DOES INFORMATION TECHNOLOGY INCREASE OR DECREASE HOSPITALS’ RISK? AN EMPIRICAL EXAMINATION OF COMPUTERIZED PHYSICIAN ORDER ENTRY AND MALPRACTICE CLAIMS

Information technology (IT) has significant potential to improve the quality of patient care, to lower costs, and to improve efficiency. However, IT leaves an electronic paper trail that may demonstrate negligence and thereby create legal risk. Emerging research suggests that this fear of electronic discovery is delaying IT adoption, thereby perpetuating inefficiencies. Is this fear founded? If it is, then policy changes are needed to remove this obstacle to streamlining the healthcare system. If not, then healthcare providers should move ahead to realize IT benefits without being stymied by irrational fears. We examined the relationship between Computerized Physician Order Entry (CPOE) and malpractice claims against hospitals in Florida between 1999 and 2006. CPOE reduces the number, severity, and disposition time of claims, while having no effect on the amounts paid. This indicates that CPOE reduces hospital legal risk, suggesting that fears of increased legal risk due to IT are unfounded

Estimating heritability of drug-induced liver injury from common variants and implications for future study designs

Recent genome-wide association studies identified certain human leukocyote antigen (HLA) alleles as the major risk factors of drug-induced liver injuries (DILI). While these alleles often cause large relative risk, their predictive values are quite low due to low prevalence of idiosyncratic DILI. Finding additional risk factors is important for precision medicine. However, optimal design of further genetic studies is hindered by uncertain overall heritability of DILI. This is a common problem for low-prevalence pharmacological traits, since it is difficult to obtain clinical outcome data in families. Here we estimated the heritability (h2) of DILI from case-control genome-wide single nucleotide polymorphism data using a method based on random effect models. We estimated the proportion of h2 captured by common SNPs for DILI to be between 0.3 and 0.5. For co-amoxiclav induced DILI, chromosome 6 explained part of the heritability, indicating additional contributions from common variants yet to be found. We performed simulations to assess the robustness of the h2 estimate with limited sample size under low prevelance, a condition typical to studies on idiosyncratic pharmacological traits. Our findings suggest that common variants outside of HLA contribute to DILI susceptability; therefore, it is valuable to conduct further GWAS with expanded case collection

Cancer Genetic Counselor Information Needs for Risk Communication: A Qualitative Evaluation of Interview Transcripts

Personalized medicine is a model of healthcare that is predictive, personalized, preventive and participatory (“P4 Medicine”). Genetic counselors are an ideal group to study when designing tools to support cancer P4 Medicine activities more broadly. The goal for this work was to gain a better understanding of the information cancer genetic counselors seek from their patients to facilitate effective information exchange for discussing risk. This was an analysis of a qualitative data set from interviews of eight cancer genetic counselors, recruited from three institutions. Genetic counselors at each site were interviewed using a semi-structured, open-ended questionnaire. A selective coding approach was used to determine major themes associated with genetic counseling information needs for communicating risk. We generated a model for understanding categories of genetic counseling information needs to support risk communication activities. Common activities for risk communication included risk assessment and tailoring communication. Categories of information needs included: (a) clinical patient characteristics, (b) social and cognitive patient characteristics and (c) patient motivation and goals for the genetic counseling session. A logical next step is for this model to inform the design of software systems for pre-visit patient planning and delivering just-in-time educational information to facilitate cancer risk communication activities

Measurement of postmortem outflow facility using iPerfusion.

The key risk factor for glaucoma is elevation of intraocular pressure (IOP) and alleviating it is the only effective therapeutic approach to inhibit further vision loss. IOP is regulated by the flow of aqueous humour across resistive tissues, and a reduction in outflow facility, is responsible for the IOP elevation in glaucoma. Measurement of outflow facility is therefore important when investigating the pathophysiology of glaucoma and testing candidate treatments for lowering IOP. Due to similar anatomy and response to pharmacological treatments, mouse eyes are a common model of human aqueous humour dynamics. The ex vivo preparation, in which an enucleated mouse eye is mounted in a temperature controlled bath and cannulated, has been well characterised and is widely used. The postmortem in situ model, in which the eyes are perfused within the cadaver, has received relatively little attention. In this study, we investigate the postmortem in situ model using the iPerfusion system, with a particular focus on i) the presence or absence of pressure-independent flow, ii) the effect of evaporation on measured flow rates and iii) the magnitude and pressure dependence of outflow facility and how these properties are affected by postmortem changes. Measurements immediately after cannulation and following multi-pressure facility measurement demonstrated negligible pressure-independent flow in postmortem eyes, in contrast to assumptions made in previous studies. Using a humidity chamber, we investigated whether the humidity of the surrounding air would influence measured flow rates. We found that at room levels of humidity, evaporation of saline droplets on the eye resulted in artefactual flow rates with a magnitude comparable to outflow, which were eliminated by a high relative humidity (>85%) environment. Average postmortem outflow facility was ∼4 nl/min/mmHg, similar to values observed ex vivo, irrespective of whether a postmortem delay was introduced prior to cannulation. The intra-animal variability of measured outflow facility values was also reduced relative to previous ex vivo data. The pressure-dependence of outflow facility was reduced in the postmortem relative to ex vivo model, and practically eliminated when eyes were cannulated >40 min after euthanisation. Overall, our results indicate that the moderately increased technical complexity associated with postmortem perfusion provides reduced variability and reduced pressure-dependence in outflow facility, when experimental conditions are properly controlled

