The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after study

Objectives: To assess the impact of a closed-loop electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration record (EMAR) system on prescribing and administration errors, confirmation of patient identity before administration, and staff time. Design, setting and participants: Before-and-after study in a surgical ward of a teaching hospital, involving patients and staff of that ward. Intervention: Closed-loop electronic prescribing, automated dispensing, barcode patient identification and EMAR system. Main outcome measures: Percentage of new medication orders with a prescribing error, percentage of doses with medication administration errors (MAEs) and percentage given without checking patient identity. Time spent prescribing and providing a ward pharmacy service. Nursing time on medication tasks. Results: Prescribing errors were identified in 3.8% of 2450 medication orders pre-intervention and 2.0% of 2353 orders afterwards (p<0.001; χ2 test). MAEs occurred in 7.0% of 1473 non-intravenous doses pre-intervention and 4.3% of 1139 afterwards (p = 0.005; χ2 test). Patient identity was not checked for 82.6% of 1344 doses pre-intervention and 18.9% of 1291 afterwards (p<0.001; χ2 test). Medical staff required 15 s to prescribe a regular inpatient drug pre-intervention and 39 s afterwards (p = 0.03; t test). Time spent providing a ward pharmacy service increased from 68 min to 98 min each weekday (p = 0.001; t test); 22% of drug charts were unavailable pre-intervention. Time per drug administration round decreased from 50 min to 40 min (p = 0.006; t test); nursing time on medication tasks outside of drug rounds increased from 21.1% to 28.7% (p = 0.006; χ2 test). Conclusions: A closed-loop electronic prescribing, dispensing and barcode patient identification system reduced prescribing errors and MAEs, and increased confirmation of patient identity before administration. Time spent on medication-related tasks increased.

Design and evaluation of intelligent classifier based intrusion detection system

We have discovered a novel approach of intrusion detection system using an intelligent data classifier based on a self organizing map (SOM). We have surveyed all other unsupervised intrusion detection methods, different alternative SOM based techniques and KDD winner IDS methods. This paper provides a robust designed and implemented intelligent data classifier technique based on a single large size (30x30) self organizing map (SOM) having the capability to detect all types of attacks given in the DARPA Archive 1999 the lowest false positive rate being 0.04 % and higher detection rate being 99.73% tested using full KDD data sets and 89.54% comparable detection rate and 0.18% lowest false positive rate tested using corrected data sets.

Dynamic recurrent neural network for system identification and control

A dynamic recurrent neural network (DRNN) that can be viewed as a generalisation of the Hopfield neural network is proposed to identify and control a class of control affine systems. In this approach, the identified network is used in the context of the differential geometric control to synthesise a state feedback that cancels the nonlinear terms of the plant yielding a linear plant which can then be controlled using a standard PID controller.

The system identification and control of Hammerstein system using non-uniform rational B-spline neural network and particle swarm optimization

In this paper a new system identification algorithm is introduced for Hammerstein systems based on observational input/output data. The nonlinear static function in the Hammerstein system is modelled using a non-uniform rational B-spline (NURB) neural network. The proposed system identification algorithm for this NURB network based Hammerstein system consists of two successive stages. First the shaping parameters in NURB network are estimated using a particle swarm optimization (PSO) procedure. Then the remaining parameters are estimated by the method of the singular value decomposition (SVD). Numerical examples including a model based controller are utilized to demonstrate the efficacy of the proposed approach. The controller consists of computing the inverse of the nonlinear static function approximated by NURB network, followed by a linear pole assignment controller.

The SAFEE on-board threat detection system

Under the framework of the European Union Funded SAFEE project(1), this paper gives an overview of a novel monitoring and scene analysis system developed for use onboard aircraft in spatially constrained environments. The techniques discussed herein aim to warn on-board crew about pre-determined indicators of threat intent (such as running or shouting in the cabin), as elicited from industry and security experts. The subject matter experts believe that activities such as these are strong indicators of the beginnings of undesirable chains of events or scenarios, which should not be allowed to develop aboard aircraft. This project aimes to detect these scenarios and provide advice to the crew. These events may involve unruly passengers or be indicative of the precursors to terrorist threats. With a state of the art tracking system using homography intersections of motion images, and probability based Petri nets for scene understanding, the SAFEE behavioural analysis system automatically assesses the output from multiple intelligent sensors, and creates. recommendations that are presented to the crew using an integrated airborn user interface. Evaluation of the system is conducted within a full size aircraft mockup, and experimental results are presented, showing that the SAFEE system is well suited to monitoring people in confined environments, and that meaningful and instructive output regarding human actions can be derived from the sensor network within the cabin.

