Comparison of Open-Source Electronic Health Record Systems Based on Functional and User Performance Criteria

Objectives: Open-source Electronic Health Record (EHR) systems have gained importance. The main aim of our research is to guide organizational choice by comparing the features, functionality, and user-facing system performance of the five most popular open-source EHR systems. Methods: We performed qualitative content analysis with a directed approach on recently published literature (2012-2017) to develop an integrated set of criteria to compare the EHR systems. The functional criteria are an integration of the literature, meaningful use criteria, and the Institute of Medicine's functional requirements of EHR, whereas the user-facing system performance is based on the time required to perform basic tasks within the EHR system. Results: Based on the Alexa web ranking and Google Trends, the five most popular EHR systems at the time of our study were OSHERA VistA, GNU Health, the Open Medical Record System (OpenMRS), Open Electronic Medical Record (OpenEMR), and OpenEHR. We also found the trends in popularity of the EHR systems and the locations where they were more popular than others. OpenEMR met all the 32 functional criteria, OSHERA VistA met 28, OpenMRS met 12 fully and 11 partially, OpenEHR-based EHR met 10 fully and 3 partially, and GNU Health met the least with only 10 criteria fully and 2 partially. Conclusions: Based on our functional criteria, OpenEMR is the most promising EHR system, closely followed by VistA. With regards to user-facing system performance, OpenMRS has superior performance in comparison to OpenEMR

VisIVOWeb: A WWW Environment for Large-Scale Astrophysical Visualization

This article presents a newly developed Web portal called VisIVOWeb that aims to provide the astrophysical community with powerful visualization tools for large-scale data sets in the context of Web 2.0. VisIVOWeb can effectively handle modern numerical simulations and real-world observations. Our open-source software is based on established visualization toolkits offering high-quality rendering algorithms. The underlying data management is discussed with the supported visualization interfaces and movie-making functionality. We introduce VisIVOWeb Network, a robust network of customized Web portals for visual discovery, and VisIVOWeb Connect, a lightweight and efficient solution for seamlessly connecting to existing astrophysical archives. A significant effort has been devoted for ensuring interoperability with existing tools by adhering to IVOA standards. We conclude with a summary of our work and a discussion on future developments

Gold aggregating gold: A novel nanoparticle biosensor approach for the direct quantification of hepatitis C virus RNA in clinical samples

The affordable and reliable detection of Hepatitis C Virus (HCV) RNA is a cornerstone in the management and control of infection, affecting approximately 3% of the global population. However, the existing technologies are expensive, labor intensive and time consuming, posing significant limitations to their wide-scale exploitation, particularly in economically deprived populations. Here, we utilized the unique optical and physicochemical properties of gold nanoparticles (AuNPs) to develop a novel assay platform shown to be rapid and robust in sensing and quantifying unamplified HCV RNA in clinical samples. The assay is based on inducing aggregation of citrate AuNPs decorated with a specific nucleic acid probe. Two types of cationic AuNPs, cysteamine and CTAB capped, were compared to achieve maximum assay performance. The technology is simple, rapid, cost effective and quantitative with 93.3% sensitivity, high specificity and detection limit of 4.57 IU/µl. Finally, our data suggest that RNA folding impact the aggregation behavior of the functionalized AuNPs, with broader applications in other nucleic acid detection technologies

A Systematic Search for High Surface Brightness Giant Arcs in a Sloan Digital Sky Survey Cluster Sample

We present the results of a search for gravitationally-lensed giant arcs conducted on a sample of 825 SDSS galaxy clusters. Both a visual inspection of the images and an automated search were performed and no arcs were found. This result is used to set an upper limit on the arc probability per cluster. We present selection functions for our survey, in the form of arc detection efficiency curves plotted as functions of arc parameters, both for the visual inspection and the automated search. The selection function is such that we are sensitive only to long, high surface brightness arcs with g-band surface brightness mu_g 10. Our upper limits on the arc probability are compatible with previous arc searches. Lastly, we report on a serendipitous discovery of a giant arc in the SDSS data, known inside the SDSS Collaboration as Hall's arc.Comment: 34 pages,8 Fig. Accepted ApJ:Jan-200

