Financial model for investment recovery period in electronic health records implementations

Technology usage for better healthcare delivery is being emphasised in the USA and other advanced nations. Electronic health records (EHR) are being widely seen as improving operational efficiency and reducing medication errors in clinic practices and hospitals. Further, hospitals and clinics stand to gain incentives from the federal government if they implement EHRs and demonstrate meaningful use of EHRs. While numerous other aspects of HER implementations is found in literature, financial models have not been well studied. Before implementing EHR, one must take into consideration investment recovery period considering the costs, savings and possible tax incentives. In this paper, we develop financial model for computing investment recovery period in EHR implementations assuming constant patient visits. We further develop required growth rate formula if investments need to be recovered in fixed number of years. The model is illustrated with numerical example.

Why fly the extra mile? Using stress biomarkers to assess wintering habitat quality in migratory shorebirds

Migratory birds make decisions about how far to travel based on cost-benefit trade-offs. However, in many cases the net effect of these trade-offs is unclear. We sought to address this question by measuring feather corticosterone (CORTf), leucocyte profile, avian malaria parasite prevalence and estimating fueling rates in three spatially segregated wintering populations of the migratory shorebird ruddy turnstone Arenaria interpres during their stay in the winter habitat. These birds fly from the high-Arctic breeding ground to Australia, but differ in that some decide to end their migration early (Broome, Western Australia), whereas others travel further to either South Australia or Tasmania. We hypothesized that the extra costs in birds migrating greater distances and overwintering in colder climates would be offset by benefits when reaching their destination. This would be evidenced by lower stress biomarkers in populations that travel further, owing to the expected benefits of greater resources and improved vitality. We show that avian malaria prevalence and physiological stress levels were lower in birds flying to South Australia and Tasmania than those overwintering in Broome. Furthermore, our modeling predicts that birds in the southernmost locations enjoy higher fueling rates. Our data are consistent with the interpretation that birds occupying more costly wintering locations in terms of higher migratory flight and thermoregulatory costs are compensated by better feeding conditions and lower blood parasite infections, which facilitates timely and speedy migration back to the breeding ground. These data contribute to our understanding of cost-benefit trade-offs in the decision making underlying migratory behaviour.

Weak negative associations between avian influenza virus infection and movement behaviour in a key host species, the mallard Anas platyrhynchos

Animal movements may contribute to the spread of pathogens. In the case of avian influenza virus, [migratory] birds have been suggested to play a role in the spread of some highly pathogenic strains (e.g. H5N1, H5N8), as well as their low pathogenic precursors which circulate naturally in wild birds. For a better understanding of the emergence and spread of both highly pathogenic (HPAIV) and low pathogenic avian influenza virus (LPAIV), the potential effects of LPAIVs on bird movement need to be evaluated. In a key host species, the mallard Anas platyrhynchos, we tested whether LPAIV infection status affected daily local (< 100 m) and regional (> 100 m) movements by comparing movement behaviour 1) within individuals (captured and sampled at two time points) and 2) between individuals (captured and sampled at one time point). We fitted free-living adult males with GPS loggers throughout the autumn LPAIV infection peak, and sampled them for LPAIV infection at logger deployment and at logger removal on recapture. Within individuals, we found no association between LPAIV infection and daily local and regional movements. Among individuals, daily regional movements of LPAIV infected mallards in the last days of tracking were lower than those of non-infected birds. Moreover, these regional movements of LPAIV infected birds were additionally reduced by poor weather conditions (i.e. increased wind and/or precipitation and lower temperatures). Local movements of LPAIV infected birds in the first days of tracking were higher when temperature decreased. Our study thus demonstrates that bird-assisted dispersal rate of LPAIV may be lower on a regional scale than expected on the basis of the movement behaviour of non-infected birds. Our study underlines the importance of understanding the impact of pathogen infection on host movement in order to assess its potential role in the emergence and spread of infectious diseases.

