Development and Deployment of the OpenMRS-Ebola Electronic Health Record System for an Ebola Treatment Center in Sierra Leone.

BACKGROUND: Stringent infection control requirements at Ebola treatment centers (ETCs), which are specialized facilities for isolating and treating Ebola patients, create substantial challenges for recording and reviewing patient information. During the 2014-2016 West African Ebola epidemic, paper-based data collection systems at ETCs compromised the quality, quantity, and confidentiality of patient data. Electronic health record (EHR) systems have the potential to address such problems, with benefits for patient care, surveillance, and research. However, no suitable software was available for deployment when large-scale ETCs opened as the epidemic escalated in 2014. OBJECTIVE: We present our work on rapidly developing and deploying OpenMRS-Ebola, an EHR system for the Kerry Town ETC in Sierra Leone. We describe our experience, lessons learned, and recommendations for future health emergencies. METHODS: We used the OpenMRS platform and Agile software development approaches to build OpenMRS-Ebola. Key features of our work included daily communications between the development team and ground-based operations team, iterative processes, and phased development and implementation. We made design decisions based on the restrictions of the ETC environment and regular user feedback. To evaluate the system, we conducted predeployment user questionnaires and compared the EHR records with duplicate paper records. RESULTS: We successfully built OpenMRS-Ebola, a modular stand-alone EHR system with a tablet-based application for infectious patient wards and a desktop-based application for noninfectious areas. OpenMRS-Ebola supports patient tracking (registration, bed allocation, and discharge); recording of vital signs and symptoms; medication and intravenous fluid ordering and monitoring; laboratory results; clinician notes; and data export. It displays relevant patient information to clinicians in infectious and noninfectious zones. We implemented phase 1 (patient tracking; drug ordering and monitoring) after 2.5 months of full-time development. OpenMRS-Ebola was used for 112 patient registrations, 569 prescription orders, and 971 medication administration recordings. We were unable to fully implement phases 2 and 3 as the ETC closed because of a decrease in new Ebola cases. The phase 1 evaluation suggested that OpenMRS-Ebola worked well in the context of the rollout, and the user feedback was positive. CONCLUSIONS: To our knowledge, OpenMRS-Ebola is the most comprehensive adaptable clinical EHR built for a low-resource setting health emergency. It is designed to address the main challenges of data collection in highly infectious environments that require robust infection prevention and control measures and it is interoperable with other electronic health systems. Although we built and deployed OpenMRS-Ebola more rapidly than typical software, our work highlights the challenges of having to develop an appropriate system during an emergency rather than being able to rapidly adapt an existing one. Lessons learned from this and previous emergencies should be used to ensure that a set of well-designed, easy-to-use, pretested health software is ready for quick deployment in future

Security Challenges from Abuse of Cloud Service Threat

Cloud computing is an ever-growing technology that leverages dynamic and versatile provision of computational resources and services. In spite of countless benefits that cloud service has to offer, there is always a security concern for new threats and risks. The paper provides a useful introduction to the rising security issues of Abuse of cloud service threat, which has no standard security measures to mitigate its risks and vulnerabilities. The threat can result an unbearable system gridlock and can make cloud services unavailable or even complete shutdown. The study has identified the potential challenges, as BotNet, BotCloud, Shared Technology Vulnerability and Malicious Insiders, from Abuse of cloud service threat. It has further described the attacking methods, impacts and the reasons due to the identified challenges. The study has evaluated the current available solutions and proposed mitigating security controls for the security risks and challenges from Abuse of cloud services threat

On component-oriented access control in lightweight virtualized server environments

2017 Fall.Includes bibliographical references.With the advancements in contemporary multi-core CPU architectures and increase in main memory capacity, it is now possible for a server operating system (OS), such as Linux, to handle a large number of concurrent services on a single server instance. Individual components of such services may run in different isolated runtime environments, such as chrooted jails or related forms of OS-level containers, and may need restricted access to system resources and the ability to share data and coordinate with each other in a regulated and secure manner. In this dissertation we describe our work on the access control framework for policy formulation, management, and enforcement that allows access to OS resources and also permits controlled data sharing and coordination for service components running in disjoint containerized environments within a single Linux OS server instance. The framework consists of two models and the policy formulation is based on the concept of policy classes for ease of administration and enforcement. The policy classes are managed and enforced through a Lightweight Policy Machine for Linux (LPM) that acts as the centralized reference monitor and provides a uniform interface for regulating access to system resources and requesting data and control objects. We present the details of our framework and also discuss the preliminary implementation and evaluation to demonstrate the feasibility of our approach

