Tracebook : a dynamic checklist support system

It has recently been demonstrated that checklist scan enable significant improvements to patient safety. However, their clinical acceptance is significantly lower than expected. This is due to the lack of good support systems. Specifically, support systems are too static: this holds for paper-based support as well as for electronic systems that digitize paper-based support naively. Both approaches are independent from clinical process and clinical context. In this paper, we propose a process-oriented and context-aware dynamic checklist support system: Tracebook. This system supports the execution of complex clinical processes and rules involving data from Electronic Medical Record systems. Workflow activities and forms are specific to individual patients based on clinical rules and they are dispatched to the right user automatically based on a process model. Besides describing the Tracebook functionality in general, this paper demonstrates the support system specifically on an example application that we are preparing for a controlled clinical evaluation. At last we discuss the difference between Tracebook and other support systems which also rely on a checklist format

DCCSS:a meta-model for dynamic clinical checklist support systems

Clinical safety checklists receive much research attention since they can reduce medical errors and improve patient safety. Computerized checklist support systems are also being developed actively. Such systems should individualize checklists based on information from the patient’s medical record while also considering the context of the clinical workflows. Unfortunately, the form definitions, database queries and workflow definitions related to dynamic checklists are too often hard-coded in the source code of the support systems. This increases the cognitive effort for the clinical stakeholders in the design process, it complicates the sharing of dynamic checklist definitions as well as the interoperability with other information systems. In this paper, we address these issues by contributing the DCCSS meta-model which enables the model-based development of dynamic checklist support systems. DCCSS was designed as an incremental extension of standard meta-models, which enables the reuse of generic model editors in a novel setting. In particular, DCCSS integrates the Business Process Model and Notation (BPMN) and the Guideline Interchange Format (GLIF), which represent best of breed languages for clinical workflow modeling and clinical rule modeling respectively. We also demonstrate one of the use cases where DCCSS has already been applied in a clinical setting

Agricultural Academy

Abstract KAYMAK, H. C., I. GUVENC and A. GUROL, 2010. Elemental analysis of different radish (Raphanus sativus L.) Cultivars by using wavelength-dispersive X-ray fluorescence spectrometry (WDXRF). Bulg. J. Agric. Sci., The aim of this work is to study the applicability of a quantitative WDXRF (Wavelength-Dispersive X-ray Fluorescence) method, for determination of minerals in radish specimens. In this study, we have quantitatively and semi-quantitatively analysed the four different radish (Raphanus sativus L.) cultivars (cvs. 'Siyah', 'Beyaz', 'Antep' and 'Iri-Kirimizi'). We have found that major elements; namely N and K; a few minor elements; Na, Mg, P, S, and Ca, and a lot of trace elements; Mn, Fe, Cu, Zn, Al, Ti, Cr, Br, Rb, Sr, Sn, Ba and La. The obtained trace element concentrations range from 0.01 to 3.24 mg per 100 g. This rapid method has been found to be a reliable technique for analyzing the mineral content in radish. At the end of this work, it was clearly said that Wavelengthdispersive X-ray fluorescence spectrometry (WDXRF) could be used for the analysis of mineral contents of radish and other vegetables

The European Union, borders and conflict transformation: the case of Cyprus

Much of the existing literature on the European Union (EU), conflict transformation and border dynamics has been premised on the assumption that the nature of the border determines EU intervention and the consequences that flow from this in terms of EU impact. The article aims to transcend this literature through assessing how domestic interpretations influence EU border transformation in conflict situations, taking Cyprus as a case study. Moreover, the objective is to fuse the literature on EU bordering impact and perceptions of the EU’s normative projection in conflict resolution. Pursuing this line of inquiry is an attempt to depart from the notion of borders being constructed solely by unidirectional EU logics of engagement or bordering practices to a conceptualization of the border as co-constituted space, where the interpretations of the EU’s normative projections by conflict parties, and the strategies that they pursue, can determine the relative openness of the EU border

Customizing Clinical Outcomes with Implantation of Two Diffractive Trifocal IOLs of Identical Design but Differing Light Distributions to the Far, Intermediate and Near Foci

