Unity in diversity: electronic patient record use in multidisciplinary practice

In this paper we examine the use of electronic patient records (EPR) by clinical specialists in their development of multidisciplinary care for diagnosis and treatment of breast cancer. We develop a practice theory lens to investigate EPR use across multidisciplinary team practice. Our findings suggest that there are oppositional tendencies towards diversity in EPR use and unity which emerges across multidisciplinary work, and this influences the outcomes of EPR use. The value of this perspective is illustrated through the analysis of a year-long, longitudinal case study of a multidisciplinary team of surgeons, oncologists, pathologists, radiologists, and nurse specialists adopting a new EPR. Each group adapted their use of the EPR to their diverse specialist practices, but they nonetheless orientated their use of the EPR to each others' practices sufficiently to support unity in multidisciplinary teamwork. Multidisciplinary practice elements were also reconfigured in an episode of explicit negotiations, resulting in significant changes in EPR use within team meetings. Our study contributes to the growing literature that questions the feasibility and necessity of achieving high levels of standardized, uniform health information technology use in healthcare.

Performance and power dissipation comparisons between 28 Gb/s NRZ, PAM, CAP and optical OFDM systems for data communication applications

Theoretical investigations have been carried out to analyze and compare the link power budget and power dissipation of non-return-to-zero (NRZ), pulse amplitude modulation-4 (PAM-4), carrierless amplitude and phase modulation-16 (CAP-16) and 16-quadrature amplitude modulation-orthogonal frequency division multiplexing (16-QAM-OFDM) systems for data center interconnect scenarios. It is shown that for multimode fiber (MMF) links, NRZ modulation schemes with electronic equalization offer the best link power budget margins with the least power dissipation for short transmission distances up to 200 m; while OOFDM is the only scheme which can support a distance of 300 m albeit with power dissipation as high as 4 times that of NRZ. For short single mode fiber (SMF) links, all the modulation schemes offer similar link power budget margins for fiber lengths up to 15 km, but NRZ and PAM-4 are preferable due to their system simplicity and low power consumption. For lengths of up to 30 km, CAP-16 and OOFDM are required although the schemes consume 2 and 4 times as much power respectively compared to that of NRZ. OOFDM alone allows link operation up to 35 km distances. © 1983-2012 IEEE.

Biofluid behaviour in 3D microchannel systems: Numerical analysis and design development of 3D microchannel biochip separators

This paper describes the design and development cycle of a 3D biochip separator and the modelling analysis of flow behaviour in the biochip microchannel features. The focus is on identifying the difference between 2D and 3D implementations as well as developing basic forms of 3D microfluidic separators. Five variants, based around the device are proposed and analysed. These include three variations of the branch channels (circular, rectangular, disc) and two variations of the main channel (solid and concentric). Ignoring the initial transient behaviour and assuming steady state flow has been established, the efficiencies of the flow between the main and side channels for the different designs are analysed and compared with regard to relevant biomicrofluidic laws or effects (bifurcation law, Fahraeus effect, cell-free phenomenon, bending channel effect and laminar flow behaviour). The modelling results identify flow features in microchannels, a constriction and bifurcations and show detailed differences in flow fields between the various designs. The manufacturing process using injection moulding for the initial base case design is also presented and discussed. The work reported here is supported as part of the UK funded 3D-MINTEGRATION project. © 2010 IEEE.

Electronic load interface for improving PV dual-converter system operational margin

An electronic load interface (ELI) for improving the operational margin of a photovoltaic (PV) dual-converter system under dynamic conditions is presented. The ELI - based on a modified buck-boost converter - interfaces the output of the converters and the load system. It improves the operational margin of the PV dual-converter system by extending the conditions under which the dual-converter system operates at the maximum power point. The ELI is activated as and when needed, so as minimise system losses. By employing the ELI, utilisation and efficiency of a PV dual-converter system increases. In general, the concept of the ELI can be applied to multi-converter PV systems - such as multi-converter inverters, and multi-converter DC-DC converter systems - for performance and efficiency improvement. © 2013 The Institution of Engineering and Technology.