Low expression and promoter hypermethylation of the tumour suppressor SLIT2, are associated with adverse patient outcomes in diffuse large B cell lymphoma

SLIT2 has been classified as a major tumour suppressor gene due to its frequent inactivation in different cancer types. However, alterations of SLIT2 expression and relation to patient outcomes in diffuse large B cell lymphoma (DLBCL) remain undefined. The aim of this study was to investigate the expression and the methylation status of SLIT2 gene as well as its relation to patient outcomes in DLBCL. Immunohistochemical (IHC) staining was carried out to detect the expression of SLIT2 in a series of 108 DLBCL cases. Re-analysis of previously published dataset (GSE10846) that measured gene expression in DLBCL patients who had received CHOP or R-CHOP therapy was performed to identify associations between SLIT2 and patients survival. Laser capture microdissection was performed to isolate GC B cells and DLBCL primary tumor cells. Bisulfite treatment and methylation-specific PCR (MSP) analysis were done to assess SLIT2 promotor methylation status. We report that the expression of SLIT2 protein was reduced in a subset of DLBCL cases and this was significantly correlated with advanced clinical stage (p = 0.041) and was an independent predictor of worse overall survival (OS) (p = 0.012). Re-analysis of published gene expression data showed that reduced SLIT2 mRNA expression was significantly correlated with worse OS in R-CHOP-treated ABC DLBCL patients (p = <0.01). Hypermethylation of the SLIT2 promotor was significantly correlated with low SLIT2 expression (p = 0.009). Our results provide a novel evidence of reduced expression of SLIT2 that is associated with promoter hypermethylation and adverse outcomes in patients with DLBCL

Resolving Fine-Scale Heterogeneity of Co-seismic Slip and the Relation to Fault Structure

Fault slip distributions provide important insight into the earthquake process. We analyze high-resolution along-strike co-seismic slip profiles of the 1992 M_w = 7.3 Landers and 1999 M_w = 7.1 Hector Mine earthquakes, finding a spatial correlation between fluctuations of the slip distribution and geometrical fault structure. Using a spectral analysis, we demonstrate that the observed variation of co-seismic slip is neither random nor artificial, but self-affine fractal and rougher for Landers. We show that the wavelength and amplitude of slip variability correlates to the spatial distribution of fault geometrical complexity, explaining why Hector Mine has a smoother slip distribution as it occurred on a geometrically simpler fault system. We propose as a physical explanation that fault complexity induces a heterogeneous stress state that in turn controls co-seismic slip. Our observations detail the fundamental relationship between fault structure and earthquake rupture behavior, allowing for modeling of realistic slip profiles for use in seismic hazard assessment and paleoseismology studies

Histotripsy Effects on the Bladder Trigone: Functional and Histologic Consequences in the Canine Model

Background: Histotripsy is an extracorporeal therapeutic ultrasound (US) technology, where high-amplitude acoustic energy is applied to targeted tissue. Previous research has demonstrated the feasibility, safety, and effectiveness of histotripsy tissue homogenization and debulking of the prostate in the canine model. Before translating this technology for human use, it is prudent to examine the susceptibility of critical periprostatic structures to cavitation injury in the event of histotripsy mistargeting. In this study, we sought to characterize the tissue effects and biologic response of directly treating the bladder trigone with histotripsy. Materials and Methods: In eight anesthetized canines, 750,000 histotripsy pulses were applied uniformly across a 2?1.5-cm area encompassing the bladder trigone and ureteral orifices. Prostate and bladder trigone were harvested immediately after treatment (2 subjects) or at 14 days (6 subjects). Flexible cystourethroscopy, US imaging, and creatinine levels were obtained at intervals until harvest, 14 days after treatment. In one control subject, harvested at 2 days, the same treatment algorithm was applied to the prostate. Results: Transrectal US imaging revealed a cavitation bubble cloud on the surface of the bladder trigone and progressive development of tissue edema during treatment. Flexible cystourethroscopy immediately after treatment confirmed edema and erythema of the trigone. In the six subjects survived 2 weeks after treatment, one incidence of transient, self-limited ureteral obstruction was noted based on hydronephrosis and creatinine levels. At harvest, ureteral orifices were confirmed patent by passage of a guide wire. Histologic evaluation revealed hemorrhage acutely with mild localized fibrosis at 14 days. Conclusions: In this study, designed along the lines of a worst-case, destructive testing scenario, direct targeting of the bladder trigone with supratherapeutic histotripsy failed to induce significant tissue damage or clinical complication. These results are reassuring and will guide treatment strategy in upcoming human clinical trials of histotripsy treatment for benign prostatic hyperplasia.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140374/1/end.2013.0234.pd

