Electronic patient records: Achieving best practice in information transfer between hospital and community providers - an integration success story

Effective healthcare integration is underpinned by clinical information transfer that is timely, legible and relevant. The aim of this study was to describe and evaluate a method for best practice information exchange. This was achieved based on the generic Mater integration methodology. Using this model the Mater Health Services have increased effective community fax discharge from 34% in 1999 to 86% in 2002. These results were predicated on applied information technology excellence involving the development of the Mater Electronic Health Referral Summary and effective change management methodology, which included addressing issues around patient consent, engaging clinicians, provision of timely and appropriate education and training, executive leadership and commitment and adequate resourcing. The challenge in achieving best practice information transfer is not solely in the technology but also in implementing the change process and engaging clinicians. General practitioners valued the intervention highly. Hospital and community providers now have an inexpensive, effective product for critical information exchange in a timely and relevant manner, enhancing the quality and safety of patient care.

Optical in-fiber Bragg grating sensor systems for medical applications

Two in-fiber Bragg grating (FBG) temperature sensor systems for medical applications are demonstrated: (1) an FBG flow-directed thermodilution catheter based on interferometric detection of wavelength shift that is used for cardiac monitoring; and (2) an FBG sensor system with a tunable Fabry-Perot filter for in vivo temperature profiling in nuclear magnetic resonance (NMR) machines. Preliminary results show that the FBG sensor is in good agreement with electrical sensors that are widely used in practice. A field test shows that the FBG sensor system is suitable for in situ temperature profiling in NMR machines for medical applications.

Optical in-fiber Bragg grating sensor systems for medical applications

Two in-fiber Bragg grating (FBG) temperature sensor systems for medical applications are demonstrated: (1) an FBG flow-directed thermodilution catheter based on interferometric detection of wavelength shift that is used for cardiac monitoring; and (2) an FBG sensor system with a tunable Fabry-Perot filter for in vivo temperature profiling in nuclear magnetic resonance (NMR) machines. Preliminary results show that the FBG sensor is in good agreement with electrical sensors that are widely used in practice. A field test shows that the FBG sensor system is suitable for in situ temperature profiling in NMR machines for medical applications.

Multimodal Man-machine Interface and Virtual Reality for Assistive Medical Systems

The results of research the intelligence multimodal man-machine interface and virtual reality means for assistive medical systems including computers and mechatronic systems (robots) are discussed. The gesture translation for disability peoples, the learning-by-showing technology and virtual operating room with 3D visualization are presented in this report and were announced at International exhibition "Intelligent and Adaptive Robots–2005".

Scheduling medical application workloads on virtualized computing systems

This dissertation presents and evaluates a methodology for scheduling medical application workloads in virtualized computing environments. Such environments are being widely adopted by providers of "cloud computing" services. In the context of provisioning resources for medical applications, such environments allow users to deploy applications on distributed computing resources while keeping their data secure. Furthermore, higher level services that further abstract the infrastructure-related issues can be built on top of such infrastructures. For example, a medical imaging service can allow medical professionals to process their data in the cloud, easing them from the burden of having to deploy and manage these resources themselves. In this work, we focus on issues related to scheduling scientific workloads on virtualized environments. We build upon the knowledge base of traditional parallel job scheduling to address the specific case of medical applications while harnessing the benefits afforded by virtualization technology. To this end, we provide the following contributions: (1) An in-depth analysis of the execution characteristics of the target applications when run in virtualized environments. (2) A performance prediction methodology applicable to the target environment. (3) A scheduling algorithm that harnesses application knowledge and virtualization-related benefits to provide strong scheduling performance and quality of service guarantees. In the process of addressing these pertinent issues for our target user base (i.e. medical professionals and researchers), we provide insight that benefits a large community of scientific application users in industry and academia. Our execution time prediction and scheduling methodologies are implemented and evaluated on a real system running popular scientific applications. We find that we are able to predict the execution time of a number of these applications with an average error of 15%. Our scheduling methodology, which is tested with medical image processing workloads, is compared to that of two baseline scheduling solutions and we find that it outperforms them in terms of both the number of jobs processed and resource utilization by 20–30%, without violating any deadlines. We conclude that our solution is a viable approach to supporting the computational needs of medical users, even if the cloud computing paradigm is not widely adopted in its current form.

Airline Deregulation, Computerized Reservation Systems, and Travel Agents

With the beginning of airline deregulations in 1978, U.S. domestic operations were in for a period of turmoil, adjustment, vibrancy, entrepreneurship, and change. A great deal has been written about the effects of deregulation on airlines and their personnel, and on the public at large. Less attention has been paid to the effects on travel agents and on the seminal role of computerized reservations systems (CRSs) in the flowering of travel agencies. This article examines both of these phenomena.

