Propuesta metodológica de intercambio electrónico de información clínica basada en estándares de telemedicina/Methodological proposal of electronic data interchange and clinical information based on telemedicine standards

El avance de las tecnologías de la información ha permitido un cambio sustancial en el desarrollo de la Salud, por lo que el uso de estándares de telemedicina como el HL7 y CEN TC 251-13606 permiten que los sistemas de información médica se comuniquen vía mensajes estandarizados facilitando el uso de los mismos. El propósito de este estudio es crear una guía metodológica de intercambio electrónico de información clínica basada en el análisis de los estándares de telemedicina HL7 y CEN TC 251- 13606 para mejorar la eficiencia de la gestión de Historias Clínicas de los pacientes. La metodología consta de 2 fases, la primera plantea el diseño e implementación del modelo de referencia de la Historia Clínica Electrónica, el mismo que define entidades necesarias en la construcción de una Historia Clínica Electrónica, en la fase 2 se define la arquitectura de la historia clínica especificando la estructura y semántica del documento mediante el lenguaje XML, el cual se utiliza en los procesos de gestión de las historias clínicas electrónicas dentro del sistema médico desarrollado. Este sistema permite control clínico a distancia facilitando la interacción médico-paciente. El sistema posee una aplicación web, una aplicación de escritorio y una plataforma hardware e- Salud. La aplicación de la metodología planteada mejora la eficiencia de la gestión de historias clínicas, puesto que el 83.32% de los médicos de la clínica consideran que se agiliza el proceso de acceso, creación e ingreso de historias clínicas y reduce recursos en el proceso de control de pacientes domiciliarios. The advance of Information and Communication Technologies has improved Health Care in last years; by providing new ways of accessing medical information. In particular, the use of telemedicine standards such as HL7 and CENTC 251-13606 allows standard communication, integration, and retrieval of electronic health records among medical systems. This article aims to create a methodological guide for the electronic exchange of clinical information based on telemedicine standards in order to improve the efficiency of electronic health records management. The proposed methodology consists of two phases: The first one states the design and implementation of the reference model of an electronic health records, which defines entities of the electronic health record. In phase 2, this methodology describes electronic health records architecture. The architecture is defined by the structure and semantics of the document using XML. In order to test the proposed methodology, a medical system was implemented that consists of a web application, desktop application, and hardware platform e- Health. This system allows the electronic exchange of clinical information to ease patient-doctor interaction. The results show 83,32% of doctors at the clinic where the system was tested agree the proposed methodology for electronic exchange improves the efficiency of electronic health records management since it speeds up the process of creation and retrieval of an electronic health records. Moreover, the system reduces resources in the control of home patients. Palabras clave: Telemedicina, HCE, HL7, CENTC 251-13606, e-Salud. Keywords: Telemedicine, EHR, HL7, CENTC 251-13606, e-Health

Phase behaviour and particle-size cutoff effects in polydisperse fluids

We report a joint simulation and theoretical study of the liquid-vapor phase behaviour of a fluid in which polydispersity in the particle size couples to the strength of the interparticle interactions. Attention is focussed on the case in which the particles diameters are distributed according to a fixed Schulz form with degree of polydispersity $\delta=14$. The coexistence properties of this model are studied using grand canonical ensemble Monte Carlo simulations and moment free energy calculations. We obtain the cloud and shadow curves as well as the daughter phase density distributions and fractional volumes along selected isothermal dilution lines. In contrast to the case of size-{\em independent} interaction strengths (N.B. Wilding, M. Fasolo and P. Sollich, J. Chem. Phys. {\bf 121}, 6887 (2004)), the cloud and shadow curves are found to be well separated, with the critical point lying significantly below the cloud curve maximum. For densities below the critical value, we observe that the phase behaviour is highly sensitive to the choice of upper cutoff on the particle size distribution. We elucidate the origins of this effect in terms of extremely pronounced fractionation effects and discuss the likely appearance of new phases in the limit of very large values of the cutoff.Comment: 12 pages, 15 figure

HEOS 1 helium observations in the solar wind

Results of alpha-particle observations performed by the European satellite HEOS 1, in the period from December 9, 1968, to April 13, 1969, and from September 6, 1969, to April 15, 1970, are presented. The average bulk velocities of protons V sub p and alpha-particles V sub alpha appear to be equal; however, due to an instrumental bias, the possibility of V sub alpha being lower than V sub p cannot be ruled out. Comparison with observations of Vela 3 and Explorer 34 satellites gives evidence of a dependence of helium abundance on the solar cycle. The problem of the stability of differences between the bulk velocities of protons and alpha-particles is investigated. The behavior of alpha-particles through interplanetary shock waves is illustrated in connection with magnetic field measurements

A monopole solution from noncommutative multi-instantons

We extend the relation between instanton and monopole solutions of the selfduality equations in SU(2) gauge theory to noncommutative space-times. Using this approach and starting from a noncommutative multi-instanton solution we construct a U(2) monopole configuration which lives in 3 dimensional ordinary space. This configuration resembles the Wu-Yang monopole and satisfies the selfduality (Bogomol'nyi) equations for a U(2) Yang-Mills-Higgs system.Comment: 19 pages; title and abstract changed, brane interpretation corrected. Version to appear in JHE

