The Implementation and Effects of Computerized Physician Order Entry in Healthcare Settings

Introduction: In the United States, medication errors has been a big problem and was the number three cause of death in 2016. Computerize Physician Order Entry (CPOE), also known as Computerized Provider Order Entry, is the process of physicians or providers entering treatment instructions or radiology, laboratory, and medication orders via computer rather than paper, and has led to a decrease in medication errors. The purpose of this study was to examine whether CPOE system could help hospitals to reduce medical errors and costs, as well as examine the new problems resulted by the use of CPOE in the United States hospitals. Methodology: The methodology for this study utilized a literature review and a semi-structured interview. It consisted of academic sources, four electronic databases, academic journals, and government websites. Thirty-eight sources were referenced for this literature review. Results: The literature review analyzed the benefits and drawbacks of CPOE implementation in the healthcare setting. It was found that CPOE implementation has created many benefits for the healthcare setting such as a decrease in medication errors, a higher return on investment, and a faster turnaround time. However, there has still been issues with CPOE such as medication errors and increased workload. Discussion/Conclusion: The implementation of CPOE can reduce hospitals’ medical errors and adverse drug events, as well as help hospitals to reduce expense and outweighs the potential limitations of CPOE. The study reviewed limitations of the study that included research and publication bias, search strategy, and only four databases were used for research. Practical implications included the continual implementation of CPOE in healthcare settings

The Use of Big Data by Managed Care Organizations

Big data have become available in all kinds of healthcare organizations. The application of big data analytics in Managed Care Organizations (MCOs) has the potential to improve health care, lower costs, save lives, and help to make better-informed decisions. The study illustrated the implication of big data in MCOs. Big data can help MCOs reduce patients’ relevance, analyze specific diseases such as asthma and diabetes. Big data also could help MCOs to reduce cost after collecting data and determined the specific patients’ situation. The implication of big data has benefited MCOs in reducing costs, improving the quality of healthcare care. Interview content, limitation, and practical implication of this study are further discussed

Parkinson’s disease etiology : beyond the brain and late adulthood

Despite much effort investigating the etiology of Parkinson’s disease (PD), the causes and the exact mechanisms underlying the disease remain elusive. Braak’s hypothesis suggests that PD pathology may start in the enteric nervous system and later spread to the brain via the vagus nerve. This hypothesis is further extended to the dual-hit hypothesis suggesting that environmental neurotropic pathogens may contribute to PD development through nasal and gut gateways that are in direct connection with each other via inhalation and ingestion. Mounting evidence also suggests the importance of neuroinflammation in the pathogenesis of PD. In this thesis, I aimed to explore the etiology of PD focusing on developmental origins related to early infection and inflammation, gastrointestinal aspects, and olfactory function using various register and population based datasets. In Study I, we conducted a cohort study to examine developmental aspects of PD regarding early life infection, parental age at birth, multiple birth. We considered birth order, sibship size, birth seasonality, and flu activity in the year of birth as surrogates for early infection and inflammation. Overall, we found that early life characteristics were not associated with future risk of PD, indicating little support for the importance of early life aspects in PD etiology. In Study II, we evaluated vagotomy and its subtypes (truncal and selective vagotomies) in relation to PD risk in a matched cohort. We found that truncal vagotomy, with the nerve trunk fully resected, appeared to be associated with a decreased risk of PD more than five years after the surgery, while selective vagotomy was not associated with the risk of PD. The results provide preliminary evidence supporting Braak’s hypothesis. In Study III, we conducted a nested case-control study in the Swedish total population and a cohort study in Swedish twins to investigate irritable bowel syndrome (IBS) diagnosis as well as IBS based on self-reported symptoms in relation to the risk of PD. The results demonstrated that IBS was linked to an elevated risk of PD. The findings add additional evidence suggesting the importance of gut-brain-axis in PD development. In Study IV, we examined whether poor olfaction is associated with long-term mortality and potential explanations for such association among older adults in a community-based cohort. We found that poor olfaction was associated with higher long-term mortality and that part of the association was explained by neurodegenerative diseases, in particular, PD and dementia, and body weight loss. In summary, by taking advantage of Swedish nationwide registers, we provide some evidence supporting Braak’s hypothesis and the importance of the gut-to-brain axis in PD development. Our data, however, do not support the importance of developmental origins of PD. Additionally, we confirmed the association between poor olfaction and mortality in healthy older adults from the Health, Aging and Body Composition study and identified PD or dementia and body weight loss as part of the potential mechanisms underlying the association

Blocking neutrophil integrin activation prevents ischemia-reperfusion injury.

