Analysis of Platforms and Functions of Mobile-Based Personal Health Record Systems

ObjectivesLittle is known about the platforms and functionalities of mobile-based personal health record (PHR) applications. The objective of this study was to investigate these two features of PHR systems.MethodsThe unit of analysis was general hospitals with more than 100 beds. This study was based on a PHR survey conducted from May 1 to June 30, 2020 and the National Health Insurance administrative data as of March 31, 2020. The study considered the platform, Android and iPhone operation system (iOS), and types of functionalities of PHR systems. Among the 316 target hospitals, 103 hospitals had adopted PHR systems. A logistic regression analysis was used.ResultsThis study found that 103 hospitals had adopted mobile-based PHR systems for their patients. Sixty-four hospitals (62.1%) were adopting both Android and iOS, but 36 (35.0%) and 3 (2.9%) hospitals were adopting Android only or iOS only, respectively. The PHR systems of hospitals adopting both platforms were more likely to have functions for viewing prescriptions, clinical diagnostic test results, and upcoming appointment status compared to those adopting a single platform (p \u3c 0.001). The number of beds (odds ratio [OR] = 1.004; confidence interval [CI], 1.001–1.007; p = 0.0029) and the number of computed tomography systems (CTs) per 100 beds (OR = 6.350; CI, 1.006–40.084; p = 0.0493) were significantly associated with the adoption of both platforms.ConclusionsMore than 60% of hospitals had adopted both Android and iOS platforms for their patients in Korea. Hospitals adopting both platforms had additional functionalities and significant association with the number of beds and CTs

Performance-Based Multiobjective Optimal Seismic Retrofit Method for a Steel Moment-Resisting Frame Considering the Life-Cycle Cost

This study proposes a performance-based multiobjective optimization seismic retrofit method for steel moment-resisting frames. The brittle joints of pre-Northridge steel moment-resisting frames are retrofitted to achieve ductility; the method involves determining the position and number of connections to be retrofitted. The optimal solution is determined by applying the nondominated sorting genetic algorithm-II (NSGA-II), which acts as a multiobjective seismic retrofit optimization technique. As objective functions, the initial cost for the connection retrofit and lifetime seismic damage cost were selected, and a seismic performance level below the 5% interstory drift ratio was employed as a constraint condition. The proposed method was applied to the SAC benchmark three- and nine-story buildings, and several Pareto solutions were obtained. The optimized retrofit solutions indicated that the lifetime seismic damage cost decreased as the initial retrofit cost increased. Although every Pareto solution existed within a seismic performance boundary set by a constraint function, the seismic performance tended to increase with the initial retrofit cost. Analysis and economic assessment of the relations among the initial retrofit cost, lifetime seismic damage cost, total cost, and seismic performance of the derived Pareto solution allow building owners to make seismic retrofit decisions more rationally

Analytical models for estimation of the maximum strain of beam structures based on optical fiber Bragg grating sensors

The structural safety of a beam structure is assessed by a comparison between the maximum stress measured during monitoring and the allowable stress of the beam. However, the strain directly measured from a fiber Bragg grat- ing (FBG) strain sensor may not be identical with the actual maximum strain induced in the structural member. Unless a FBG strain sensor is installed exactly on where maximum strain occurs, the reliability of the evaluated safety based on the measured strain depends on the number and location of sensors. Therefore, in this paper, analytical models are presented for estimation of the maximum values of strains in a linear elastic beam using the local strains measured from FBG sensors. The model is tested in an experiment by comparing estimated maximum strain from FBG sensors and directly measured strain from electrical gages. For the assessment of safety of typical beam structures in buildings and infrastructures, analytical models for various loading and boundary conditions are provided

Improved reversibility in lithium-oxygen battery: Understanding elementary reactions and surface charge engineering of metal alloy catalyst

Most Li-O-2 batteries suffer from sluggish kinetics during oxygen evolution reactions (OERs). To overcome this drawback, we take the lesson from other catalysis researches that showed improved catalytic activities by employing metal alloy catalysts. Such research effort has led us to find Pt3Co nanoparticles as an effective OER catalyst in Li-O-2 batteries. The superior catalytic activity was reflected in the substantially decreased overpotentials and improved cycling/rate performance compared to those of other catalysts. Density functional theory calculations suggested that the low OER overpotentials are associated with the reduced adsorption strength of LiO2 on the outermost Pt catalytic sites. Also, the alloy catalyst generates amorphous Li2O2 conformally coated around the catalyst and thus facilitates easier decomposition and higher reversibility. This investigation conveys an important message that understanding elementary reactions and surface charge engineering of air-catalysts are one of the most effective approaches in resolving the chronic sluggish charging kinetics in Li-O-2 batteries.

