CPOE in Iran-A viable prospect?. Physicians' opinions on using CPOE in an Iranian teaching hospital

Background: In recent years, the theory that on-line clinical decision support systems can improve patients' safety among hospitalised individuals has gained greater acceptance. However, the feasibility of implementing such a system in a middle or low-income country has rarely been studied. Understanding the current prescription process and a proper needs assessment of prescribers can act as the key to successful implementation. Objectives: The aim of this study was to explore physicians' opinions on the current prescription process, and the expected benefits and perceived obstacles to employ Computerised Physician Order Entry in an Iranian teaching hospital. Methods: Initially, the interview guideline was developed through focus group discussions with eight experts. Then semi-structured interviews were held with 19 prescribers. After verbatim transcription, inductive thematic analysis was performed on empirical data. Forty hours of on-looker observations were performed in different wards to explore the current prescription process. Results: The current prescription process was identified as a physician-centred, top-down, model, where prescribers were found to mostly rely on their memories as well as being overconfident. Some errors may occur during different paper-based registrations, transcriptions and transfers. Physician opinions on Computerised Physician Order Entry were categorised into expected benefits and perceived obstacles. Confidentiality issues, reduction of medication errors and educational benefits were identified as three themes in the expected benefits category. High cost, social and cultural barriers, data entry time and problems with technical support emerged as four themes in the perceived obstacles category. Conclusions: The current prescription process has a high possibility of medication errors. Although there are different barriers confronting the implementation and continuation of Computerised Physician Order Entry in Iranian hospitals, physicians have a willingness to use them if these systems provide significant benefits. A pilot study in a limited setting and a comprehensive analysis of health outcomes and economic indicators should be performed, to assess the merits of introducing Computerised Physician Order Entry with decision support capabilities in Iran. © 2008 Elsevier Ireland Ltd. All rights reserved

Signature of Arctic first-year ice melt pond fraction in X-band SAR imagery

In this paper we investigate the potential of melt pond fraction retrieval from X-band polarimetric synthetic aperture radar (SAR) on drifting first-year sea ice. Melt pond fractions retrieved from a helicopter-borne camera system were compared to polarimetric features extracted from four dual-polarimetric X-band SAR scenes, revealing significant relationships. The correlations were strongly dependent on wind speed and SAR incidence angle. Co-polarisation ratio was found to be the most promising SAR feature for melt pond fraction estimation at intermediate wind speeds (6. 2 m s−1), with a Spearman's correlation coefficient of 0. 46. At low wind speeds (0. 6 m s−1), this relation disappeared due to low backscatter from the melt ponds, and backscatter VV-polarisation intensity had the strongest relationship to melt pond fraction with a correlation coefficient of −0. 53. To further investigate these relations, regression fits were made both for the intermediate (R2fit = 0. 21) and low (R2fit = 0. 26) wind case, and the fits were tested on the satellite scenes in the study. The regression fits gave good estimates of mean melt pond fraction for the full satellite scenes, with less than 4 % from a similar statistics derived from analysis of low-altitude imagery captured during helicopter ice-survey flights in the study area. A smoothing window of 51 × 51 pixels gave the best reproduction of the width of the melt pond fraction distribution. A considerable part of the backscatter signal was below the noise floor at SAR incidence angles above  ∼  40°, restricting the information gain from polarimetric features above this threshold. Compared to previous studies in C-band, limitations concerning wind speed and noise floor set stricter constraints on melt pond fraction retrieval in X-band. Despite this, our findings suggest new possibilities in melt pond fraction estimation from X-band SAR, opening for expanded monitoring of melt ponds during melt season in the future

ABCD Neurocognitive Prediction Challenge 2019: Predicting individual fluid intelligence scores from structural MRI using probabilistic segmentation and kernel ridge regression

We applied several regression and deep learning methods to predict fluid intelligence scores from T1-weighted MRI scans as part of the ABCD Neurocognitive Prediction Challenge (ABCD-NP-Challenge) 2019. We used voxel intensities and probabilistic tissue-type labels derived from these as features to train the models. The best predictive performance (lowest mean-squared error) came from Kernel Ridge Regression (KRR; $\lambda=10$), which produced a mean-squared error of 69.7204 on the validation set and 92.1298 on the test set. This placed our group in the fifth position on the validation leader board and first place on the final (test) leader board.Comment: Winning entry in the ABCD Neurocognitive Prediction Challenge at MICCAI 2019. 7 pages plus references, 3 figures, 1 tabl

Patients' satisfaction with information at discharge

Background: Adequate patient knowledge and engagement with their condition and its management can reduce re-hospitalisations and improve outcomes after acute admission for circulatory system disease. Aim: To evaluate the perceptions of cardio- or cerebrovascular patients of their satisfaction with discharge processes and to determine if this differs by demographic groups. Methods: A sample of 536 eligible public hospital inpatients was extracted from a consumer experience surveillance system. Questions relating to the discharge process were analysed using descriptive statistics to compare patient satisfaction levels against demographic variables. Results: Dissatisfaction rates were highest within the ‘Written information provided’ (37.8%) and ‘Danger signals communicated’ (34.7%) categories. Women and people aged ≥80 were more likely to express dissatisfaction. Conclusion: Although respondents were largely satisfied, there are important differences in the characteristics of those that were dissatisfied. The communication of important discharge information to older people and women was less likely to meet their perceived needs

