enable worldwide researchers to improve the data gathering, organization, and preprocessing phases; ii) to test machine-learning-powered proposals; and, finally, iii) to improve state-of-the-art solutions on social bots detection, analysis, and classification. Note that the data are anonymized to preserve the privacy of the users. Throughout our analysis, we enriched the collected data with meaningful features in addition to the ones provided by Twitter. In particular, the tweets collection presents the tweets' topic mentions and keywords (in the form of political bag-of-words), and the sentiment score. The users' collection includes one field indicating the likelihood of one account being a bot. Furthermore, for those accounts classified as bots, it also includes a score that indicates the affinity to a political party and the followers/followings list.

BEHACOM - a dataset modelling users' behaviour in computers.

This paper details the methodology and approach conducted to monitor the behaviour of twelve users interacting with their computers for fifty-five consecutive days without preestablished indications or restrictions. The generated dataset, called BEHACOM, contains for each user a set of features that models, in one-minute time windows, the usage of computer resources such as CPU or memory, as well as the activities registered by applications, mouse and keyboard. It has to be stated that the collected data have been treated in a privacy-preserving way during each phase of the collection and analysis. Together with the features and their explanation, we also detail the software used to gather and process the data. Finally, this article describes the data distribution of the BEHACOM dataset.