Role of Computerized Physician Order Entry Usability in the Reduction of Prescribing Errors

Some hospitals have implemented computerized physician order entry (CPOE) systems to reduce the medical error rates. However, research in this area has been very limited, especially regarding the impact of CPOE use on the reduction of prescribing errors. Moreover, the past studies have dealt with the overall impact of CPOE on the reduction of broadly termed "medical errors", and they have not specified which medical errors have been reduced by CPOE. Furthermore, the majority of the past research in this field has been either qualitative or has not used robust empirical techniques. This research examined the impacts of usability of CPOE systems on the reduction of doctors' prescribing errors. Methods: One hundred and sixty-six questionnaires were used for quantitative data analyses. Since the data was not normally distributed, partial least square path modelling-as the second generation of multivariate data analyses-was applied to analyze data. Results: It was found that the ease of use of the system and information quality can significantly reduce prescribing errors. Moreover, the user interface consistency and system error prevention have a significant positive impact on the perceived ease of use. More than 50% of the respondents believed that CPOE reduces the likelihood of drug allergy, drug interaction, and drug dosing errors thus improving patient safety. Conclusions: Prescribing errors in terms of drug allergy, drug interaction, and drug dosing errors are reduced if the CPOE is not error-prone and easy to use, if the user interface is consistent, and if it provides quality information to doctors

Spatial models of cell distribution in human lumbar dorsal root ganglia

Dorsal root ganglia (DRG), which contain the somata of primary sensory neurons, have increasingly been considered as novel targets for clinical neural interfaces, both for neuroprosthetic and pain applications. Effective use of either neural recording or stimulation technologies requires an appropriate spatial position relative to the target neural element, whether axon or cell body. However, the internal three- dimensional spatial organization of human DRG neural fibers and somata has not been quantitatively described. In this study, we analyzed 202 cross- sectional images across the length of 31 human L4 and L5 DRG from 10 donors. We used a custom semi- automated graphical user interface to identify the locations of neural elements in the images and normalize the output to a consistent spatial reference for direct comparison by spinal level. By applying a recursive partitioning algorithm, we found that the highest density of cell bodies at both spinal levels could be found in the inner 85% of DRG length, the outer- most 25- 30% radially, and the dorsal- most 69- 76%. While axonal density was fairly homogeneous across the DRG length, there was a distinct low density region in the outer 7- 11% radially. These findings are consistent with previous qualitative reports of neural distribution in DRG. The quantitative measurements we provide will enable improved targeting of future neural interface technologies and DRG- focused pharmaceutical therapies, and provide a rigorous anatomical description of the bridge between the central and peripheral nervous systems.Dorsal root ganglia (DRG) are novel targets for neural interface technologies that treat neurological disorders, such as chronic pain and spinal cord injury. The three- dimensional cellular anatomy of DRG are not well- mapped, particularly in humans, limiting the effectiveness of neurotechnology. We developed a semi- automated algorithm to quantify the three- dimensional distribution of neural elements in histologically- processed tissue. We applied this algorithm to sequential NF200- stained histology slices obtained from human lumbar DRG and demonstrated that cell bodies typically congregate around the dorsal edge of the ganglia. These results are crucial to the development of safe and effective clinical neural interface technologies.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/155471/1/cne24848_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/155471/2/cne24848.pd

Electronic Prescribing Usability: Reduction of Mental Workload and Prescribing Errors Among Community Physicians

