The Electronic Chart Display and Information System (ECDIS): An Operational Handbook

The electronic chart system(ECS) is a navigational equipment with a simple electronic chart and is used in small and medium sized vessels such as coastal cargo ships, fishing boats. For the purpose of preventing marine accidents of oil tanker ships in the 1990s, the prohibition of passage of oil tankers was set up, and also forced to install the ECS to record and save the track of the ship at the same time. However, regulations for the installation of AIS (Automatic Identification System) for ships corresponding to the Ship Safety Act were newly introduced, and the enforcement regulations for the installation of ECS were deleted in 2009. However, the operators of small vessels such as barges in which there is no chart and operated without electric and navigational system, and fishing boats of less than G/T 50 tons, which are not the vessels to be installed AIS, are using the ECS as navigational equipment due to the convenience of operation. However, marine accidents such as collision, aground are occurring due to the lack of follow-up service for the customers of ECS and safety awareness of the ship operators. In this paper, we analyzed the case of marine accidents such as aground and collision caused by the misuse of ECS in the small and medium sized ships with the coastal area of the Republic of Korea. In addition, as an improvement measure to prevent marine accidents, we suggested some ways that construct a simple electronic chart updating system of the ECS, strengthening infrastructure, upgrading simplified electronic charts, and establishing management plans.

An Electronic Chart system is now very important aid for navigation. But there is no standard display monitor and nautical symbols of this system. Therefore a new display system was developed here by an Electronic Chart system made by personal computer. The results were as follows: (1) A lighthouse flashed on the display is very effective for navigation. (2) At the color matching of an Electronic Chart, human functional psychology should be considered. (3) Zoom system is a functionally useful. (4) Electronic Chart should include cross bearing function. (5) Operating Electronic Chart system becomes very easy by using "mouse". Although these results were obtained through a personal computer, we regard this work as an investigation of the progress of universal Electronic Chart.

The purpose of this study is to propose an approach to fuse multiscale charts into three-dimensional (3D) electronic navigational chart (ENC) systems based on underwater topography and remote sensing image. This is the first time that the fusion of multiscale standard ENCs in the 3D ENC system has been studied. First, a view-dependent visualization technology is presented for the determination of the display condition of a chart. Second, a map sheet processing method is described for dealing with the map sheet splice problem. A process order called “3D order” is designed to adapt to the characteristics of the chart. A map sheet clipping process is described to deal with the overlap between the adjacent map sheets. And our strategy for map sheet splice is proposed. Third, the rendering method for ENC objects in the 3D ENC system is introduced. Fourth, our picking-up method for ENC objects is proposed. Finally, we implement the above methods in our system: automotive intelligent chart (AIC) 3D electronic chart display and information systems (ECDIS). And our method can handle the fusion problem well.

Currently Global Navigation Satellite Systems (GNSS) are the primary source for the determination of absolute position, velocity and time (PVT) for merchant vessel navigation. On a ship bridge a number of systems like Electronic Chart and Information Systems (ECDIS), automatic track control systems and the Automatic Identification System (AIS) are relying on that PVT provision. Nevertheless it is well known that GNSS performance can strongly degrade due to space weather events, jamming and spoofing. Especially the availability and usage of low cost jammers, so called personal privacy devices (PPD), lead to the question on how a continuous onboard provision of PVT data can be realized in the presence of such a PPD jammer. Generally three possible solutions for that challenge are contemplated: i) the usage of a terrestrial backup system, ii) a jamming resistant GNSS receiver or iii) the integration of GNSS with other onboard self-contained navigation sensors like, e.g. speed log, gyrocompass and inertial sensors (Inertial Measurement Unit - IMU). The paper will focus on option (iii) and addresses the question whether it is possible to bridge real maritime GNSS Jamming attacks by a Kalman Filter (KF) using GNSS, inertial and Doppler velocity log (DVL). The main challenge for the KF here is, that a free inertial integration needs to be performed after a time period with already degraded GNSS signal reception. As KF are known to be optimum estimators only under the assumption of known statistics of the measurements, the question arises, whether the pseudoranges under the influence of jamming still follow a certain statistics. In order answer this question an additional lab experiment was performed and analyzed. Concretely the sensor fusion was realized by using both loosely and tightly coupled architectures which have been implemented using an Unscented Kalman Filter (UKF). The fusion algorithm is formulated in ECEF coordinate frame with quaternion attitude parameterization, where the heading observability is addressed by fusing the baseline measurements from the GNSS compass. In order to evaluate the performance of the proposed sensor fusion scheme under the influence of a real maritime jamming attack we performed an experiment in our civilian maritime jamming testbed in the Baltic, which has been established together with the German Federal Network Agency approximately 6 nmi north of the peninsula Dars. Here a PPD jammer was mounted on the monkey deck of an anchored vessel. A test vessel was maneuvering around the jammer. As a test vessel the multipurpose research and diving vessel Baltic Diver II (length 29 m, beam 6.7 m and draught 2.8 m) was used, which was equipped with three dual frequency GNSS receivers, a fiber-optic gyroscope IMU and a Doppler velocity log. The obtained results confirm that real maritime jamming attacks using PPD Jammers can be bridged by the proposed tightly coupled GNSS-IMU-DVL integration scheme resulting in horizontal position errors of less than 10m only.