CRIRES-POP: A library of high resolution spectra in the near-infrared

New instrumental capabilities and the wealth of astrophysical information extractable from the near-infrared wavelength region have led to a growing interest in the field of high resolution spectroscopy at 1-5 mu. We aim to provide a library of observed high-resolution and high signal-to-noise-ratio near-infrared spectra of stars of various types throughout the Hertzsprung-Russell diagram. This is needed for the exploration of spectral features in this wavelength range and for comparison of reference targets with observations and models. High quality spectra were obtained using the CRIRES near-infrared spectrograph at ESO's VLT covering the range from 0.97 to 5.3 mu at high spectral resolution. Accurate wavelength calibration and correction for of telluric lines were performed by fitting synthetic transmission spectra for the Earth's atmosphere to each spectrum individually. We describe the observational strategy and the current status and content of the library which includes 13 objects. The first examples of finally reduced spectra are presented. This publication will serve as a reference paper to introduce the library to the community and explore the extensive amount of material.Comment: accepted for publication in A&A; see also the project webpage http://www.univie.ac.at/crirespo

A novel procedure for genotyping of single nucleotide polymorphisms in trisomy with genomic DNA and the invader assay

Individuals with trisomy 21 display complex phenotypes with differing degrees of severity. Numerous reliable methods have been established to diagnose the initial trisomy in these patients, but the identification and characterization of the genetic basis of the phenotypic variation in individuals with trisomy remains challenging. To date, methods that can accurately determine genotypes in trisomic DNA samples are expensive, require specialized equipment and complicated analyses. Here we report proof-of-concept results for an Invader® assay-based genotyping procedure that can determine SNP genotypes in trisomic genomic DNA samples in a simple and cost-effective manner. The procedure requires only two experimental steps: a real-time measurement of the fluorescent Invader® signal and analysis with a specifically designed clustering algorithm. The approach was tested using genomic DNA samples from 23 individuals with trisomy 21, and results were compared to genotypes previously determined with pyrosequencing. Additional assays for 15 SNPs were tested in a set of 21 DNA samples to assess assay performance. Our method successfully identified the correct SNP genotypes for the trisomic genomic DNA samples tested, and thus provides an alternative to determine SNP genotypes in trisomic DNA samples for subsequent association studies in patients with Down syndrome and other trisomies

Urban biodiversity : State of the science and future directions

Since the 1990s, recognition of urban biodiversity research has increased steadily. Knowledge of how ecological communities respond to urban pressures can assist in addressing global questions related to biodiversity. To assess the state of this research field in meeting this aim, we conducted a systematic review of the urban biodiversity literature published since 1990. We obtained data from 1209 studies that sampled ecological communities representing 12 taxonomic groups. While advances have been made in the field over the last 30 years, we found that urban biodiversity research has primarily been conducted in single cities within the Palearctic and Nearctic realms, within forest remnants and residential locations, and predominantly surveys plants and birds, with significant gaps in research within the Global South and little integration of multi-species and multi-trophic interactions. Sample sizes remain limited in spatial and temporal scope, but citizen science and remote sensing resources have broadened these efforts. Analytical approaches still rely on taxonomic diversity to describe urban plant and animal communities, with increasing numbers of integrated phylogenetic and trait-based analyses. Despite the implementation of nature-based solutions across the world's cities, only 5% of studies link biodiversity to ecosystem function and services, pointing to substantial gaps in our understanding of such solutions. We advocate for future research that encompasses a greater diversity of taxonomic groups and urban systems, focusing on biodiversity hotspots. Implementing such research would enable researchers to move forward in an equitable and multidisciplinary way to tackle the complex issues facing global urban biodiversity.Peer reviewe

What they fill in today, may not be useful tomorrow: Lessons learned from studying Medical Records at the Women hospital in Tabriz, Iran

<p>Abstract</p> <p>Background</p> <p>The medical record is used to document patient's medical history, illnesses and treatment procedures. The information inside is useful when all needed information is documented properly. Medical care providers in Iran have complained of low quality of Medical Records. This study was designed to evaluate the quality of the Medical Records at the university hospital in Tabriz, Iran.</p> <p>Methods</p> <p>In order to get a background of the quality of documentation, 300 Medical Records were randomly selected among all hospitalized patient during September 23, 2003 and September 22, 2004. Documentation of all records was evaluated using checklists. Then, in order to combine objective data with subjective, 10 physicians and 10 nurses who were involved in documentation of Medical Records were randomly selected and interviewed using two semi structured guidelines.</p> <p>Results</p> <p>Almost all 300 Medical Records had problems in terms of quality of documentation. There was no record in which all information was documented correctly and compatible with the official format in Medical Records provided by Ministry of Health and Medical Education. Interviewees believed that poor handwriting, missing of sheets and imperfect documentation are major problems of the Paper-based Medical Records, and the main reason was believed to be high workload of both physicians and nurses.</p> <p>Conclusion</p> <p>The Medical Records are expected to be complete and accurate. Our study has unveiled that the Medical Records are not documented properly in the university hospital where the Medical Records are also used for educational purposes. Such incomplete Medical Records are not reliable resources for medical care too. Some influencing factors external to the structure of the Medical Records (i.e. human factors and work conditions) are involved.</p