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.

Effects of preferential transport in turbulent bluff-body-stabilized lean premixed CH 4/air flames

Preferential species diffusion is known to have important effects on local flame structure in turbulent premixed flames, and differential diffusion of heat and mass can have significant effects on both local flame structure and global flame parameters, such as turbulent flame speed. However, models for turbulent premixed combustion normally assume that atomic mass fractions are conserved from reactants to fully burnt products. Experiments reported here indicate that this basic assumption may be incorrect for an important class of turbulent flames. Measurements of major species and temperature in the near field of turbulent, bluff-body stabilized, lean premixed methane-air flames (Le=0.98) reveal significant departures from expected conditional mean compositional structure in the combustion products as well as within the flame. Net increases exceeding 10% in the equivalence ratio and the carbon-to-hydrogen atom ratio are observed across the turbulent flame brush. Corresponding measurements across an unstrained laminar flame at similar equivalence ratio are in close agreement with calculations performed using Chemkin with the GRI 3.0 mechanism and multi-component transport, confirming accuracy of experimental techniques. Results suggest that the large effects observed in the turbulent bluff-body burner are cause by preferential transport of H 2 and H 2O through the preheat zone ahead of CO 2 and CO, followed by convective transport downstream and away from the local flame brush. This preferential transport effect increases with increasing velocity of reactants past the bluff body and is apparently amplified by the presence of a strong recirculation zone where excess CO 2 is accumulated. © 2011 The Combustion Institute.

Polarisation diversity of conformal arrays based on geometric algebra via convex optimisation

A simple and general design procedure is presented for the polarisation diversity of arbitrary conformal arrays; this procedure is based on the mathematical framework of geometric algebra and can be solved optimally using convex optimisation. Aside from being simpler and more direct than other derivations in the literature, this derivation is also entirely general in that it expresses the transformations in terms of rotors in geometric algebra which can easily be formulated for any arbitrary conformal array geometry. Convex optimisation has a number of advantages; solvers are widespread and freely available, the process generally requires a small number of iterations and a wide variety of constraints can be readily incorporated. The study outlines a two-step approach for addressing polarisation diversity in arbitrary conformal arrays: first, the authors obtain the array polarisation patterns using geometric algebra and secondly use a convex optimisation approach to find the optimal weights for the polarisation diversity problem. The versatility of this approach is illustrated via simulations of a 7×10 cylindrical conformal array. © 2012 The Institution of Engineering and Technology.

Wide Area Passive UHF RFID System using Antenna Diversity Combined with Phase and Frequency Hopping

This paper presents a long range and effectively error-free ultra high frequency (UHF) radio frequency identification (RFID) interrogation system. The system is based on a novel technique whereby two or more spatially separated transmit and receive antennas are used to enable greatly enhanced tag detection performance over longer distances using antenna diversity combined with frequency and phase hopping. The novel technique is first theoretically modelled using a Rician fading channel. It is shown that conventional RFID systems suffer from multi-path fading resulting in nulls in radio environments. We, for the first time, demonstrate that the nulls can be moved around by varying the phase and frequency of the interrogation signals in a multi-antenna system. As a result, much enhanced coverage can be achieved. A proof of principle prototype RFID system is built based on an Impinj R2000 transceiver. The demonstrator system shows that the new approach improves the tag detection accuracy from <50% to 100% and the tag backscatter signal strength by 10dB over a 20 m x 9 m area, compared with a conventional switched multi-antenna RFID system.

A body force-based method for prediction of multiple-pure-tone noise: Validation

Emissions, fuel burn, and noise are the main drivers for innovative aircraft design. Embedded propulsion systems, such as for example used in hybrid-wing body aircraft, can offer fuel burn and noise reduction benefits but the impact of inlet flow distortion on the generation and propagation of turbomachinery noise has yet to be assessed. A novel approach is used to quantify the effects of non-uniform flow on the creation and propagation of multiple pure tone (MPT) noise. The ultimate goal is to conduct a parametric study of S-duct inlets to quantify the effects of inlet design parameters on the acoustic signature. The key challenge is that the effects of distortion transfer, noise source generation and propagation through the non-uniform flow field are inherently coupled such that a simultaneous computation of the aerodynamics and acoustics is required to capture the mechanisms at play. The technical approach is based on a body force description of the fan blade row that is able to capture the distortion transfer and the blade-to-blade flow variations that cause the MPT noise while reducing computational cost. A single, 3-D full-wheel CFD simulation, in which the Euler equations are solved to second-order spatial and temporal accuracy, simultaneously computes the MPT noise generation and its propagation in distorted inlet flow. A new method of producing the blade-to-blade variations in the body force field for MPT noise generation has been developed and validated. The numerical dissipation inherent to the solver is quantified and used to correct for non-physical attenuation in the far-field noise spectra. Source generation, acoustic propagation and acoustic energy transfer between modes is examined in detail. The new method is validated on NASA's Source Diagnostic Test fan and inlet, showing good agreement with experimental data for aerodynamic performance, acoustic source generation, and far-field noise spectra. The next steps involve the assessment of MPT noise in serpentine inlet ducts and the development of a reduced order formulation suitable for incorporation into NASA's ANOPP framework. © 2010 by Jeff Defoe, Alex Narkaj & Zoltan Spakovszky.

First-principles energetics of water: a many-body analysis

Standard forms of density-functional theory (DFT) have good predictive power for many materials, but are not yet fully satisfactory for solid, liquid and cluster forms of water. We use a many-body separation of the total energy into its 1-body, 2-body (2B) and beyond-2-body (B2B) components to analyze the deficiencies of two popular DFT approximations. We show how machine-learning methods make this analysis possible for ice structures as well as for water clusters. We find that the crucial energy balance between compact and extended geometries can be distorted by 2B and B2B errors, and that both types of first-principles error are important.

Autonomous rigid body attitude synchronization

Control laws to synchronize attitudes in a swarm of fully actuated rigid bodies, in the absence of a common reference attitude or hierarchy in the swarm, are proposed in [Smith, T. R., Hanssmann, H., & Leonard, N.E. (2001). Orientation control of multiple underwater vehicles with symmetry-breaking potentials. In Proc. 40th IEEE conf. decision and control (pp. 4598-4603); Nair, S., Leonard, N. E. (2007). Stable synchronization of rigid body networks. Networks and Heterogeneous Media, 2(4), 595-624]. The present paper studies two separate extensions with the same energy shaping approach: (i) locally synchronizing the rigid bodies' attitudes, but without restricting their final motion and (ii) relaxing the communication topology from undirected, fixed and connected to directed, varying and uniformly connected. The specific strategies that must be developed for these extensions illustrate the limitations of attitude control with reduced information. © 2008 Elsevier Ltd.