Integrating clinical decision support systems for pharmacogenomic testing into clinical routine - a scoping review of designs of user-system interactions in recent system development

Background: Pharmacogenomic clinical decision support systems (CDSS) have the potential to help overcome some of the barriers for translating pharmacogenomic knowledge into clinical routine. Before developing a prototype it is crucial for developers to know which pharmacogenomic CDSS features and user-system interactions have yet been developed, implemented and tested in previous pharmacogenomic CDSS efforts and if they have been successfully applied. We address this issue by providing an overview of the designs of user-system interactions of recently developed pharmacogenomic CDSS. Methods: We searched PubMed for pharmacogenomic CDSS published between January 1, 2012 and November 15, 2016. Thirty-two out of 118 identified articles were summarized and included in the final analysis. We then compared the designs of user-system interactions of the 20 pharmacogenomic CDSS we had identified. Results: Alerts are the most widespread tools for physician-system interactions, but need to be implemented carefully to prevent alert fatigue and avoid liabilities. Pharmacogenomic test results and override reasons stored in the local EHR might help communicate pharmacogenomic information to other internal care providers. Integrating patients into user-system interactions through patient letters and online portals might be crucial for transferring pharmacogenomic data to external health care providers. Inbox messages inform physicians about new pharmacogenomic test results and enable them to request pharmacogenomic consultations. Search engines enable physicians to compare medical treatment options based on a patient’s genotype. Conclusions: Within the last 5 years, several pharmacogenomic CDSS have been developed. However, most of the included articles are solely describing prototypes of pharmacogenomic CDSS rather than evaluating them. To support the development of prototypes further evaluation efforts will be necessary. In the future, pharmacogenomic CDSS will likely include prediction models to identify patients who are suitable for preemptive genotyping

Application and evaluation of interactive 3D PDF for presenting and sharing planning results for liver surgery in clinical routine

Background & Objectives The Portable Document Format (PDF) is the de-facto standard for the exchange of electronic documents. It is platform-independent, suitable for the exchange of medical data, and allows for the embedding of three-dimensional (3D) surface mesh models. In this article, we present the first clinical routine application of interactive 3D surface mesh models which have been integrated into PDF files for the presentation and the exchange of Computer Assisted Surgery Planning (CASP) results in liver surgery. We aimed to prove the feasibility of applying 3D PDF in medical reporting and investigated the user experience with this new technology. Methods We developed an interactive 3D PDF report document format and implemented a software tool to create these reports automatically. After more than 1000 liver CASP cases that have been reported in clinical routine using our 3D PDF report, an international user survey was carried out online to evaluate the user experience. Results Our solution enables the user to interactively explore the anatomical configuration and to have different analyses and various resection proposals displayed within a 3D PDF document covering only a single page that acts more like a software application than like a typical PDF file (“PDF App”). The new 3D PDF report offers many advantages over the previous solutions. According to the results of the online survey, the users have assessed the pragmatic quality (functionality, usability, perspicuity, efficiency) as well as the hedonic quality (attractiveness, novelty) very positively. Conclusion The usage of 3D PDF for reporting and sharing CASP results is feasible and well accepted by the target audience. Using interactive PDF with embedded 3D models is an enabler for presenting and exchanging complex medical information in an easy and platform-independent way. Medical staff as well as patients can benefit from the possibilities provided by 3D PDF. Our results open the door for a wider use of this new technology, since the basic idea can and should be applied for many medical disciplines and use cases

Unter die Haube geschaut. Bildverarbeitung mit MeVisLab. Tl.2

Im ersten Teil des Workshops zur digitalen Bildverarbeitung zählten selbst gebaute Spezialanwendungen die Bohrungen von Platinen und Euromünzen auf Fotos - diesmal erzeugt das kostenlos nutzbare MeVisLab-Paket druckfähige 3D-Modelle aus Computertomografien und versteckt komplexe Programme hinter grafischen Bedienoberflächen

