A methodological proposal and tool support for the HL7 standards compliance in the development of health information systems

Health information systems are increasingly complex, and their development is presented as a challenge for software development companies offering quality, maintainable and interoperable products. HL7 (Health level 7) International, an international non-profit organization, defines and maintains standards related to health information systems. However, the modelling languages proposed by HL7 are far removed from standard languages and widely known by software engineers. In these lines, NDT is a software development methodology that has a support tool called NDT-Suite and is based, on the one hand, on the paradigm of model-driven engineering and, on the other hand, in UML that is a widely recognized standard language. This paper proposes an extension of the NDT methodology called MoDHE (Model Driven Health Engineering) to offer software engineers a methodology capable of modelling health information systems conforming to HL7 using UML domain models

Software Process Accessibility in Practice: A Case Study

AbstractSoftware processes are recognized as fundamental assets in development organizations since they support the capability to pro- duce better products. A means for handling the complexity of these processes is through models, and software process modeling languages (SPMLs) are languages to express those processes. Different requirements for SPMLs have been identified by some authors, but accessibility is not one of them. There is little empirical evidence of the use of software processes by people with accessibility difficulties in software organizations. The goal of this case study is to investigate what are the requirements to make software processes become accessible. The subjects are users of a methodology called NDT and its support tools, and who have a kind of disability. The objective is to know the main requirements in order to read and execute software processes and become a process engineer. Conclusions and future work in this field are also presented to improve this area

Data-Driven ECG Denoising Techniques for Characterising Bipolar Lead Sets along the Left Arm in Wearable Long-Term Heart Rhythm Monitoring

Abnormal heart rhythms (arrhythmias) are a major cause of cardiovascular disease and death in Europe. Sudden cardiac death accounts for 50% of cardiac mortality in developed countries; ventricular tachycardia or ventricular fibrillation is the most common underlying arrhythmia. In the ambulatory population, atrial fibrillation is the most common arrhythmia and is associated with an increased risk of stroke and heart failure, particularly in an aging population. Early detection of arrhythmias allows appropriate intervention, reducing disability and death. However, in the early stages of disease arrhythmias may be transient, lasting only a few seconds, and are thus difficult to detect. This work addresses the problem of extracting the far-field heart electrogram signal from noise components, as recorded in bipolar leads along the left arm, using a data driven ECG (electrocardiogram) denoising algorithm based on ensemble empirical mode decomposition (EEMD) methods to enable continuous non-invasive monitoring of heart rhythm for long periods of time using a wrist or arm wearable device with advanced biopotential sensors. Performance assessment against a control denoising method of signal averaging (SA) was implemented in a pilot study with 34 clinical cases. EEMD was found to be a reliable, low latency, data-driven denoising technique with respect to the control SA method, achieving signal-to-noise ratio (SNR) enhancement to a standard closer to the SA control method, particularly on the upper arm-ECG bipolar leads. Furthermore, the SNR performance of the EEMD was improved when assisted with an FFT (fast Fourier transform ) thresholding algorithm (EEMD-fft)

Interaction of landscape varibles on the potential geographical distribution of parrots in the Yucatan Peninsula, Mexico