An efficient but comprehensive documentation system is essential for reducing nursing workload and ensuring adequate time for direct patient care. A "focus" is a nursing diagnosis or patient problem. The purpose of this project is to review and revise the focuses in the electronic charting system and to develop new focuses for documentation of clinical pathways. In addition, this project evaluated the impact of these changes on time required for documentation and nurse satisfaction. In 2012, a large hospital in Taiwan implemented a self-developed electronic charting system that had 217 focuses in the database. Staff reported low job satisfaction and too much time on documentation. Three major issues were identified, including repetitious and redundant documentation, incorrect templates, and an incomprehensive database. A clinical nurse specialist devised quality improvement project was implemented on one 50-bed surgical unit. Forty-one focuses were revised and 13 new focuses were developed for clinical pathways. The implementation of new focus templates enhanced evidence-based practice and prevented redundant documentation. Focus templates also incorporated nursing policies and/or patient education materials. Two outcome indicators, time spent documenting and nurse satisfaction, were evaluated 3 months after implementation. Documentation time decreased by 60% (from 138.5 to 55.8 hours) per week. The median documentation time per patient per day decreased from 18.4 minutes to 9.3 minutes. Average scores for satisfaction in usability, content, functionality, and effectiveness were increased. Evidence-based focus templates used for documentation can reduce documentation time and increase nurse satisfaction. Clinical nurse specialists play an important role in leading the development of quality improvement projects while improving work efficiency.

During recent years there has been significant development in several technologies which can contribute to the efficiency and safety of maritime traffic. The most important of these are accurate positioning systems (DGPS), digital data transmission/transponder technology, electronic chart systems (ECDIS), control of ships using electronic passage plans, and ship path prediction. With a widespread implementation of these new techniques, combined with advanced ship-shore and ship-ship data transfer, significant improvements can be achieved in traffic situation awareness both in a VTS and onboard. This paper describes the research carried out at VTT on VTS development, and especially gives an outline of new VTS functions using ship—shore and ship—ship data transfer.

IntroductionThe ability to utilize the electronic health record (EHR) without compromising the doctor-patient relationship (DPR) is an essential skill of all physicians and trainees, yet little time is spent on educating or assessing learners on needed techniques. To address this gap, we developed a conventional OSCE station coupled with a simulated patient chart within the Epic program in order to assess our students' skills utilizing the EHR during a patient encounter.MethodsOf third-year medical students, 119 were given full access to the patient's simulated chart 24 hours in advance of their OSCE to review clinical data. During an in-person OSCE with a standardized patient (SP), students performed a focused history and physical, using the EHR to verify allergies and medications. Students completed an electronic patient note graded by faculty. SPs evaluated the students on communication and interpersonal skills with specific rubric elements. Faculty graded the students' notes to evaluate their expression of clinical reasoning in the assessment and plan.ResultsTraining SPs and faculty to assess students on EHR skills was feasible. After implementation of a comprehensive curriculum focused on EHR and DPR, there was a significant difference on EHR-related communication skills (M = 76.4, SD = 17.6) versus (M = 37, SD = 28.9) before curriculum enhancement t (117.9) = −12.4, p <.001.DiscussionThe EHR OSCE station provided a standardized method of assessing students' EHR skills during a patient encounter. Challenges still exist in the technological requirements to develop and deliver cases in today's EHR platform.