Enhanced transmission of slit arrays in an extremely thin metallic film

Horizontal resonances of slit arrays are studied. They can lead to an enhanced transmission that cannot be explained using the single-mode approximation. A new type of cavity resonance is found when the slits are narrow for a wavelength very close to the period. It can be excited for very low thicknesses. Optimization shows these structures could constitute interesting monochromatic filters

Irredundant Triangular Decomposition

Triangular decomposition is a classic, widely used and well-developed way to represent algebraic varieties with many applications. In particular, there exist sharp degree bounds for a single triangular set in terms of intrinsic data of the variety it represents, and powerful randomized algorithms for computing triangular decompositions using Hensel lifting in the zero-dimensional case and for irreducible varieties. However, in the general case, most of the algorithms computing triangular decompositions produce embedded components, which makes it impossible to directly apply the intrinsic degree bounds. This, in turn, is an obstacle for efficiently applying Hensel lifting due to the higher degrees of the output polynomials and the lower probability of success. In this paper, we give an algorithm to compute an irredundant triangular decomposition of an arbitrary algebraic set $W$ defined by a set of polynomials in C[x_1, x_2, ..., x_n]. Using this irredundant triangular decomposition, we were able to give intrinsic degree bounds for the polynomials appearing in the triangular sets and apply Hensel lifting techniques. Our decomposition algorithm is randomized, and we analyze the probability of success

Equilibrium phase behavior of polydisperse hard spheres

We calculate the phase behavior of hard spheres with size polydispersity, using accurate free energy expressions for the fluid and solid phases. Cloud and shadow curves, which determine the onset of phase coexistence, are found exactly by the moment free energy method, but we also compute the complete phase diagram, taking full account of fractionation effects. In contrast to earlier, simplified treatments we find no point of equal concentration between fluid and solid or re-entrant melting at higher densities. Rather, the fluid cloud curve continues to the largest polydispersity that we study (14%); from the equilibrium phase behavior a terminal polydispersity can thus only be defined for the solid, where we find it to be around 7%. At sufficiently large polydispersity, fractionation into several solid phases can occur, consistent with previous approximate calculations; we find in addition that coexistence of several solids with a fluid phase is also possible

High-capacity wave energy conversion by multi-floats, multi-PTO, control and prediction: generalised state-space modelling with linear optimal control and arbitrary headings

Wave energy converters with capacity similar to, or greater than, wind turbines are desirable for the supply of electricity to the grid. It is shown that this may be provided by multiple floats in a hinged raft-type configuration with multimode forcing. The case analysed has 8 floats and 4 power take off (PTO) units. Analysis is based on linear diffraction-radiation modelling, validated in wave basin experiments with a smaller number of floats. Control is desirable to improve energy capture, mainly demonstrated for point absorbers, but this has not previously been applied to such a complex problem with many freedoms. The linear hydrodynamic model in a state-space form makes it possible to implement advanced control algorithms in real time. Linear non-causal optimal control (LNOC) is applied with wave force prediction from auto-regression. For the design case with zero heading, as the configuration heads naturally into the wave direction, energy capture is improved by between 21% and 83%. The energy capture is about 62% the maximum possible from idealised analyses. Off-design, non-zero headings are also analysed to indicate how energy capture can be reduced; this is again improved by control, by several times at 90 degrees heading

Teledermatology before, during, and after the COVID-19 pandemic

La teledermatología ha avanzado en aceptación y uso en los últimos 2 meses de confinamiento por SARS-CoV-2 más que en los últimos 20 años. Su repentina popularidad –aun entre los más escépticos– ha sido el resultado de buscar una respuesta a las necesidades de los pacientes, que se han encontrado bruscamente sin atención dermatológica presencial tanto en lo privado como en lo público. Incluso aquellos servicios que incluían la modalidad asíncrona tuvieron que generar sistemas que permitieran la atención directa (direct-to-consumer) entre el especialista y el paciente. El siguiente artículo propone algunas maneras prácticas de implementación segura para agilizar y optimizar las consultas dermatológicas, aplicables no solamente a tiempos de pandemia.The use and acceptance of teledermatology increased more in the last 2 months of the recent lockdown owing to coronavirus disease 2019 than in the preceding 20 years. This sudden popularity –even among the greatest skeptics– was driven by the need to offer solutions to patients in both public and private settings who suddenly found themselves unable to access in-person dermatological care. Even departments already offering an asynchronous, store-and-forward teledermatology service were obliged to create new systems to support direct interaction between specialists and patients (the direct-to-consumer model). This article suggests some practical ways to implement TD safely and to expedite and optimize teleconsultations; these ideas are not just applicable to a pandemic situation

Coherent State Description of the Ground State in the Tavis-Cummings Model and its Quantum Phase Transitions

Quantum phase transitions and observables of interest of the ground state in the Tavis-Cummings model are analyzed, for any number of atoms, by using a tensorial product of coherent states. It is found that this "trial" state constitutes a very good approximation to the exact quantum solution, in that it globally reproduces the expectation values of the matter and field observables. These include the population and dipole moments of the two-level atoms and the squeezing parameter. Agreement in the field-matter entanglement and in the fidelity measures, of interest in quantum information theory, is also found.The analysis is carried out in all three regions defined by the separatrix which gives rise to the quantum phase transitions. It is argued that this agreement is due to the gaussian structure of the probability distributions of the constant of motion and the number of photons. The expectation values of the ground state observables are given in analytic form, and the change of the ground state structure of the system when the separatrix is crossed is also studied.Comment: 38 pages, 16 figure