DNA microarrays on a dendron-modified surface improve significantly the detection of single nucleotide variations in the p53 gene

Selectivity and sensitivity in the detection of single nucleotide polymorphisms (SNPs) are among most important attributes to determine the performance of DNA microarrays. We previously reported the generation of a novel mesospaced surface prepared by applying dendron molecules on the solid surface. DNA microarrays that were fabricated on the dendron-modified surface exhibited outstanding performance for the detection of single nucleotide variation in the synthetic oligonucleotide DNA. DNA microarrays on the dendron-modified surface were subjected to the detection of single nucleotide variations in the exons 5–8 of the p53 gene in genomic DNAs from cancer cell lines. DNA microarrays on the dendron-modified surface clearly discriminated single nucleotide variations in hotspot codons with high selectivity and sensitivity. The ratio between the fluorescence intensity of perfectly matched duplexes and that of single nucleotide mismatched duplexes was >5–100 without sacrificing signal intensity. Our results showed that the outstanding performance of DNA microarrays fabricated on the dendron-modified surface is strongly related to novel properties of the dendron molecule, which has the conical structure allowing mesospacing between the capture probes. Our microarrays on the dendron-modified surface can reduce the steric hindrance not only between the solid surface and target DNA, but also among immobilized capture probes enabling the hybridization process on the surface to be very effective. Our DNA microarrays on the dendron-modified surface could be applied to various analyses that require accurate detection of SNPs

WATCHFUL OBSERVATION VERSUS EARLY AORTIC VALVE REPLACEMENT FOR SYMPTOMATIC PATIENTS WITH LOW-GRADIENT SEVERE AORTIC STENOSIS AND PRESERVED EJECTION FRACTION

Brief Communications Arising: arising from X. Dong, B. Milholland & J. Vijg Nature 538, 257–259 (2016); doi:10.1038/nature19793. Comments by: Beer, J.A.A. de, Bardoutsos, A. & Janssen, F. (2017)

Factors of quality of care and their association with smartphone based PHR adoption in South Korean hospitals

Background Healthcare organizations have begun to adopt personal health records (PHR) systems to engage patients, but little is known about factors associated with the adoption of PHR systems at an organizational level. The objective of this study is to investigate factors associated with healthcare organizations’ adoption of PHR systems in South Korea. Methods The units of analysis were hospitals with more than 100 beds. Study data of 313 hospitals were collected from May 1 to June 30, 2020. The PHR adoption status for each hospital was collected from PHR vendors and online searches. Adoption was then confirmed by downloading the hospital’s PHR app and the PHR app was examined to ascertain its available functions. One major outcome variable was PHR adoption status at hospital level. Data were analysed by logistic regressions using SAS 9.4 version. Results Out of 313 hospitals, 103 (32.9%) hospitals adopted PHR systems. The nurse-patient ratio was significantly associated with PHR adoption (OR 0.758; 0.624 to 0.920, p = 0.005). The number of health information management staff was associated with PHR adoption (OR 1.622; 1.228 to 2.141, p = 0.001). The number of CTs was positively associated with PHR adoption (OR 5.346; 1.962 to 14.568, p = 0.001). Among the hospital characteristics, the number of beds was significantly related with PHR adoption in the model of standard of nursing care (OR 1.003; 1.001 to 1.005, p < 0.001), HIM staff (OR 1.004; 1.002 to 1.006, p < 0.001), and technological infrastructure (OR 1.050; 1.003 to 1.006, p < 0.001). Conclusions One-third of study hospitals had adopted PHR systems. Standard of nursing care as well as information technology infrastructure in terms of human resources for health information management and advanced technologies were significantly associated with adoption of PHR systems. A favourable environment for adopting new technologies in general may be associated with the adoption and use of PHR systems.This study was supported for two years by a Pusan National University Research Grant

Takotsubo Cardiomyopathy: A Case of Persistent Apical Ballooning Complicated by an Apical Mural Thrombus

Takotsubo cardiomyopathy (TTC) is an infrequent cardiac syndrome characterized by acute onset chest pain with apical ballooning on echocardiography. It is often triggered by severe emotional or physical stress, and in contrast to acute myocardial infarction (AMI), the regional wall motion abnormality returns to normal within days. Here, we describe a 62-year-old female who presented with acute onset chest pain during treatment for a liver abscess. We presumed a diagnosis of AMI because of ST segment elevation on electrocardiography and elevated cardiac enzyme levels. However, the patient's coronary arteries were normal on angiography, and apical ballooning was seen on echocardiography. A diagnosis of TTC was made, and the patient was managed with intensive cardiopulmonary support using vasopressors in our hospital's medical intensive care unit. The patient's symptoms improved, but persistent severe left ventricular dysfunction was detected on follow-up echocardiography. After 5 weeks, a new apical mural thrombus appeared, and anticoagulation therapy was started. The apical ballooning persisted 3 months later, although the patient's overall ejection fraction was slightly improved. The apical thrombus was completely resolved without any embolic event. Non-adrenergic inotropics can be recommended in TTC with shock, and clinicians should keep in mind the potential risk of thrombus formation and cardioembolism