AimsLithium is clinically indicated for use in the UK for treatment and prophylaxis of mania, treatment and prophylaxis of bipolar disorder, treatment and prophylaxis of recurrent depressive disorder and treatment and prophylaxis of aggressive or self-harming behaviour. Prior to commencing lithium, there is a need for several physical health checks and blood tests to be completed to ensure that lithium remains appropriate to prescribe.This audit aimed to establish whether Mersey Care NHS Foundation Trust’s prescribing practices of lithium are in keeping with national guidance prior to initiation and how the Trust’s performance compared with national performance as identified by the Prescribing Observatory for Mental Health (POMH) lithium audit.MethodsA total of 127 patients under the care of the Trust who were prescribed lithium (lithium carbonate and lithium citrate, tablet and liquid formulations) were identified using the Trust's electronic record system and electronic prescription chart system. The POMH lithium audit tool was used to capture data for each lithium patient as Mersey Care NHS Foundation Trust was participating in the national POMH lithium audit. Each patient's electronic record was scrutinised to determine whether the following were measured prior to lithium being initiated – weight/body mass index (BMI)/waist circumference, Thyroid Function Tests (TFTs), serum calcium level and estimated Glomerular Filtration Rate (eGFR).ResultsOf the sample of lithium patients included in the audit, 78% of patients had a weight/BMI/waist circumference done prior to initiation of lithium; 80% of patients had a serum calcium level; 93% had TFTs done; and 100% of patients had an eGFR completed prior to initiation of lithium.ConclusionThe results of this audit indicate that the Trust is performing well with the required physical health monitoring prior to initiation of lithium. Trust performance for all four parameters that were included and assessed in this audit were above the national compliance level reported in the POMH lithium audit. There is clearly a need, however, to improve performance and to ensure that both medical and nursing staff across the Trust are aware of the physical health monitoring required before initiating any patient on lithium. A Quality Performance Alert will be sent to all medical and nursing staff to raise awareness and lithium monitoring will be included in the induction for junior doctors working in the Trust. Future auditing of Trust performance on required physical health monitoring prior to commencing lithium will be conducted.

Tasks of finding the shortest path as one of the optimization functions arise in various fields of science and technology. From issues of maritime navigation and flight plans to routing of information packets in computer networks and automated transport management. In the process of developing cartographic information collection system (CICS) with remotely piloted aerial vehicles (RPV) complex for maritime vessels’ control, was performed analysis of algorithms for optimizing flight path of RPV during information obtaining. Speed of information obtaining for subsequent processing directly depends on the optimality of the flight plan. The article provides an overview and comparison of the main algorithms used to search for optimal values in the graph to solve shortest path problem from the point of view of temporary, hardware and software positions.

This paper introduces China’s development of a fully controllable, intelligent, and digital visualization service for navigation warnings, based on the International Hydrographic Organization (IHO) S-124 standard. It also outlines the practical applications of this service, encompassing data production and its utilization in both APPs and shipborne Electronic Chart Systems (ECS).

Summary of Discussions on Electronic Chart System

Background: Allergen-specific immunotherapy is currently the only disease-modifying treatment for allergic asthma, and it has been shown to improve control of asthma while reducing both drug use and asthma exacerbations. However, its effects on lung function — especially its longterm effects — remain controversial. We aimed to identify factors associated with a possible beneficial effect of allergen-specific immunotherapy on lung function in asthma by retrospectively evaluating the long-term changes in lung function in children with asthma who received house dust mite subcutaneous immunotherapy (HDM-SCIT). Methods: We enrolled children with asthma who had undergone HDM-SCIT for more than 1 year. Clinical information and lung function measurements were retrieved from the electronic chart system. To characterize the trajectory of lung function change, we performed linear regression analysis to evaluate the maximal expiratory flow at 50% of the forced vital capacity during two periods: before and during HDM-SCIT. Slopes from a least-squares regression line for the two periods, i.e., S1 before HDM-SCIT and S2 during HDM-SCIT, were compared. The subjects were then classified into two groups: an improving group (Group I) defined as S2–S1 > 0, and a declining group (Group D) defined as S2–S1 < 0. The clinical factors at the start of HDM-SCIT were compared between the two groups. Results: A total of 16 patients were analyzed. Eight patients were classified into each of Group I and Group D. The mean ages were 10.5 and 11.8 years, and the mean treatment periods were 4.1 and 3.9 years. Group I had a significantly lower blood eosinophil count and a significantly higher HDM-specific IgE level than Group D. Logistic regression showed a strong relationship between those two markers and the lung function trajectory. Conclusion: Control of the blood eosinophil count in highly HDM-sensitized patients may increase the beneficial effect of HDM-SCIT on lung function.