Background: Medical errors are common in hospitals, and research is always needed to find ways of reducing these. This study attempts to address three gaps in this field. First, the factors leading to the reduction of mental workload and its relationship with the reduction of prescribing errors by improving electronic prescribing (e-prescribing) usability have not been empirically examined before. Second, the past research in the field of e-prescribing usability lacks robust theoretical models. Third, there are no existing studies to examine the direct influences of user interface consistency and error prevention with the reduction of mental workload and prescribing errors. Materials and Methods: A quantitative survey method was used to collect data from 188 community physicians. The partial least squares path modeling technique was applied to analyze the data. Results: Prescribing errors were reduced by improving the information quality, user interface consistency, system ease of use, and mental workload reduction. Mental workload is reduced by ease of use, error prevention, and consistency. No significant relationships between prescribing error reduction with error prevention and also between information quality with mental workload reduction were found. Conclusions: The designers of e-prescribing should improve the error prevention and consistency of the system and make it easy to use if they wish for the system to reduce users’ mental workload. They should also improve the system information quality, ease of use, and consistency if they claim that their system reduces physicians’ prescribing errors. The system should also reduce users’ mental workload to meet this objective

Adsorpcja i hamowanie korozji stali nierdzewnej 316 przez alifatyczne związki aminowe w kwaśnym roztworze

Gravimetric and electrochemical measurements were performed to investigate the effectiveness of an aliphatic amine compound with trade name of Armohib 28. It was found that the percentage inhibition efficiency increased with the increase of the compound concentration. Polarization curves indicate that the inhibitor under investigation acts as cathodic type which retards the rate of corrosion reactions by adsorbing on to the steel surface according to Langmuir adsorption isotherm. The activation energy and thermodynamic parameters were calculated and analyzed. The data obtained from electrochemical impedance spectroscopy (EIS) were analyzed to model the corrosion inhibition process through equivalent circuit.W celu zbadania skuteczności alifatycznego związku aminowego o nazwie handlowej Armohib 28 przeprowadzono pomiary grawimetryczne i elektrochemiczne. Stwierdzono, że procentowa skuteczność hamowania wzrosła wraz ze wzrostem stężenia związku. Krzywe polaryzacji wskazują, że badany inhibitor działa jak inhibitor typu katodowego, który opóźnia szybkość reakcji korozji adsorbując na powierzchni stali według izotermy adsorpcji Langmuira. Energia aktywacji i parametry termodynamiczne zostały obliczone i analizowane. Dane uzyskane z elektrochemicznej spektroskopii impedancyjnej (EIS) wykorzystano do modelowania procesu hamowania korozji przy użyciu obwodu zastępczego

Electrochemical effects of silane pretreatments containing cerium nitrate on cathodic disbonding properties of epoxy coated steel

Published online: 27 Mar 2013.In the recent years, silane materials, because of their environmental friendly nature and ease of application have been attended as an alternative for chromate conversion coatings. Different materials were searched for improvement of the efficiency of silane formulation. In this research, pretreatment of carbon steel substrates was carried out using γ-glycidoxypropyl-trimethoxysilane (γ-GPS) as functionalized silane. Cerium nitrate as a corrosion inhibitor material was introduced into the silane material and epoxy resin was applied on the pretreated steel substrates. Effects of the pretreatment on electrochemical properties, cathodic disbondment, dry and wet adhesion strength, and surface morphology of resultant epoxy coating were investigated. Results showed that pretreatment of steel substrate with γglycidoxypropyl-trimethoxysilane (γ-GPS) doped with cerium nitrate leads to improvement of cathodic disbondment and also dry and wet adhesion of epoxy coating. Furthermore, this type of pretreatment reduced the disruption of interfacial bonds at the binder/substrate interface. Addition of 2 wt% cerium nitrate into the silane formulation led to the maximum efficiency of resultant coating.Sadeq Hooshmand Zaferania, Mahmood Peikaria, Davood Zaareib and Iman Danaei

Clustering Analysis for Semi-supervised Learning Improves Classification Performance of Digital Pathology