Neutrophil recruitment, mediated by β2 integrins, combats pyogenic infections but also plays a key role in ischemia-reperfusion injury and other inflammatory disorders. Talin induces allosteric rearrangements in integrins that increase affinity for ligands (activation). Talin also links integrins to actin and other proteins that enable formation of adhesions. Structural studies have identified a talin1 mutant (L325R) that perturbs activation without impairing talin's capacity to link integrins to actin and other proteins. Here, we found that mice engineered to express only talin1(L325R) in myeloid cells were protected from renal ischemia-reperfusion injury. Dissection of neutrophil function in vitro and in vivo revealed that talin1(L325R) neutrophils had markedly impaired chemokine-induced, β2 integrin-mediated arrest, spreading, and migration. Surprisingly, talin1(L325R) neutrophils exhibited normal selectin-induced, β2 integrin-mediated slow rolling, in sharp contrast to the defective slow rolling of neutrophils lacking talin1 or expressing a talin1 mutant (W359A) that blocks talin interaction with integrins. These studies reveal the importance of talin-mediated activation of integrins for renal ischemia-reperfusion injury. They further show that neutrophil arrest requires talin recruitment to and activation of integrins. However, although neutrophil slow rolling requires talin recruitment to integrins, talin-mediated integrin activation is dispensable

Corporate Credit Rating: A Survey

Corporate credit rating (CCR) plays a very important role in the process of contemporary economic and social development. How to use credit rating methods for enterprises has always been a problem worthy of discussion. Through reading and studying the relevant literature at home and abroad, this paper makes a systematic survey of CCR. This paper combs the context of the development of CCR methods from the three levels: statistical models, machine learning models and neural network models, summarizes the common databases of CCR, and deeply compares the advantages and disadvantages of the models. Finally, this paper summarizes the problems existing in the current research and prospects the future of CCR. Compared with the existing review of CCR, this paper expounds and analyzes the progress of neural network model in this field in recent years.Comment: 11 page

Enabling Neuromorphic Computing for Artificial Intelligence with Hardware-Software Co-Design

In the last decade, neuromorphic computing was rebirthed with the emergence of novel nano-devices and hardware-software co-design approaches. With the fast advancement in algorithms for today’s artificial intelligence (AI) applications, deep neural networks (DNNs) have become the mainstream technology. It has been a new research trend to enable neuromorphic designs for DNNs computing with high computing efficiency in speed and energy. In this chapter, we will summarize the recent advances in neuromorphic computing hardware and system designs with non-volatile resistive access memory (ReRAM) devices. More specifically, we will discuss the ReRAM-based neuromorphic computing hardware and system implementations, hardware-software co-design approaches for quantized and sparse DNNs, and architecture designs

Research of lightning transient potential on the jacket foundation offshore wind turbines

Offshore wind turbines are often struck by lightning due to their tall structures and the harsh marine environment. The high transient potential from lightning strike can cause serious damage for the devices of offshore turbines. For analysing the effect of transient potential, a complete transient circuit model is established and an efficient algorithm is also presented to evaluate the circuit parameters of blade, tower, and jacket foundation. On the basis of the circuit model, the transient potential at the different locations of the offshore wind turbine can be carried out during direct lightning strike by PSCAD. Finally, the circuit model is used by a numerical example of an actual Chinese-built offshore wind turbine

Mapping the landscape of histomorphological cancer phenotypes using self-supervised learning on unannotated pathology slides

Cancer diagnosis and management depend upon the extraction of complex information from microscopy images by pathologists, which requires time-consuming expert interpretation prone to human bias. Supervised deep learning approaches have proven powerful, but are inherently limited by the cost and quality of annotations used for training. Therefore, we present Histomorphological Phenotype Learning, a self-supervised methodology requiring no labels and operating via the automatic discovery of discriminatory features in image tiles. Tiles are grouped into morphologically similar clusters which constitute an atlas of histomorphological phenotypes (HP-Atlas), revealing trajectories from benign to malignant tissue via inflammatory and reactive phenotypes. These clusters have distinct features which can be identified using orthogonal methods, linking histologic, molecular and clinical phenotypes. Applied to lung cancer, we show that they align closely with patient survival, with histopathologically recognised tumor types and growth patterns, and with transcriptomic measures of immunophenotype. These properties are maintained in a multi-cancer study

Analysis of factors influencing the organizational capacity of Institutional Review Boards In China: a crisp-set Qualitative Comparative Analysis based on 107 cases