La interacción de las variables del paisaje en la distribución geográfica potencial de los loros en la península de Yucatán, México La pérdida, degradación y fragmentación de las zonas boscosas están poniendo en peligro a las poblaciones de loros. En este estudio se determinó la influencia de la fragmentación en relación con la cobertura vegetal, los usos del suelo y la configuración espacial de los fragmentos, sobre los modelos de distribución geográfica potencial de los loros en la península de Yucatán, México. Se utilizó la distribución geográfica potencial de ocho especies de loros, teniendo en cuenta los mapas publicados recientemente y obtenidos con el algoritmo de máxima entropía, y se incorporó el mapa de probabilidad de distribución de cada especie. Se calcularon 71 parámetros y variables que evalúan la fragmentación forestal, la configuración espacial de los fragmentos, la proporción ocupada por vegetación y los usos del suelo en 100 parcelas de aproximadamente 29 km² distribuidas al azar dentro de las zonas de presencia y ausencia predichas para cada especie. Además, se tuvo en cuenta la relación entre las variables ambientales y la probabilidad de distribución de las especies. Se empleó una regresión de mínimos cuadrados parciales para analizar la relación existente entre las variables empleadas y los modelos de distribución potencial. Ninguna de las variables ambientales analizadas determina por sí sola la presencia, la ausencia ni la probabilidad de distribución de los loros en la península. Se observó que para las ocho especies, ya sea debido a la presencia y la ausencia o a la probabilidad de distribución, las variables explicativas más importantes son la interacción entre tres variables, en especial la interacción entre la superficie forestal total, la longitud total de los perímetros de los fragmentos y la cantidad de bosque tropical subperennifolio de altura mediana. La fragmentación del hábitat influye sobre la distribución geográfica potencial de estas especies en combinación con otros factores ambientales asociados a la misma, como son la proporción de las diferentes coberturas vegetales y los usos del suelo que se desarrollan en las áreas deforestadas.La interacción de las variables del paisaje en la distribución geográfica potencial de los loros en la península de Yucatán, México La pérdida, degradación y fragmentación de las zonas boscosas están poniendo en peligro a las poblaciones de loros. En este estudio se determinó la influencia de la fragmentación en relación con la cobertura vegetal, los usos del suelo y la configuración espacial de los fragmentos, sobre los modelos de distribución geográfica potencial de los loros en la península de Yucatán, México. Se utilizó la distribución geográfica potencial de ocho especies de loros, teniendo en cuenta los mapas publicados recientemente y obtenidos con el algoritmo de máxima entropía, y se incorporó el mapa de probabilidad de distribución de cada especie. Se calcularon 71 parámetros y variables que evalúan la fragmentación forestal, la configuración espacial de los fragmentos, la proporción ocupada por vegetación y los usos del suelo en 100 parcelas de aproximadamente 29 km² distribuidas al azar dentro de las zonas de presencia y ausencia predichas para cada especie. Además, se tuvo en cuenta la relación entre las variables ambientales y la probabilidad de distribución de las especies. Se empleó una regresión de mínimos cuadrados parciales para analizar la relación existente entre las variables empleadas y los modelos de distribución potencial. Ninguna de las variables ambientales analizadas determina por sí sola la presencia, la ausencia ni la probabilidad de distribución de los loros en la península. Se observó que para las ocho especies, ya sea debido a la presencia y la ausencia o a la probabilidad de distribución, las variables explicativas más importantes son la interacción entre tres variables, en especial la interacción entre la superficie forestal total, la longitud total de los perímetros de los fragmentos y la cantidad de bosque tropical subperennifolio de altura mediana. La fragmentación del hábitat influye sobre la distribución geográfica potencial de estas especies en combinación con otros factores ambientales asociados a la misma, como son la proporción de las diferentes coberturas vegetales y los usos del suelo que se desarrollan en las áreas deforestadas.The loss, degradation, and fragmentation of forested areas are endangering parrot populations. In this study, we determined the influence of fragmentation in relation to vegetation cover, land use, and spatial configuration of fragments on the potential geographical distribution patterns of parrots in the Yucatan Peninsula, Mexico. We used the potential geographical distribution for eight parrot species, considering the recently published maps obtained with the maximum entropy algorithm, and we incorporated the probability distribution for each species. We calculated 71 metrics/variables that evaluate forest fragmentation, spatial configuration of fragments, the ratio occupied by vegetation, and the land use in 100 plots of approximately 29 km², randomly distributed within the presence and absence areas predicted for each species. We also considered the relationship between environmental variables and the distribution probability of species. We used a partial least squares regression to explore patterns between the variables used and the potential distribution models. None of the environmental variables analyzed alone determined the presence/absence or the probability distribution of parrots in the Peninsula. We found that for the eight species, either due to the presence/absence or the probability distribution, the most important explanatory variables were the interaction among three variables, particularly the interactions among the total forest area, the total edge, and the tropical semi–evergreen medium– height forest. Habitat fragmentation influenced the potential geographical distribution of these species in terms of the characteristics of other environmental factors that are expressed together with the geographical division, such as the different vegetation cover ratio and land uses in deforested areas