Future Proofing IoT Embedded Platforms for Cryptographic Primitives Support

Information security is an important property in areas with distributed and decentralized communication like the Internet of Things (IoT) or Wireless Sensor Nodes (WSNs). Secure communication realises the protection goals of confidentiality, integrity, and authenticity, which are implemented by cryptographic functions. These functions need to evolve steadily in order to catch up with new attack vectors employed by cyber-criminals. This cryptographic evolution brings an increase of resource demand and consumption with it as cryptographic functions rise in complexity. The demand is difficult to satisfy by embedded platforms since they are often limited in their resources due to design efficiency. Therefore, adequate resource buffering is a crucial task in designing embedded systems that are future proof from a security point of view. In this work, we introduce a methodology for comparable resource benchmarking of cryptographic functions on embedded systems. Our approach enables designers and developers of embedded systems to achieve comparable results over an extended range of algorithms and implementations. This aids in the estimation of the cryptographic resource footprint. Further, we develop a measurement architecture for experimentation on different embedded platforms. We conduct a sample of reference measurements confirming well-known patterns in cryptography showing the validity of our framework. Finally, we argue for an open collaboration platform for sharing of benchmark results conducted with the framework

Application of prototype flume tests for beach nourishment assessment

The development of underwater profiles and sand losses from the dune respectively the beach by various water level and wave conditions has been studied worldwide in large wave flumes since 1955. Virtually all major results collected over the last decades are documented and described in this paper. Moreover, to this overview results from the MAST III-SAFE experiments, carried out in the Grosser Wellenkanal (GWK) in Hannover, are summarized and discussed in more detail. The tests were focused on beach and dune stability under given conditions with normal and raised water levels. The results are concentrated on surf zone profiles, beach slope and erosion. Furthermore, dune erosion with and without barriers, built into the dune face, and perched surf zone by means of an underwater sill were investigated

Bloom filter–based efficient broadcast algorithm for the Internet of things

In the Internet of things, a large number of objects can be embedded over a region of interest where almost every device is connected to the Internet. This work scrutinizes the broadcast overhead problem in an Internet of things network, containing a very large number of objects. The work proposes a probabilistic structure (bloom filter)-based technique, which uses a new broadcast structure that attempts to reduce the number of duplicate copies of a packet at every node. This article utilizes a clustering concept to make the broadcast efficient in terms of memory space, broadcast overhead, and energy usage. The unique idea of a bloom-based network uses a filter to incorporate neighbor information when taking a forwarding decision to reduce broadcast overhead. The simulation results show that parallel broadcasting among different clusters and the use of a bloom filter can achieve a reduction in broadcast overhead from hundreds to ones and tens, when compared with a conventional non-bloom-based broadcast algorithm and a bloom-based algorithm. In addition, it helps to reduce energy usage evenly throughout the network, 1/100 times, when compared with conventional broadcast (non-bloom-based) and, 1/10 times, when compared with bloom-based broadcast. This increases the lifetime of a network by having control over network density usage and communications overhead as a result of broadcasting

Systemic mesalazine treatment prevents spontaneous skin fibrosis in PLK2-deficient mice

Skin fibrosis is a complex biological remodeling process occurring in disease like systemic sclerosis, morphea, or eosinophilic fasciitis. Since the knowledge about the underlying pathomechanisms is still incomplete, there is currently no therapy, which prevents or reverses skin fibrosis sufficiently. The present study investigates the role of polo-like kinase 2 (PLK2) and the pro-fibrotic cytokine osteopontin (OPN) in the pathogenesis of cutaneous fibrosis and demonstrates the antifibrotic effects of systemic mesalazine treatment in vivo. Isolated primary dermal fibroblasts of PLK2 wild-type (WT) and knockout (KO) mice were characterized in vitro. Skin thickness and histoarchitecture were studied in paraffin-embedded skin sections. The effects of mesalazine treatment were examined in isolated fibroblasts and PLK2 KO mice, which were fed 100 µg/g mesalazine for 6 months via the drinking water. Compared to WT, PLK2 KO fibroblasts displayed higher spontaneous myofibroblast differentiation, reduced proliferation rates, and overexpression of the fibrotic cytokine OPN. In vitro, 72 h of treatment with 10 mmol/L mesalazine induced phenotype conversion in PLK2 KO fibroblasts and attenuated OPN expression by inhibiting ERK1/2. In vivo, dermal myofibroblast differentiation, collagen accumulation, and skin thickening were prevented by mesalazine in PLK2 KO. Plasma creatinine levels indicated good tolerability of systemic long-term mesalazine treatment. The current study reveals a spontaneous fibrotic skin phenotype and ERK1/2-dependent OPN overexpression in PLK2 KO mice. We provide experimental evidence for the antifibrotic effectiveness of systemic mesalazine treatment to prevent fibrosis of the skin, suggesting further investigation in experimental and clinical settings