Medical Data Access Accountability in EHR Systems, A Practical Perspective

The world has experienced a large increase in the amount of available data. Therefore, it requires better and more specialized tools for data storage and retrieval and information privacy. Recently Electronic Health Record (EHR) Systems have emerged to fulfill this need in health systems. They play an important role in medicine by granting access to information that can be used in medical diagnosis. Traditional systems have a focus on the storage and retrieval of this information, usually leaving issues related to privacy in the background. Doctors and patients may have different objectives when using an EHR system: patients try to restrict sensible information in their medical records to avoid misuse information while doctors want to see as much information as possible to ensure a correct diagnosis. One solution to this dilemma is the Accountable e-Health model, an access protocol model based in the Information Accountability Protocol. In this model patients are warned when doctors access their restricted data. They also enable a non-restrictive access for authenticated doctors. In this work we use FluxMED, an EHR system, and augment it with aspects of the Information Accountability Protocol to address these issues. The Implementation of the Information Accountability Framework (IAF) in FluxMED provides ways for both patients and physicians to have their privacy and access needs achieved. Issues related to storage and data security are secured by FluxMED, which contains mechanisms to ensure security and data integrity. The effort required to develop a platform for the management of medical information is mitigated by the FluxMED's workflow-based architecture: the system is flexible enough to allow the type and amount of information being altered without the need to change in your source code.

Development and validation of a multilevel model for predicting workload under routine and nonroutine conditions in an air traffic management center

Objective: The aim of this study was to develop a model capable of predicting variability in the mental workload experienced by frontline operators under routine and nonroutine conditions. Background: Excess workload is a risk that needs to be managed in safety-critical industries. Predictive models are needed to manage this risk effectively yet are difficult to develop. Much of the difficulty stems from the fact that workload prediction is a multilevel problem. Method: A multilevel workload model was developed in Study 1 with data collected from an en route air traffic management center. Dynamic density metrics were used to predict variability in workload within and between work units while controlling for variability among raters. The model was cross-validated in Studies 2 and 3 with the use of a high-fidelity simulator. Results: Reported workload generally remained within the bounds of the 90% prediction interval in Studies 2 and 3. Workload crossed the upper bound of the prediction interval only under nonroutine conditions. Qualitative analyses suggest that nonroutine events caused workload to cross the upper bound of the prediction interval because the controllers could not manage their workload strategically. Conclusion: The model performed well under both routine and nonroutine conditions and over different patterns of workload variation. Application: Workload prediction models can be used to support both strategic and tactical workload management. Strategic uses include the analysis of historical and projected workflows and the assessment of staffing needs. Tactical uses include the dynamic reallocation of resources to meet changes in demand.

The significance of controlled conditions in lentiviral vector titration and in the use of multiplicity of infection (MOI) for predicting gene transfer events

Background: Although lentiviral vectors have been widely used for in vitro and in vivo gene therapy researches, there have been few studies systematically examining various conditions that may affect the determination of the number of viable vector particles in a vector preparation and the use of Multiplicity of Infection (MOI) as a parameter for the prediction of gene transfer events. Methods: Lentiviral vectors encoding a marker gene were packaged and supernatants concentrated. The number of viable vector particles was determined by in vitro transduction and fluorescent microscopy and FACs analyses. Various factors that may affect the transduction process, such as vector inoculum volume, target cell number and type, vector decay, variable vector - target cell contact and adsorption periods were studied. MOI between 0-32 was assessed on commonly used cell lines as well as a new cell line. Results: We demonstrated that the resulting values of lentiviral vector titre varied with changes of conditions in the transduction process, including inoculum volume of the vector, the type and number of target cells, vector stability and the length of period of the vector adsorption to target cells. Vector inoculum and the number of target cells determine the frequencies of gene transfer event, although not proportionally. Vector exposure time to target cells also influenced transduction results. Varying these parameters resulted in a greater than 50-fold differences in the vector titre from the same vector stock. Commonly used cell lines in vector titration were less sensitive to lentiviral vector-mediated gene transfer than a new cell line, FRL 19. Within 0-32 of MOI used transducing four different cell lines, the higher the MOI applied, the higher the efficiency of gene transfer obtained. Conclusion: Several variables in the transduction process affected in in vitro vector titration and resulted in vastly different values from the same vector stock, thus complicating the use of MOI for predicting gene transfer events. Commonly used target cell lines underestimated vector titre. However, within a certain range of MOI, it is possible that, if strictly controlled conditions are observed in the vector titration process, including the use of a sensitive cell line, such as FRL 19 for vector titration, lentivector-mediated gene transfer events could be predicted. © 2004 Zhang et al; licensee BioMed Central Ltd.