A Performance Improvement Project to Improve Hand-off Communication Documentation within the Surgical Services Department

Over 80% of adverse events in healthcare are due to miscommunication. To improve patient safety, The Joint Commission recommended the use of standardized hand-off communication tools in 2012. One acute care hospital in Southeast Florida implemented standardized handoff reports in 2014 with few revisions since that time. The COVID-19 pandemic brought to light additional critical information was needed to keep patients and staff safe, such as laboratory results indicating the need for isolation precautions. The nurses within the surgical services noticed this critical information was not sufficiently included in the handoff report. The lack of this information led to unnecessary staff exposures and delays in treatment. The quality improvement nurse noticed a significant drop in the use of the standardized hand-off report form used during this time. This drop in compliance lead to concerns for patient and staff safety. The purpose of this performance improvement project was to improve the quality of handoff reports as measured by the level of documentation using the standardized handoff report. The project followed the Plan-Do-Check-Act model for performance improvement, monitoring documentation compliance and reporting the results to the leaders and staff. The handoff report form was revised with input from the staff, resulting in improved efficiency. The nurses’ level of satisfaction with the form improved resulting in improved compliance and reducing miscommunications

La propiedad intelectual, una necesidad impostergable en el sistema de salud de nuestro municipio

La respuesta es sencilla: los derechos de propiedad intelectual se asemejan a cualquier otro derecho de propiedad (permiten al creador o al titular de una patente, marca o derecho de autor, beneficiarse de su obra o inversión).  Estos derechos figuran en el Artículo 27 de la Declaración Universal de Derechos Humanos, donde se establece el derecho a beneficiarse de la protección de los intereses morales y materiales resultantes de la autoría de toda producción científica, literaria o artística.La importancia de la propiedad intelectual empezó por ser reconocida en el Convenio de París para la Protección de la Propiedad Industrial de 1883 y en el Convenio de Berna para la Protección de las Obras Literarias y Artísticas de 1886. La Organización Mundial de la Propiedad Intelectual (OMPI) administra ambos tratados

The physiology of ex vitro pineapple ( Ananas comosus L. Merr. var MD-2) as CAM or C3 is regulated by environmental conditions: proteomic and transcriptomic profiles

Pineapple is one of the most important tropical crops worldwide. The use of Temporary Immersion Bioreactors (TIB) for the first stages of pineapple propagation enables precise control of plant growth, increases the rate of plant multiplication, decreases space, energy and labor requirements for pineapple plants in commercial micropropagation. Once the plantlets are ready to be taken from the reactors, they are carefully acclimatized to adapt to natural environmental conditions, and a facultative C3/CAM metabolism in the first two months of growth is characteristic of pineapple plants, depending on environmental conditions. We subjected two sets of micropropagated pineapple plants to C3 and CAM-inducing environmental conditions, determined by light intensity/relative humidity (respectively 40μmol.m-2s-1/85% and 260μmol.m-2.s-1/50%). Leaves of pineapple plants grown under CAM inducing conditions showed higher leaf thickness and more developed cuticles and hypodermic tissue. Proteomic profiles of several proteins, isoenzyme patterns and transcriptomic profiles were also measured. Five major spots were isolated and identified, two of them for the first time in Ananas comosus (OEE 1; OEE 2) and the other three corresponding to small fragments of the large subunit of Rubisco (LSU). PEPC and PEPCK were also detected by immunobloting of 2DE at the end of both ex vitro treatments (C3/CAM) during the dark period. Isoenzymes of SOD and CAT were identified by electrophoresis and the transcript levels of OEE 1 and CAT were associated with CAM metabolism in pineapple plants