Background: Allergen-specific immunotherapy is currently the only disease-modifying treatment for allergic asthma, and it has been shown to improve control of asthma while reducing both drug use and asthma exacerbations. However, its effects on lung function—especially its long-term effects—remain controversial. We aimed to identify factors associated with a possible beneficial effect of allergen-specific immunotherapy on lung function in asthma by retrospectively evaluating the long-term changes in lung function in children with asthma who received house dust mite subcutaneous immunotherapy (HDM-SCIT). Methods: We enrolled children with asthma who had undergone HDM-SCIT for more than 1 year. Clinical information and lung function measurements were retrieved from the electronic chart system. To characterize the trajectory of lung function change, we performed linear regression analysis to evaluate the maximal expiratory flow at 50% of the forced vital capacity during two periods: before and during HDM-SCIT. Slopes from a least-squares regression line for the two periods, i.e., S1 before HDM-SCIT and S2 during HDM-SCIT, were compared. The subjects were then classified into two groups: an improving group (Group I) defined as S2 − S1 > 0, and a declining group (Group D) defined as S2 − S1 < 0. The clinical factors at the start of HDM-SCIT were compared between the two groups. Results: A total of 16 patients were analyzed. Eight patients were classified into each of Group I and Group D. The mean ages were 10.5 and 11.8 years, and the mean treatment periods were 4.1 and 3.9 years. Group I had a significantly lower blood eosinophil count and a significantly higher HDM-specific IgE level than Group D. Logistic regression showed a strong relationship between those two markers and the lung function trajectory. Conclusion: Control of the blood eosinophil count in highly HDM-sensitized patients may increase the beneficial effect of HDM-SCIT on lung function.

Background: Systemic inflammatory responses after cardiac surgery are associated with hemodynamic instability and an increased risk of end-organ injury. We recently identified mast cell activation as a critical mechanism of tissue injury, local and systemic inflammation in a rat model of circulatory arrest (CA). To test the clinical relevance of these findings, we now examined mast cell activation in patients undergoing cardiopulmonary bypass (CPB) and CA. Methods: After institutional review board approval, 31 patients with elective aortic arch surgery employing CPB and CA were prospectively enrolled from June 2013 until April 2015. Arterial blood samples were obtained at induction of anesthesia, on CPB when reaching target temperature, 10 minutes after CA, and after weaning from CPB. Plasma mast cell specific chymase, IL-6, TNFa, and IL-8 were measured by ELISA. Patient demographics and clinical parameters were retrieved from the electronic charting system. Statistical analysis was performed using SAS software. Results: Chymase levels increased with institution of CPB (delta baseline chymase: 5.59±6.29* at target temperature, 5.46±6.14* after CA, and 9.66±7.82* at end of CPB; * pg/mg plasma protein, p≤0.05). We observed no changes in TNFα at any time-point and significant changes of IL-6 and IL-8 only after end of CPB (delta baseline: 1.4±2.6pg/mg plasma protein and 10.8±6.3pg/mg plasma protein, p≤0.05). Time and area under the curve of a mean arterial pressure below 60 were significantly increased in patients with above-median chymase level vs. patients with below-median chymase levels at the end of CPB (p=0.0097 and p=0.014 respectively by 2-sample t test). Also, in these patients there was a consistent trend towards increased intraoperative phenylephrine, vasopressin, and epinephrine dose, increased postoperative lactate levels and a higher incidence of postoperative renal injury. Analysis of surgical factors revealed an association of chymase levels with higher target temperatures during CA, but not with duration of CPB or CA. Conclusions: We provide first evidence that significant and rapid mast cell activation occurs during cardiac surgery and is associated with a complicated intraoperative and early postoperative clinical course.

It is seen that high technology and its products work to meet every stage and need of human life and navigational safety in the maritime sector. Electronic systems have been developed and are used today as a result of the search for alternatives to the well-known and approved classical methods used in safe navigation on the world's seas. Electronic systems are susceptible and more accurate than classical methods and significantly benefit maritime transport. Bridge electronic systems and infrastructures supporting its components also work with advanced technology products. In this context, electronic navigational charts - ENC, Electronic Chart Display Information systems - ECDIS and Automatic Information systems - AIS are undoubtedly the best examples. These and similar bridge and auxiliary devices ensure the safety of navigation on both national and international seas and oceans and cause a decrease in human error rates. This study mentions the positive effects of high-tech bridge navigation systems developed in the maritime sector on maritime transportation.