This manuscript was presented at the MLMI workshop, MICCAI2015 in Munich, GermanyPurpose: Completely labeled datasets of pathology slides are often difficult and time consuming to obtain. Semi-supervised learning methods are able to learn reliable models from small number of labeled instances and large quantities of unlabeled data. In this paper, we explored the potential of clustering analysis for semi-supervised support vector machine (SVM) classifier. Method: A clustering analysis method was proposed to find regions of high density prior to finding the decision boundary using a supervised SVM and was compared with another stateof-the-art semi-supervised technique. Different percentages of labeled instances were used to train supervised and semi-supervised SVM learners from an image dataset generated from 50 whole-mount images (8 patients) of breast specimen. Their cross-validated classification performances were compared with each other using the area under the ROC curve measure. Result: Our proposed clustering analysis for semisupervised learning was able to produce a reliable classification model from small amounts of labeled data. Comparing the proposed method in this study with a well-known implementation of semi-supervised SVM, our method performed much faster and produced better results.This research is funded by Canadian Cancer Society (grant # 703006). Reference

Maternal serum Dehydroepiandrosterone Sulfate levels and the efficiency of labor

To evaluate the maternal serum dehydroepiandrosterone (DHEA) sulfate levels as a factor influencing labor ‘efficiency’ at term and unsuccessful labor induction. This is a prospective study. In this study the mean (± standard error) maternal serum DHEA sulfate levels of 90 singleton pregnant women in 3 groups with spontaneous labor, need for augmentation and need for induction were compared.Pregnancies complicated by diabetes mellitus, hypertension, fetal growth restriction, tobacco consumption, corticosteriod use or chorioamintis were excluded. Bishop score of all cases was less than 5. Serum DHEA sulfate levels were measured by radioimmunoassay. Dehydroepiandrosteone sulfate levels and other obstetric variables were correlated retrospectively with the clinically determined requirements of oxytocin augmentation of labor, and the outcome of each induction attempt. The t-test, Variance analysis Kruskal –Wallis test, Mann-Whitney test, chi-square (X2) distribution, linear correlation and regression were used for statistical analysis. P<0.05 was considered statistically significant. This study showed that the mean (± standard error) maternal serum DHEA sulfate level was not significantly higher in women who progressed spontaneously through labor (n=30) than in those who required augmentation (n=30) (60.78±4.22 versus 70.38±5.84). No significant difference was found between the mean DHEA sulfate levels of spontaneous labor group (n=30) and cases who had prolonged latent phase (n=21) (66.78±4.22 versus 67.02±7.13) or prolonged active phase disorders (n=9) (60.78±4.22 µg/dl versus 78.22±10.23 µg/dl p=0.25)This study showed that the mean maternal serum DEHA sulfate level was significantly higher in women with spontaneous labor (n=30) than in those who needed induction (n=30) (60.78±4.22 µg/dl versus 39.49±4.56 µg/dl, respectively; p=0.001).In the group who needed induction, the mean DHEA sulfate level waa significantly higher in women who progressed to active labor (n=18) than in whom attempts were unsuccessful (n=12). (48.83±6.48 µg/dl versus 26.96±5.10, respectively p=0.035). in the group who were induced, the main cause of C/S was failure of labor progression (77.8%).The mean DHEA level was significantly higher in women with spontaneous labor (n=28) than in those requiring cesarean delivery (n=7) (61.01±4.22 µg/dl versus 24.67±7.06, respectively; p=0.001). The maternal serum DHEA sulfate level did not correlate significantly with cervical Bishop score on admission (r=0.02, p=0.78). DHEA sulfate may be an important factor iin successful labor induction, and in efficient labo

Using silane films to produce an alternative for chromate conversion coatings

Preprint available online: October 17, 2012Recently, many efforts have been made to find environmentally friendly substitutes for carcinogen Cr⁶⁺ in the pretreatments of metal substrates. Silane films are one of the important candidates for this purpose. The use of silane films on metallic substrates provides corrosion protection as a result of excellent adhesion and good barrier properties. Their corrosion protection can be improved by adding suitable dopants. There are various methods for applying these films on the metal substrates (sol-gel dip coatings and electrodeposited coating). In this review, several main researches in the field of silane films have been indicated and their results have been analyzed.S.H. Zaferani, M. Peikari, D. Zaarei, I. Danaee, J.M. Fakhraei, and M. Mohammad