Precipitation In Small Systems--II. Mean Field Equations More Effective Than Population Balance

Part I (Manjunath et al., 1994, Chem. Engng Sci. 49, 1451-1463) of this paper showed that the random particle numbers and size distributions in precipitation processes in very small drops obtained by stochastic simulation techniques deviate substantially from the predictions of conventional population balance. The foregoing problem is considered in this paper in terms of a mean field approximation obtained by applying a first-order closure to an unclosed set of mean field equations presented in Part I. The mean field approximation consists of two mutually coupled partial differential equations featuring (i) the probability distribution for residual supersaturation and (ii) the mean number density of particles for each size and supersaturation from which all average properties and fluctuations can be calculated. The mean field equations have been solved by finite difference methods for (i) crystallization and (ii) precipitation of a metal hydroxide both occurring in a single drop of specified initial supersaturation. The results for the average number of particles, average residual supersaturation, the average size distribution, and fluctuations about the average values have been compared with those obtained by stochastic simulation techniques and by population balance. This comparison shows that the mean field predictions are substantially superior to those of population balance as judged by the close proximity of results from the former to those from stochastic simulations. The agreement is excellent for broad initial supersaturations at short times but deteriorates progressively at larger times. For steep initial supersaturation distributions, predictions of the mean field theory are not satisfactory thus calling for higher-order approximations. The merit of the mean field approximation over stochastic simulation lies in its potential to reduce expensive computation times involved in simulation. More effective computational techniques could not only enhance this advantage of the mean field approximation but also make it possible to use higher-order approximations eliminating the constraints under which the stochastic dynamics of the process can be predicted accurately.

Fault tolerance in multiprocessor systems

Multiprocessor systems which afford a high degree of parallelism are used in a variety of applications. The extremely stringent reliability requirement has made the provision of fault-tolerance an important aspect in the design of such systems. This paper presents a review of the various approaches towards tolerating hardware faults in multiprocessor systems. It. emphasizes the basic concepts of fault tolerant design and the various problems to be taken care of by the designer. An indepth survey of the various models, techniques and methods for fault diagnosis is given. Further, we consider the strategies for fault-tolerance in specialized multiprocessor architectures which have the ability of dynamic reconfiguration and are suited to VLSI implementation. An analysis of the state-óf-the-art is given which points out the major aspects of fault-tolerance in such architectures.

Conductivity Scale In Disordered-Systems

A reanalysis of the correction to the Boltzmann conductivity due to maximally crossed graphs for degenerate bands explains why the conductivity scale in many-valley semiconductors is an order of magnitude higher than Mott's "minimum metallic conductivity." With the use of a reasonable assumption for the Boltzmann mean free path, the lowest-order perturbation theory is seen to give a remarkably good, semiquantitative, description of the conductivity variation in both uncompensated doped semiconductors and amorphous alloys.

Memory of past random wave conditions in submarine groundwater discharge

Submarine groundwater discharge (SGD) is an integral part of the hydrological cycle and represents an important aspect of land-ocean interactions. We used a numerical model to simulate flow and salt transport in a nearshore groundwater aquifer under varying wave conditions based on yearlong random wave data sets, including storm surge events. The results showed significant flow asymmetry with rapid response of influxes and retarded response of effluxes across the seabed to the irregular wave conditions. While a storm surge immediately intensified seawater influx to the aquifer, the subsequent return of intruded seawater to the sea, as part of an increased SGD, was gradual. Using functional data analysis, we revealed and quantified retarded, cumulative effects of past wave conditions on SGD including the fresh groundwater and recirculating seawater discharge components. The retardation was characterized well by a gamma distribution function regardless of wave conditions. The relationships between discharge rates and wave parameters were quantifiable by a regression model in a functional form independent of the actual irregular wave conditions. This statistical model provides a useful method for analyzing and predicting SGD from nearshore unconfined aquifers affected by random waves

Exploring profit - Sustainability trade-offs in cropping systems using evolutionary algorithms

Models that implement the bio-physical components of agro-ecosystems are ideally suited for exploring sustainability issues in cropping systems. Sustainability may be represented as a number of objectives to be maximised or minimised. However, the full decision space of these objectives is usually very large and simplifications are necessary to safeguard computational feasibility. Different optimisation approaches have been proposed in the literature, usually based on mathematical programming techniques. Here, we present a search approach based on a multiobjective evaluation technique within an evolutionary algorithm (EA), linked to the APSIM cropping systems model. A simple case study addressing crop choice and sowing rules in North-East Australian cropping systems is used to illustrate the methodology. Sustainability of these systems is evaluated in terms of economic performance and resource use. Due to the limited size of this sample problem, the quality of the EA optimisation can be assessed by comparison to the full problem domain. Results demonstrate that the EA procedure, parameterised with generic parameters from the literature, converges to a useable solution set within a reasonable amount of time. Frontier ‘‘peels’’ or Pareto-optimal solutions as described by the multiobjective evaluation procedure provide useful information for discussion on trade-offs between conflicting objectives.