A camera based digit location and recognition system for garment tracking

Garment information tracking is required for clean room garment management. In this paper, we present a camera-based robust system with implementation of Optical Character Reconition (OCR) techniques to fulfill garment label recognition. In the system, a camera is used for image capturing; an adaptive thresholding algorithm is employed to generate binary images; Connected Component Labelling (CCL) is then adopted for object detection in the binary image as a part of finding the ROI (Region of Interest); Artificial Neural Networks (ANNs) with the BP (Back Propagation) learning algorithm are used for digit recognition; and finally the system is verified by a system database. The system has been tested. The results show that it is capable of coping with variance of lighting, digit twisting, background complexity, and font orientations. The system performance with association to the digit recognition rate has met the design requirement. It has achieved real-time and error-free garment information tracking during the testing.

Identification and minimization of IIR tap coefficients for the cancellation of complex multipath in terrestrial television

By using a deterministic approach, an exact form for the synchronous detected video signal under a ghosted condition is presented. Information regarding the phase quadrature-induced ghost component derived from the quadrature forming nature of the vestigial sideband (VSB) filter is obtained by crosscorrelating the detected video with the ghost cancel reference (GCR) signal. As a result, the minimum number of taps required to correctly remove all the ghost components is subsequently presented. The results are applied to both National Television System Committee (NTSC) and phase alternate line (PAL) television.

A comparison of two identification and tracking methods for polar lows

In this study, we compare two different cyclone-tracking algorithms to detect North Atlantic polar lows, which are very intense mesoscale cyclones. Both approaches include spatial filtering, detection, tracking and constraints specific to polar lows. The first method uses digital bandpass-filtered mean sea level pressure (MSLP) fieldsin the spatial range of 200�600 km and is especially designed for polar lows. The second method also uses a bandpass filter but is based on the discrete cosine transforms (DCT) and can be applied to MSLP and vorticity fields. The latter was originally designed for cyclones in general and has been adapted to polar lows for this study. Both algorithms are applied to the same regional climate model output fields from October 1993 to September 1995 produced from dynamical downscaling of the NCEP/NCAR reanalysis data. Comparisons between these two methods show that different filters lead to different numbers and locations of tracks. The DCT is more precise in scale separation than the digital filter and the results of this study suggest that it is more suited for the bandpass filtering of MSLP fields. The detection and tracking parts also influence the numbers of tracks although less critically. After a selection process that applies criteria to identify tracks of potential polar lows, differences between both methods are still visible though the major systems are identified in both.

Human red blood cells at work: identification and visualization of erythrocytic eNOS activity in health and disease

A nitric oxide synthase (NOS)-like activity has been demonstrated in human red blood cells (RBCs), but doubts about its functional significance, isoform identity and disease relevance remain. Using flow cytometry in combination with the NO-imaging probe DAF-FM we find that all blood cells form NO intracellularly, with a rank order of monocytes > neutrophils > lymphocytes > RBCs > platelets. The observation of a NO-related fluorescence within RBCs was unexpected given the abundance of the NO-scavenger oxyhemoglobin. Constitutive normoxic NO formation was abolished by NOS inhibition and intracellular NO scavenging, confirmed by laser-scanning microscopy and unequivocally validated by detection of the DAF-FM reaction product with NO using HPLC and LC-MS/MS. Employing immunoprecipitation, ESI-MS/MS-based peptide sequencing and enzymatic assay we further demonstrate that human RBCs contain an endothelial NOS (eNOS) that converts L-3H-Arginine to L-3H-Citrulline in a Ca2+/Calmodulin-dependent fashion. Moreover, in patients with coronary artery disease, red cell eNOS expression and activity are both lower than in age-matched healthy individuals and correlate with the degree of endothelial dysfunction. Thus, human RBCs constitutively produce NO under normoxic conditions via an active eNOS isoform the activity of which is compromised in patients with coronary artery disease.