Hakan Kaymak,1,2 Richard Potvin,3 Kai Neller,1,2 Karsten Klabe,1 Robert Donald Anello4 On behalf of the NINO Study Group1Internationale Innovative Ophthalmochirurgie GbR, Duesseldorf, Germany; 2Institute of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany; 3Science in Vision, Frisco, TX, USA; 4Global Clinical and Medical Affairs, Hoya Surgical Optics, Irvine, CA, USACorrespondence: Robert Donald Anello, HOYA Surgical Optics, 110 Progress, Suite 175, Irvine, CA, 92618, USA, Tel +1 909-224-6149, Email [email protected]: To evaluate clinical outcomes after bilateral or contralateral implantation of the Gemetric™ (G) and Gemetric™ Plus (GPlus) diffractive trifocal intraocular lenses (IOLs).Methods: This was a prospective, randomized, multi-center open-label study comparing clinical results and subjective patient responses around 6 months after implantation of the study lenses (toric and non-toric) in three different groups (bilateral G, bilateral GPlus and contralateral G/GPlus implantation). Results included the manifest refraction, uncorrected and distance corrected monocular and binocular visual acuity (VA) at distance, intermediate and near; the defocus curve; contrast sensitivity; and patient reported outcomes regarding spectacle independence, satisfaction and visual disturbances.Results: There was no statistically significant difference in the mean refraction spherical equivalent between the two lens models (p = 0.33) or between the toric and non-toric lenses (p = 0.06). Monocular VA was better at distance with the G lens and better at near with the GPlus lens (p 0.24).Conclusion: The two diffractive trifocal IOLs studied here may be used either bilaterally or contralaterally for the correction of presbyopia in cataract patients, providing excellent visual acuity with low levels of visual disturbances and high rates of overall spectacle independence. Bilateral Gemetric implantation resulted in slightly better distance and intermediate vision while contralateral implantation provided slightly better near vision. There was no apparent advantage to implanting the GPlus IOL bilaterally.Keywords: Gemetric™, Gemetric™ Plus, trifocal, presbyopia-correcting, diffractive, trifocal, Vivinex&#x212

Extreme ionization of heavy atoms in solid-density plasmas by relativistic second-harmonic laser pulses

Stripping heavy atoms in solid matter of most of their electrons requires the extreme conditions that exist in astrophysical plasmas, but are difficult to create in the laboratory1–3. Here we demonstrate solid-density gold plasmas with atoms stripped of up to 72 electrons (N-like Au72+) over large target depths. This record ionization is achieved by irradiating solid foils and near-solid-density nanowire arrays with highly relativistic (3 × 1021 W cm−2) second-harmonic femtosecond laser pulses of '10 J energy focused into a 1.6 µm spot. The short wavelength and high intensity enable the interaction to occur at a relativistic critical density4,5 of 1023 cm−3. Solid targets reach a higher average charge in 1- to 2-µm-thick layers, while the less dense nanowire plasmas are heated to much larger depths ('8 µm) by energetic electrons generated near the nanowire tips. Larger laser spots could result in solid Au plasmas ionized up to He-like.Fil: Hollinger, R.. State University of Colorado - Fort Collins; Estados UnidosFil: Wang, S.. State University of Colorado - Fort Collins; Estados UnidosFil: Wang, Y.. State University of Colorado - Fort Collins; Estados UnidosFil: Moreau, A.. State University of Colorado - Fort Collins; Estados UnidosFil: Capeluto, Maria Gabriela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Física de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Física de Buenos Aires; ArgentinaFil: Song, H.. State University of Colorado - Fort Collins; Estados UnidosFil: Rockwood, A.. State University of Colorado - Fort Collins; Estados UnidosFil: Bayarsaikhan, E.. State University of Colorado - Fort Collins; Estados UnidosFil: Kaymak, V.. Universitat Dusseldorf; AlemaniaFil: Pukhov, A.. Universitat Dusseldorf; AlemaniaFil: Shlyaptsev, V.N.. State University of Colorado - Fort Collins; Estados UnidosFil: Rocca, J.J.. State University of Colorado - Fort Collins; Estados Unido