Spinel-Corundum Phase Equilibria in the Systems Mn-Cr-Al-O and Co-Cr-Al-O at 1373 K

The tie lines delineating ion-exchange equilibria between MCr2O4-MAl2O4 spinel solid solution, where M is either Mn or Co, and Cr2O3-Al2O3 solid solution with the corundum structure were determined at 1373 K by electron microprobe and E0AX point count analysis of the oxide phases equilibrated with metallic Co and Au-5% Mn. The component activities in the spinel solid solutions are derived from the tie lines and the thernodynamic data for Cr2O3-Al2O3 soiid solutions available hi the literature. The Gibbs free energies of mixing calculated from the experimental data are discussed in relation to the values derived from the cation distribution a.odel based on the site preference energies and assuming random mixing on both tetrahedral and octahedral sites. Positive deviations from ideality observed in this study suggest a miscibility gap for both series of spinel solid solutions at low temperatures in the absence of oxidation.

Real-time wide-area loading margin sensitivity (WALMS) in power systems

Loading margin sensitivity (LMS) has been widely used in applications in the realm of voltage stability assessment and control. Typically, LMS is derived based on system equilibrium equations near bifurcation and therefore requires full detailed system model and significant computation effort. Availability of phasor measurement units (PMUs) due to the recent development of wide-area monitoring system (WAMS) provides an alternative computation-friendly approach for calculating LMS. With such motivation, this work proposes measurement-based wide-area loading margin sensitivity (WALMS) in bulk power systems. The proposed sensitivity, with its simplicity, has great potential to be embedded in real-time applications. Moreover, the calculation of the WALMS is not limited to low voltage near bifurcation point. A case study on IEEE 39-bus system verifies the proposed sensitivity. Finally, a voltage control scenario demonstrates the potential application of the WALMS.

Theory of freezing in simple systems

The transition parameters for the freezing of two one-component liquids into crystalline solids are evaluated by two theoretical approaches. The first system considered is liquid sodium which crystallizes into a body-centered-cubic (bcc) lattice; the second system is the freezing of adhesive hard spheres into a face-centered-cubic (fcc) lattice. Two related theoretical techniques are used in this evaluation: One is based upon a recently developed bifurcation analysis; the other is based upon the theory of freezing developed by Ramakrishnan and Yussouff. For liquid sodium, where experimental information is available, the predictions of the two theories agree well with experiment and each other. The adhesive-hard-sphere system, which displays a triple point and can be used to fit some liquids accurately, shows a temperature dependence of the freezing parameters which is similar to Lennard-Jones systems. At very low temperature, the fractional density change on freezing shows a dramatic increase as a function of temperature indicating the importance of all the contributions due to the triplet direction correlation function. Also, we consider the freezing of a one-component liquid into a simple-cubic (sc) lattice by bifurcation analysis and show that this transition is highly unfavorable, independent of interatomic potential choice. The bifurcation diagrams for the three lattices considered are compared and found to be strikingly different. Finally, a new stability analysis of the bifurcation diagrams is presented.

Grazing for Healthy Coastal Wetlands: Guidelines for managing coastal wetlands in grazing systems.

Grazing for Healthy Coastal Wetlands has been developed to provide graziers, landowners and extension officers with information on managing grazing in and around Queensland’s coastal wetlands to maintain healthy coastal wetlands and productive grazing enterprises. It provides practical advice on how grazing and associated land management practices can be implemented to support the long-term health of coastal wetlands whilst maintaining production. The guidelines have been compiled from published literature, grazier knowledge, wetlands managers and the experience of extension and natural resource management professionals. They reflect the current knowledge of suitable management practices for coastal wetlands. They are designed to complement and be considered in conjunction with existing information resources including the EDGEnetwork Grazing Land Management series and best management practice guidelines from regional Natural Resource Management (NRM) groups. While the recommendations apply broadly to Queensland’s coastal wetlands, regional, catchment and landscape-scale variations in wetland characteristics and the objectives of the individual grazing enterprise should be taken into account in planning and deciding management actions for wetlands. An individual grazing property may even have a range of wetland types with different management needs and objectives which should be identified during whole of property planning. Specific land and wetland management advice should also be sought from local grazing extension officers and NRM professionals.