Information Discovery on Electronic Health Records Using Authority Flow Techniques

Background As the use of electronic health records (EHRs) becomes more widespread, so does the need to search and provide effective information discovery within them. Querying by keyword has emerged as one of the most effective paradigms for searching. Most work in this area is based on traditional Information Retrieval (IR) techniques, where each document is compared individually against the query. We compare the effectiveness of two fundamentally different techniques for keyword search of EHRs. Methods We built two ranking systems. The traditional BM25 system exploits the EHRs' content without regard to association among entities within. The Clinical ObjectRank (CO) system exploits the entities' associations in EHRs using an authority-flow algorithm to discover the most relevant entities. BM25 and CO were deployed on an EHR dataset of the cardiovascular division of Miami Children's Hospital. Using sequences of keywords as queries, sensitivity and specificity were measured by two physicians for a set of 11 queries related to congenital cardiac disease. Results Our pilot evaluation showed that CO outperforms BM25 in terms of sensitivity (65% vs. 38%) by 71% on average, while maintaining the specificity (64% vs. 61%). The evaluation was done by two physicians. Conclusions Authority-flow techniques can greatly improve the detection of relevant information in EHRs and hence deserve further study.

Computerized Medical Diagnosis of Melanocytic Lesions based on the ABCD approach

Melanoma is a type of skin cancer and is caused by the uncontrolled growth of atypical melanocytes. In recent decades, computer aided diagnosis is used to support medical professionals; however, there is still no globally accepted tool. In this context, similar to state-of-the-art we propose a system that receives a dermatoscopy image and provides a diagnostic if the lesion is benign or malignant. This tool is composed with next modules: Preprocessing, Segmentation, Feature Extraction, and Classification. Preprocessing involves the removal of hairs. Segmentation is to isolate the lesion. Feature extraction is considering the ABCD dermoscopy rule. The classification is performed by the Support Vector Machine. Experimental evidence indicates that the proposal has 90.63 % accuracy, 95 % sensitivity, and 83.33 % specificity on a data-set of 104 dermatoscopy images. These results are favorable considering the performance of diagnosis by traditional progress in the area of dermatology

Building a Open Source Framework for Virtual Medical Training

This paper presents a framework to build medical training applications by using virtual reality and a tool that helps the class instantiation of this framework. The main purpose is to make easier the building of virtual reality applications in the medical training area, considering systems to simulate biopsy exams and make available deformation, collision detection, and stereoscopy functionalities. The instantiation of the classes allows quick implementation of the tools for such a purpose, thus reducing errors and offering low cost due to the use of open source tools. Using the instantiation tool, the process of building applications is fast and easy. Therefore, computer programmers can obtain an initial application and adapt it to their needs. This tool allows the user to include, delete, and edit parameters in the functionalities chosen as well as storing these parameters for future use. In order to verify the efficiency of the framework, some case studies are presented.

An algorithm for computerized automatic tuning of power system stabilizers

The main objective of this paper is to relieve the power system engineers from the burden of the complex and time-consuming process of power system stabilizer (PSS) tuning. To achieve this goal, the paper proposes an automatic process for computerized tuning of PSSs, which is based on an iterative process that uses a linear matrix inequality (LMI) solver to find the PSS parameters. It is shown in the paper that PSS tuning can be written as a search problem over a non-convex feasible set. The proposed algorithm solves this feasibility problem using an iterative LMI approach and a suitable initial condition, corresponding to a PSS designed for nominal operating conditions only (which is a quite simple task, since the required phase compensation is uniquely defined). Some knowledge about the PSS tuning is also incorporated in the algorithm through the specification of bounds defining the allowable PSS parameters. The application of the proposed algorithm to a benchmark test system and the nonlinear simulation of the resulting closed-loop models demonstrate the efficiency of this algorithm. (C) 2009 Elsevier Ltd. All rights reserved.

Distribution systems fault analysis considering fault resistance estimation

Fault resistance is a critical component of electric power systems operation due to its stochastic nature. If not considered, this parameter may interfere in fault analysis studies. This paper presents an iterative fault analysis algorithm for unbalanced three-phase distribution systems that considers a fault resistance estimate. The proposed algorithm is composed by two sub-routines, namely the fault resistance and the bus impedance. The fault resistance sub-routine, based on local fault records, estimates the fault resistance. The bus impedance sub-routine, based on the previously estimated fault resistance, estimates the system voltages and currents. Numeric simulations on the IEEE 37-bus distribution system demonstrate the algorithm`s robustness and potential for offline applications, providing additional fault information to Distribution Operation Centers and enhancing the system restoration process. (C) 2011 Elsevier Ltd. All rights reserved.

Effectiveness of two systems for the spraying of pesticides in citrus trees

Citriculture normally uses high application volumes in pesticide solutions (of 2.000 to 5.000 L ha(-1)) to control pests and diseases that affect the crop, which generates an increase in operational costs. For this reason, diverse systems of application are being developed to reduce application volumes and improve the uniformity of pesticide deposition. The goal of this work was to evaluate the efficiency of two application systems of pesticides in citrus trees. One system used a prototype for terrestrial application with rotary disc atomizers that are widely used in agricultural aviation, and the other system used hollow cone tip hydraulics. For the treatment of the trees the insecticide Metidation was used at the dose of 180 gr per hectare. To study the droplet spectrum, water-sensitive papers were installed at different positions in the trees canopy, and for the study of insecticide deposition leaves of the treated plants were collected. The water-sensitive papers were collected and analyzed using a computerized image analysis system (e-Sprinkle, EMBRAPA, Sao Paulo, Brazil), and the leaves analyzed by the technique of gas chromatography. Pesticide deposition was similar in both application system, although the solution volume used by the application system equipped with rotary disc atomizers was one quarter of the volume used by the application system equipped with hydraulic tips, reducing considerably the cost of the phytosanitary treatments.