Real-time identification and modelling in pervasive mining

This paper introduces an architecture for identifying and modelling in real-time at a copper mine using new technologies as M2M and cloud computing with a server in the cloud and an Android client inside the mine. The proposed design brings up pervasive mining, a system with wider coverage, higher communication efficiency, better fault-tolerance, and anytime anywhere availability. This solution was designed for a plant inside the mine which cannot tolerate interruption and for which their identification in situ, in real time, is an essential part of the system to control aspects such as instability by adjusting their corresponding parameters without stopping the process.

Automated identification and tracking of polar-cap plasma patches at solar minimum

A method of automatically identifying and tracking polar-cap plasma patches, utilising data inversion and feature-tracking methods, is presented. A well-established and widely used 4-D ionospheric imaging algorithm, the Multi-Instrument Data Assimilation System (MIDAS), inverts slant total electron content (TEC) data from ground-based Global Navigation Satellite System (GNSS) receivers to produce images of the free electron distribution in the polar-cap ionosphere. These are integrated to form vertical TEC maps. A flexible feature-tracking algorithm, TRACK, previously used extensively in meteorological storm-tracking studies is used to identify and track maxima in the resulting 2-D data fields. Various criteria are used to discriminate between genuine patches and "false-positive" maxima such as the continuously moving day-side maximum, which results from the Earth's rotation rather than plasma motion. Results for a 12-month period at solar minimum, when extensive validation data are available, are presented. The method identifies 71 separate structures consistent with patch motion during this time. The limitations of solar minimum and the consequent small number of patches make climatological inferences difficult, but the feasibility of the method for patches larger than approximately 500 km in scale is demonstrated and a larger study incorporating other parts of the solar cycle is warranted. Possible further optimisation of discrimination criteria, particularly regarding the definition of a patch in terms of its plasma concentration enhancement over the surrounding background, may improve results.

An enhanced fall detection system for elderly person monitoring using consumer home networks

Various fall-detection solutions have been previously proposed to create a reliable surveillance system for elderly people with high requirements on accuracy, sensitivity and specificity. In this paper, an enhanced fall detection system is proposed for elderly person monitoring that is based on smart sensors worn on the body and operating through consumer home networks. With treble thresholds, accidental falls can be detected in the home healthcare environment. By utilizing information gathered from an accelerometer, cardiotachometer and smart sensors, the impacts of falls can be logged and distinguished from normal daily activities. The proposed system has been deployed in a prototype system as detailed in this paper. From a test group of 30 healthy participants, it was found that the proposed fall detection system can achieve a high detection accuracy of 97.5%, while the sensitivity and specificity are 96.8% and 98.1% respectively. Therefore, this system can reliably be developed and deployed into a consumer product for use as an elderly person monitoring device with high accuracy and a low false positive rate.

In silico identification and three-dimensional modelling of the missense mutation in ADAMTS2 in a sheep flock with dermatosparaxis

Background Dermatosparaxis (Ehlers–Danlos syndrome in humans) is characterized by extreme fragility of the skin. It is due to the lack of mature collagen caused by a failure in the enzymatic processing of procollagen I. We investigated the condition in a commercial sheep flock. Hypothesis/Objectives Mutations in the ADAM metallopeptidase with thrombospondin type 1 motif, 2 (ADAMTS2) locus, are involved in the development of dermatosparaxis in humans, cattle and the dorper sheep breed; consequently, this locus was investigated in the flock. Animals A single affected lamb, its dam, the dam of a second affected lamb and the rams in the flock were studied. Methods DNA was purified from blood, PCR primers were used to detect parts of the ADAMS2 gene and nucleotide sequencing was performed using Sanger's procedure. Skin samples were examined using standard histology procedures. Results A missense mutation was identified in the catalytic domain of ADAMTS2. The mutation is predicted to cause the substitution in the mature ADAMTS2 of a valine molecule by a methionine molecule (V15M) affecting the catalytic domain of the enzyme. Both the ‘sorting intolerant from tolerant’ (SIFT) and the PolyPhen-2 methodologies predicted a damaging effect for the mutation. Three-dimensional modelling suggested that this mutation may alter the stability of the protein folding or distort the structure, causing the protein to malfunction. Conclusions and clinical importance Detection of the mutation responsible for the pathology allowed us to remove the heterozygote ram, thus preventing additional cases in the flock.