Analysis of compressive load on intervertebral joint in standing and sitting postures

BACKGROUND: There have been some disagreements on the comparison of disc pressures in the standing and sitting postures in literature. Most research on in vivo pressure needle measurement found higher disc pressure in sitting than in standing. The disc pressure data can help to advocate better postures for clinical advice. OBJECTIVE: The aim of this paper is to develop a procedure to study the compressive load on intervertebral joint in the standing and sitting postures through the approach of motion capture and musculoskeletal modeling. METHODS: The marker data of six subjects performing various standing and sitting postures was obtained during the motion capture experiment and used to train the musculoskeletal model with an enhanced discretized spine developed for subject in the inverse and forward simulations. RESULTS: Compressive loads on L3-L4 and L4-L5 joints are found higher in upright sitting than in upright standing. Slumped sitting, cross-legged sitting and flexion sitting can introduce higher compressive loads on intervertebral joints compared with upright sitting. CONCLUSIONS: These findings indicate the effects of standing and sitting postures on the spinal joint loads. The results can provide doctors and therapists with more information on clinical advice on better postures for people with spinal problems.

At the crossroads: does the configuration of roadside vegetation affect woodland bird communities in rural landscapes?

In agricultural regions worldwide, linear networks of vegetation such as hedges, fencerows and live fences provide habitat for plant and animal species in heavily modified landscapes. In Australia, networks of remnant native vegetation along roadsides are a distinctive feature of many rural landscapes. Here, we investigated the richness and composition of woodland-dependent bird communities in networks of eucalypt woodland vegetation along roadsides, in an agricultural region in which >80% of native woodland and forest vegetation has been cleared. We stratified sites in a) cross sections and b) linear strips of roadside vegetation, to test the influence on woodland birds of site location and configuration in the linear network (the 'intersection effect'). We also examined the influence of tree size at the site, the amount of wooded vegetation surrounding the site, and the abundance of an aggressive native species, the noisy miner Manorina melanocephala. Birds were surveyed at 26 pairs of sites (cross section or linear strip) on four occasions. A total of 66 species was recorded, including 35 woodland species. The richness of woodland bird species was influenced by site configuration, with more species present at cross sections, particularly those with larger trees (>30 cm diameter). However, the strongest influence on species richness was the relative abundance of the noisy miner. The richness of woodland birds at sites where noisy miners were abundant was ~20% of that where miners were absent. These results recognise the value of networks of roadside vegetation as habitat for woodland birds in depleted agricultural landscapes; but highlight that this value is not realised for much of this vast vegetation network because of the dominance of the noisy miner. Nevertheless, roadside vegetation is particularly important where the configuration of networks create nodes that facilitate movement. Globally, the protection, conservation and restoration of such linear networks has an important influence on the persistence of biota within human-dominated landscapes.

Machine-to-machine communications with in-network data aggregation, processing, and actuation for large-scale cyber-physical systems

Machine-to-Machine (M2M) paradigm enables machines (sensors, actuators, robots, and smart meter readers) to communicate with each other with little or no human intervention. M2M is a key enabling technology for the cyber-physical systems (CPSs). This paper explores CPS beyond M2M concept and looks at futuristic applications. Our vision is CPS with distributed actuation and in-network processing. We describe few particular use cases that motivate the development of the M2M communication primitives tailored to large-scale CPS. M2M communications in literature were considered in limited extent so far. The existing work is based on small-scale M2M models and centralized solutions. Different sources discuss different primitives. Few existing decentralized solutions do not scale well. There is a need to design M2M communication primitives that will scale to thousands and trillions of M2M devices, without sacrificing solution quality. The main paradigm shift is to design localized algorithms, where CPS nodes make decisions based on local knowledge. Localized coordination and communication in networked robotics, for matching events and robots, were studied to illustrate new directions.

Placement of re-nests following predation: are birds managing risk?

Nest predation is the most important source of reproductive failure for many bird species, thus placing nests in 'safe' locations that minimise predation risk is paramount to maximising fitness. After a nest predation event, some species have been shown to manage the risk of nest predation for subsequent re-nesting attempts by moving to a new location, placing re-nests in areas with increased cover, or changing the height above ground at which the re-nest is placed. The extent to which this is an adaptive behaviour for birds in general is not yet clear, as existing studies are almost exclusively restricted to northern hemisphere species and species that do not breed cooperatively. Here, we examined the re-nesting behaviour of Bell Miners (Manorina melanophrys), a species of honeyeater endemic to Australia that is both multi-brooded and also frequently re-nests soon after nesting failure; females can build up to five nests in a breeding season. We tested if these females managed within-season nest predation risk by changing nest site characteristics (height from ground and distance between nests) between successive nesting attempts. We found that female miners did indeed manage predation risk by reducing the height from the ground at which they placed re-nests following predation events, but contrary to our second prediction we found no difference in distances moved to re-nest after females experienced nest predation or successfully rearing young.