Digestion capasity, nutrient digestibilities and physico-chemical conditions in the intestine influenced by the age of growing turkeys

Six experiments have been conducted to examine digestibility and feeding value of domestic Finnish fibre-rich cereals (barley and oats as compared to maize and wheat) and protein sources (rapeseed meal and cake, peas, faba beans, lupin seeds) for growing turkeys and to investigate effects of age of the birds (from 3 to 12 weeks of age) on digestion process and estimated nutrient digestibility and energy values. Besides, an objective of the study was to test applications of digestibility research methodology for turkeys. Total tract digestibility and apparent metabolizable energy (AME) was assayed in experimental cages using excreta collection, and a slaughter method was applied to sample small intestinal digesta for determination of apparent ileal crude protein digestibility (AICPD), jejuno-duodenal digesta viscosity and caecal volatile fatty acid (VFA) concentration. Digesta viscosity decreased and caecal VFA production increased with age of growing turkeys. Digesta retention times in the small intestine were generally longer in the older birds than in the younger ones. Crude fat digestibility and AME increased with age of growing turkeys, especially with viscous diets. AICPD seemed to decrease with age in most cases. Supplementation with β-gucanase-xylanase decreased viscosity, improved crude fat digestibility and metabolizable energy value and increased VFA production especially in barley-fed turkeys and especially in the young birds. Poor protein digestibility and low energy value of rapeseed meal and rapeseed cake decreased their feeding value for turkeys. In addition, a typical goitrogenic effect of rapeseed feeding was detected. Use of legume seeds as feed for growing turkeys is limited mostly by the low energy value in lupin seeds and the low ileal protein and amino acid digestibility in faba beans. Digestibility of fibre-rich protein sources was not improved with age of the turkeys. Euthanizing the turkeys for AICPD determination by carbon dioxide and bleeding led to lower digestibility values than mechanical stunning and cervical dislocation, suggesting inferiority of carbon dioxide stunning in experimental use. Comparison of AICPD and AME results obtained using different markers showed that considerable differences may occur, especially on total tract level, when acid-insoluble ash gave considerably lower AME values than titanium dioxide and chromic oxide.

Photochemical Reactions in Oriented Systems

Modification of chemical reactions through the use of constrained and/or organized media has attracted a great deal of attention recently. Results from our laboratory in this direction which include a study of photochemical reactions in solid state and in cyclodextrins are presented here. A study of solid state photochemical behavior of coumarins has provided information regarding subtler aspects of topochemical postulates of photodimerization. Results pertaining to geometrical criteria for photodimerization and "chloro" as a crystal engineering group are discussed. As a part of an attempt to correlate chemical reactivity with molecular packing in the solid state, photooxidation of diarylthioketones in the solid state has been investigated. The observed differences in the reactivity of these crystals are rationalized in terms of crystal packing. Though cyclodextrins have been extensively studied, very few photochemical reactions involving molecules complexed to cyclodextrins have been examined. In this connection, the utility of cyclodextrins in bringing about selectivity in photochemical reactions through the study of excited state behavior of olefins and aryl alkyl ketones has been demonstrated in our laboratory.

Can soil nematode community structure be used to indicate soil carbon dynamics in horticultural systems?

There is a need to develop indicators that relate the dynamics of soil organic carbon (SOC) with changes in land management of horticultural production systems. Soil nematode communities have been shown to be sensitive to land management changes, but often do not include plant-parasites in the calculation of soil nematode community indices. The concept of nematode functional guilds was used to estimate the proportion of carbon entering the soil ecosystem through different channels, such as through decomposition of organic material, the detrital channel, through the roots of plants, the root channel or recycled through the activity of predators, a predation channel. Calculations of the indices were developed and validated using case studies in the north Queensland banana industry. Firstly, a survey of organic and conventional banana farms found a greater proportion of C entering the soil ecosystem through the detrital channel and a reduced proportion of C originating through the root channel at the organic sites relative to conventional sites. Secondly, a field experiment comparing compost amendments, found application of fresh compost significantly increased the proportion of C entering the soil ecosystem through the detrital channel and decreased proportion of C originating from the root channel. Thirdly, a field experiment comparing 'conventional' banana production to an 'alternative' system which incorporated organic matter, found the proportion of C entering the soil ecosystem through the root channel was significantly greater in the conventional systems relative to the alternative system. This research demonstrates that nematode indices can be used to assess horticultural systems, by indicating the origins of SOC.