Abstract Background Institutional Review Boards (IRBs) play a vital role in safeguarding the rights and interests of both research participants and researchers. However, China initiated the establishment of its own IRB system relatively late in comparison to international standards. Despite commendable progress, there is a pressing need to strengthen the organizational capacity building of Chinese IRBs. Hence, this study aims to analyze the key factors driving the enhancement of organizational capacity within these committees. Method The cross-sectional survey for this research was conducted from July 2020 to January 2022. Following the statistical grouping based on the "2020 China Health Statistical Yearbook", a systematic investigation of IRBs in various provinces of China was carried out. In-depth interviews and questionnaire surveys were conducted with the chairpersons and administrative executives (or secretaries) of highly cooperative IRBs. Subsequently, data were collected from 107 IRBs. Qualitative Comparative Analysis (QCA) was employed as the method to analyze the factors influencing the organizational capacity of medical ethics committees and explore the diverse combinations of these factors. Results Through a singular necessary condition analysis, the variable "protection of rights and interests" emerges as a critical factor contributing to the robust construction of Institutional Review Boards Institutional Review Boards (IRBs). Conversely, the variables of "lack of member ability, absence of review process, and deficiency in the supervision mechanism" collectively constitute a sufficient condition leading to weaker IRB construction. The state analysis uncovers three interpretation modes: member ability-oriented (M1), system process-oriented mode (M2), and resource system-oriented mode (M3). Conclusions The results of this study are effectively explicable using the "Triangular Force" model proposed for the hypothesis of IRBs' organizational capacity, which provides a solid foundation for the development of organizational capabilities in IRBs. To enhance the organizational capacity of IRBs in China, it is imperative to elevate the competence of committee members and strengthen team development. This can be achieved by establishing a comprehensive regulatory framework and refining procedural protocols. Moreover, clarifying the organizational structure and optimizing resource allocation are essential steps in bolstering the overall organizational capabilities of these committees

Children's Quality of Life Based on the KIDSCREEN-27 : Child Self-Report, Parent Ratings and Child-Parent Agreement in a Swedish Random Population Sample

Background The KIDSCREEN-27 is a measure of child and adolescent quality of life (QoL), with excellent psychometric properties, available in child-report and parent-rating versions in 38 languages. This study provides child-reported and parent-rated norms for the KIDSCREEN-27 among Swedish 11-16 year-olds, as well as child-parent agreement. Sociodemographic correlates of self-reported wellbeing and parent-rated wellbeing were also measured. Methods A random population sample consisting of 600 children aged 11-16, 100 per age group and one of their parents (N = 1200), were approached for response to self-reported and parentrated versions of the KIDSCREEN-27. Parents were also asked about their education, employment status and their own QoL based on the 26-item WHOQOL-Bref. Based on the final sampling pool of 1158 persons, a 34.8% response rate of 403 individuals was obtained, including 175 child-parent pairs, 27 child singleton responders and 26 parent singletons. Gender and age differences for parent ratings and child-reported data were analyzed using t-tests and the Mann-Whitney U-test. Post-hoc Dunn tests were conducted for pairwise comparisons when the p-value for specific subscales was 0.05 or lower. Child-parent agreement was tested item-by-item, using the Prevalence-and Bias-Adjusted Kappa (PABAK) coefficient for ordinal data (PABAK-OS); dimensional and total score agreement was evaluated based on dichotomous cut-offs for lower well-being, using the PABAK and total, continuous scores were evaluated using Bland-Altman plots. Results Compared to European norms, Swedish children in this sample scored lower on Physical wellbeing (48.8 SE/49.94 EU) but higher on the other KIDSCREEN-27 dimensions: Psychological wellbeing (53.4/49.77), Parent relations and autonomy (55.1/49.99), Social Support and peers (54.1/49.94) and School (55.8/50.01). Older children self-reported lower wellbeing than younger children. No significant self-reported gender differences occurred and parent ratings showed no gender or age differences. Item-by-item child-parent agreement was slight for 14 items (51.9%), fair for 12 items (44.4%), and less than chance for one item (3.7%), but agreement on all dimensions as well as the total score was substantial according to the PABAK-OS. Visual interpretation of the Bland-Altman plot suggested that when children's average wellbeing score was lower parents seemed to rate their children as having relatively higher total wellbeing, but as children's average wellbeing score increased, parents tended to rate their children as having relatively lower total wellbeing. Children living with both parents had higher wellbeing than those who lived with only one parent. Conclusions Results agreed with European findings that adolescent wellbeing decreases with age but contrasted with some prior Swedish research identifying better wellbeing for boys on all dimensions but Social support and peers. The study suggests the importance of considering children's own reports and not only parental or other informant ratings. Future research should be conducted at regular intervals and encompass larger samples