Freeze-Dried Ham Promotes Azoxymethane-Induced Mucin-Depleted Foci and Aberrant Crypt Foci in Rat Colon

Processed and red meat consumption is associated with the risk of colorectal cancer. Meta-analyses have suggested that the risk associated with processed meat is higher. Most processed meats are cured and cooked, which leads to formation of free nitrosyl heme. We speculated that free nitrosyl heme is more toxic than native myoglobin. The promoting effect of a freeze-dried, cooked, cured ham diet was looked for in a 100-day study. Colon carcinogenesis endpoints were aberrant crypt foci and mucin depleted foci (MDF). A second study (14 days) was designed 1) to compare the effect of ham, hemoglobin, and hemin; and 2) to test the effect of sodium chloride, nitrite, and phosphate in diet on early biomarkers associated with heme-induced promotion. In the 100-day study, control and ham-fed rats had 3.5 and 8.5 MDF/colon, respectively (P < 0.0001). Promotion was associated with cytotoxicity and lipid peroxidation. In the short-term study, cytotoxicity and lipid peroxidation of fecal water, and the urinary marker of lipid peroxidation, increased dramatically in ham- and hemin-fed rat. In contrast, the hemoglobin diet, sodium chloride, nitrite, phosphate diet had no effect. Freeze-dried cooked ham can promote colon carcinogenesis in a rodent model. Hemin, but not hemoglobin, mimicked ham effect on early biochemical markers associated with carcinogenesis

Measurement of a reaction-diffusion crossover in exciton-exciton recombination inside carbon nanotubes using femtosecond optical absorption

Exciton-exciton recombination in isolated semiconducting single-walled carbon nanotubes was studied using femtosecond transient absorption. Under sufficient excitation to saturate the optical absorption, we observed an abrupt transition between reaction- and diffusion- limited kinetics, arising from reactions between incoherent localized excitons with a finite probability of ~ 0.2 per encounter. This represents the first experimental observation of a crossover between classical and critical kinetics in a 1D coalescing random walk, which is a paradigm for the study of non- equilibrium systems.Comment: Accepted for Physical Review Letters. Title changed, and "exciton fusion" replaced by "exciton-exciton recombination". Present address of Prof Tom Brown added. 12 pages plus 3 figure

A Magellan-IMACS-IFU Search for Dynamical Drivers of Nuclear Activity. I. Reduction Pipeline and Galaxy Catalog

Using the Inamori Magellan Areal Camera and Spectrograph (IMACS) integral-field unit (IFU) on the 6.5m Magellan telescope, we have designed the first statistically significant investigation of the two-dimensional distribution and kinematics of ionized gas and stars in the central kiloparsec regions of a well-matched sample of Seyfert and inactive control galaxies selected from the Sloan Digital Sky Survey. The goals of the project are to use the fine spatial sampling (0.2 arcsec/pixel) and large wavelength coverage (4000-7000A) of the IMACS-IFU to search for dynamical triggers of nuclear activity in the central region where active galactic nucleus (AGN) activity and dynamical timescales become comparable, to identify and assess the impact of AGN-driven outflows on the host galaxy and to provide a definitive sample of local galaxy kinematics for comparison with future three-dimensional kinematic studies of high-redshift systems. In this paper, we provide the first detailed description of the procedure to reduce and calibrate data from the IMACS-IFU in `long mode' to obtain two-dimensional maps of the distribution and kinematics of ionized gas and stars. The sample selection criteria are presented, observing strategy described and resulting maps of the sample galaxies presented along with a description of the observed properties of each galaxy and the overall observed properties of the sample.Comment: 62 pages. 41 figures. 5 tables. Accepted for publication in ApJS. High-resolution version available at: http://www.astro.ljmu.ac.uk/~pbw/IMACS-IFU/IMACS-1-highRes.pd