OSCAR: A Collaborative Bandwidth Aggregation System

The exponential increase in mobile data demand, coupled with growing user expectation to be connected in all places at all times, have introduced novel challenges for researchers to address. Fortunately, the wide spread deployment of various network technologies and the increased adoption of multi-interface enabled devices have enabled researchers to develop solutions for those challenges. Such solutions aim to exploit available interfaces on such devices in both solitary and collaborative forms. These solutions, however, have faced a steep deployment barrier. In this paper, we present OSCAR, a multi-objective, incentive-based, collaborative, and deployable bandwidth aggregation system. We present the OSCAR architecture that does not introduce any intermediate hardware nor require changes to current applications or legacy servers. The OSCAR architecture is designed to automatically estimate the system's context, dynamically schedule various connections and/or packets to different interfaces, be backwards compatible with the current Internet architecture, and provide the user with incentives for collaboration. We also formulate the OSCAR scheduler as a multi-objective, multi-modal scheduler that maximizes system throughput while minimizing energy consumption or financial cost. We evaluate OSCAR via implementation on Linux, as well as via simulation, and compare our results to the current optimal achievable throughput, cost, and energy consumption. Our evaluation shows that, in the throughput maximization mode, we provide up to 150% enhancement in throughput compared to current operating systems, without any changes to legacy servers. Moreover, this performance gain further increases with the availability of connection resume-supporting, or OSCAR-enabled servers, reaching the maximum achievable upper-bound throughput

Proceedings of the NSSDC Conference on Mass Storage Systems and Technologies for Space and Earth Science Applications

The proceedings of the National Space Science Data Center Conference on Mass Storage Systems and Technologies for Space and Earth Science Applications held July 23 through 25, 1991 at the NASA/Goddard Space Flight Center are presented. The program includes a keynote address, invited technical papers, and selected technical presentations to provide a broad forum for the discussion of a number of important issues in the field of mass storage systems. Topics include magnetic disk and tape technologies, optical disk and tape, software storage and file management systems, and experiences with the use of a large, distributed storage system. The technical presentations describe integrated mass storage systems that are expected to be available commercially. Also included is a series of presentations from Federal Government organizations and research institutions covering their mass storage requirements for the 1990's

CHORUS Deliverable 2.1: State of the Art on Multimedia Search Engines

Based on the information provided by European projects and national initiatives related to multimedia search as well as domains experts that participated in the CHORUS Think-thanks and workshops, this document reports on the state of the art related to multimedia content search from, a technical, and socio-economic perspective. The technical perspective includes an up to date view on content based indexing and retrieval technologies, multimedia search in the context of mobile devices and peer-to-peer networks, and an overview of current evaluation and benchmark inititiatives to measure the performance of multimedia search engines. From a socio-economic perspective we inventorize the impact and legal consequences of these technical advances and point out future directions of research

A new generation of real-time systems in the JET tokamak

Recently a new recipe for developing and deploying real-time systems has become increasingly adopted in the JET tokamak. Powered by the advent of x86 multi-core technology and the reliability of the JET’s well established Real-Time Data Network (RTDN) to handle all real-time I/O, an official Linux vanilla kernel has been demonstrated to be able to provide realtime performance to user-space applications that are required to meet stringent timing constraints. In particular, a careful rearrangement of the Interrupt ReQuests’ (IRQs) affinities together with the kernel’s CPU isolation mechanism allows to obtain either soft or hard real-time behavior depending on the synchronization mechanism adopted. Finally, the Multithreaded Application Real-Time executor (MARTe) framework is used for building applications particularly optimised for exploring multicore architectures. In the past year, four new systems based on this philosophy have been installed and are now part of the JET’s routine operation. The focus of the present work is on the configuration and interconnection of the ingredients that enable these new systems’ real-time capability and on the impact that JET’s distributed real-time architecture has on system engineering requirements, such as algorithm testing and plant commissioning. Details are given about the common real-time configuration and development path of these systems, followed by a brief description of each system together with results regarding their real-time performance. A cycle time jitter analysis of a user-space MARTe based application synchronising over a network is also presented. The goal is to compare its deterministic performance while running on a vanilla and on a Messaging Real time Grid (MRG) Linux kernel