Impact of Electronic Health Records On Patient Outcomes

With the passing of the HITECH Act, EHRs have come into prominence and sharper focus, due to efforts by the government to push for a national adoption of EHRs into our healthcare system. This push for a national adoption of EHRs is based on the premise that it will help improve the quality delivery of health care services and reduce costs. However, this push for a “national adoption” has experienced mixed results. This study was designed to assess the impact of EHRs post-2009, the year of the HITECH Act, to review some of the key contributing factors to this mixed results. The findings of the study show that implementing EHRs has positively impacted the US health care system in a variety of ways. Thus, while we may conclude that the implementation EHRs have definitely improve the quality of healthcare in the US, and show great promise for the future of health care in this nation, there is still much work to be done to ensure that their full potential is realized. These findings will contribute towards the ongoing effort to expand the implementation of HER by making them secure and easy to use

Information Technology Ethics: A Research Framework

Information technology has become so pervasive that opportunities for abuses abound. IT Ethics has taken on increasing importance as the size and complexity of IT issues continues to grow. This paper outlines a research framework to analyze: Do significant ethical differences exist amongst undergraduate and graduate MIS students

The Relationship of E-Commerce Readiness to Technology Acceptance: The Case of Barbados

This is an exploratory study that examines the relationship between selected components of ecommerce readiness and dimensions of Davis’ (1989) Technology Acceptance Model. Building upon the notion that there exists some linkage between ecommerce readiness and technology Acceptance, this study seeks to examine these linkages in e-businesses within Barbados. Three relationships are proposed – a relationship between technology acceptance and the existing e-Readiness infrastructure, a relationship between technology acceptance and current telecommunications access, and a relationship between technology acceptance and education. The results of this study demonstrated that there are strong relationships between e-commerce readiness components and various technology acceptance dimensions

Resource-Based View of Knowledge Management for Competitive Advantage

We are not only in a new millennium, but also in a new era: the knowledge era. Sustainable competitive advantage is dependent on building and exploiting core competencies. The resource-based view (RBV) of the firm defines a strategic asset as one that is rare, valuable, imperfectly imitiable and non-substitutable. Knowledge is seen as a strategic asset with the potential to be a source of competitive advantage for an organization. In this paper, we provide a model that examines how and why knowledge management (KM) can be sued to create competitive advantage from the RBV of the firm

Cytomegalovirus drives Vδ2neg γδ T cell inflation in many healthy virus carriers with increasing age

Cytomegalovirus (CMV) usually causes lifelong asymptomatic infection, but over time can distort immune profiles. Recent reports describe selective expansion of Vδ2(neg) γδ T cells in healthy and immunocompromised CMV carriers. Having shown previously that virus-specific CD8(+) and CD4(+) T cell responses are increased significantly in elderly CMV carriers, probably driven by chronic stimulation, we hypothesized that Vδ2(neg) γδ T cells may also be expanded with age. Our results show that Vδ2(neg) γδ T cells are increased significantly in CMV-seropositive healthy individuals compared to CMV-seronegative controls in all age groups. The differences were most significant in older age groups (P < 0·0001). Furthermore, while Vδ2(neg) γδ T- cells comprise both naive and memory cells in CMV-seronegative donors, highly differentiated effector memory cells are the dominant phenotype in CMV carriers, with naive cells reduced significantly in numbers in CMV-seropositive elderly. Although phenotypically resembling conventional CMV-specific T cells, Vδ2(neg) γδ T cells do not correlate with changes in magnitude of CMV-specific CD4(+) or CD8(+) T cell frequencies within those individuals, and do not possess ex-vivo immediate effector function as shown by CMV-specific CD4(+) and CD8(+) T cells. However, after short-term culture, Vδ2(neg) γδ T cells demonstrate effector T cell functions, suggesting additional requirements for activation. In summary, Vδ2(neg) γδ T cells are expanded in many older CMV carriers, demonstrating a further level of lymphocyte subset skewing by CMV in healthy individuals. As others have reported shared reactivity of Vδ2(neg) γδ T cells towards tumour cells, the composition of γδ T cell subsets may also have implications for risk of developing cancer in elderly people

Few are as Good as Many: An Ontology-Based Tweet Spam Detection Approach

Due to the high popularity of Twitter, spammers tend to favor its use in spreading their commercial messages. In the context of detecting twitter spams, different statistical and behavioral analysis approaches were proposed. However, these techniques suffer from many limitations due to (1) ongoing changes to Twitter\u2019s streaming API which constrains access to a user\u2019s list of followers/followees, (2) spammer\u2019s creativity in building diverse messages, (3) use of embedded links and new accounts, and (4) need for analyzing different characteristics about users without their consent. To address the aforementioned challenges, we propose a novel ontology-based approach for spam detection over Twitter during events by analyzing the relationship between ham user tweets vs. spams. Our approach relies solely on public tweet messages while performing the analysis and classification tasks. In this context, ontologies are derived and used to generate a dictionary that validates real tweet messages from random topics. Similarity ratio among the dictionary and tweets is used to reflect the legitimacy of the messages. Experiments conducted on real tweet data illustrate that message-to-message techniques achieved a low detection rate compared to our ontology based approach which outperforms them by approximately 200%, in addition to promising scalability for large data analysis

Genome-Wide Analysis of Menin Binding Provides Insights into MEN1 Tumorigenesis

Multiple endocrine neoplasia type I (MEN1) is a familial cancer syndrome characterized primarily by tumors of multiple endocrine glands. The gene for MEN1 encodes a ubiquitously expressed tumor suppressor protein called menin. Menin was recently shown to interact with several components of a trithorax family histone methyltransferase complex including ASH2, Rbbp5, WDR5, and the leukemia proto-oncoprotein MLL. To elucidate menin's role as a tumor suppressor and gain insights into the endocrine-specific tumor phenotype in MEN1, we mapped the genomic binding sites of menin, MLL1, and Rbbp5, to approximately 20,000 promoters in HeLa S3, HepG2, and pancreatic islet cells using the strategy of chromatin-immunoprecipitation coupled with microarray analysis. We found that menin, MLL1, and Rbbp5 localize to the promoters of thousands of human genes but do not always bind together. These data suggest that menin functions as a general regulator of transcription. We also found that factor occupancy generally correlates with high gene expression but that the loss of menin does not result in significant changes in most transcript levels. One exception is the developmentally programmed transcription factor, HLXB9, which is overexpressed in islets in the absence of menin. Our findings expand the realm of menin-targeted genes several hundred-fold beyond that previously described and provide potential insights to the endocrine tumor bias observed in MEN1 patients

Pelvic trauma : WSES classification and guidelines

Complex pelvic injuries are among the most dangerous and deadly trauma related lesions. Different classification systems exist, some are based on the mechanism of injury, some on anatomic patterns and some are focusing on the resulting instability requiring operative fixation. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic impairment of pelvic ring function and the associated injuries. The management of pelvic trauma patients aims definitively to restore the homeostasis and the normal physiopathology associated to the mechanical stability of the pelvic ring. Thus the management of pelvic trauma must be multidisciplinary and should be ultimately based on the physiology of the patient and the anatomy of the injury. This paper presents the World Society of Emergency Surgery (WSES) classification of pelvic trauma and the management Guidelines.Peer reviewe