GaMnAs-based hybrid multiferroic memory device

A rapidly developing field of spintronics is based on the premise that substituting charge with spin as a carrier of information can lead to new devices with lower power consumption, non-volatility and high operational speed. Despite efficient magnetization detection, magnetization manipulation is primarily performed by current-generated local magnetic fields and is very inefficient. Here we report a novel non-volatile hybrid multiferroic memory cell with electrostatic control of magnetization based on strain-coupled GaMnAs ferromagnetic semiconductor and a piezoelectric material. We use the crystalline anisotropy of GaMnAs to store information in the orientation of the magnetization along one of the two easy axes, which is monitored via transverse anisotropic magnetoresistance. The magnetization orientation is switched by applying voltage to the piezoelectric material and tuning magnetic anisotropy of GaMnAs via the resulting stress field.Comment: 4 pages, 5 figure

Evidence for reversible control of magnetization in a ferromagnetic material via spin-orbit magnetic field

Conventional computer electronics creates a dichotomy between how information is processed and how it is stored. Silicon chips process information by controlling the flow of charge through a network of logic gates. This information is then stored, most commonly, by encoding it in the orientation of magnetic domains of a computer hard disk. The key obstacle to a more intimate integration of magnetic materials into devices and circuit processing information is a lack of efficient means to control their magnetization. This is usually achieved with an external magnetic field or by the injection of spin-polarized currents. The latter can be significantly enhanced in materials whose ferromagnetic properties are mediated by charge carriers. Among these materials, conductors lacking spatial inversion symmetry couple charge currents to spin by intrinsic spin-orbit (SO) interactions, inducing nonequilibrium spin polarization tunable by local electric fields. Here we show that magnetization of a ferromagnet can be reversibly manipulated by the SO-induced polarization of carrier spins generated by unpolarized currents. Specifically, we demonstrate domain rotation and hysteretic switching of magnetization between two orthogonal easy axes in a model ferromagnetic semiconductor.Comment: 10 pages including supplemental materia

A theory-grounded framework of Open Source Software adoption in SMEs

This is a post-peer-review, pre-copyedit version of an article published in European Journal of Information Systems. The definitive publisher-authenticated version Macredie, RD and Mijinyawa, K (2011), "A theory-grounded framework of Open Source Software adoption in SMEs", European Journal of Informations Systems, 20(2), 237-250 is available online at: http://www.palgrave-journals.com/ejis/journal/v20/n2/abs/ejis201060a.html.The increasing popularity and use of Open Source Software (OSS) has led to significant interest from research communities and enterprise practitioners, notably in the small business sector where this type of software offers particular benefits given the financial and human capital constraints faced. However, there has been little focus on developing valid frameworks that enable critical evaluation and common understanding of factors influencing OSS adoption. This paper seeks to address this shortcoming by presenting a theory-grounded framework for exploring these factors and explaining their influence on OSS adoption, with the context of study being small- to medium-sized Information Technology (IT) businesses in the U.K. The framework has implications for this type of business – and, we will suggest, more widely – as a frame of reference for understanding, and as tool for evaluating benefits and challenges in, OSS adoption. It also offers researchers a structured way of investigating adoption issues and a base from which to develop models of OSS adoption. The study reported in this paper used the Decomposed Theory of Planned Behaviour (DTPB) as a basis for the research propositions, with the aim of: (i) developing a framework of empirical factors that influence OSS adoption; and (ii) appraising it through case study evaluation with 10 U.K. Small- to medium-sized enterprises in the IT sector. The demonstration of the capabilities of the framework suggests that it is able to provide a reliable explanation of the complex and subjective factors that influence attitudes, subjective norms and control over the use of OSS. The paper further argues that the DTPB proved useful in this research area and that it can provide a variety of situation-specific insights related to factors that influence the adoption of OSS

In Vitro Models for Glaucoma Research: Effects of Hydrostatic Pressure

PURPOSE. The response of cells (e.g., optic nerve head [ONH] cells) to mechanical stress is important in glaucoma. Studies have reported the biological effects of hydrostatic pressure on ONH cells cultured on a rigid substrate. An apparatus, designed to independently vary hydrostatic pressure and gas tension (including oxygen tension) in culture medium, was used to evaluate the effects of pressure and tension on cell migration, shape, and α-tubulin architecture in a transformed cell line (DITNC1 rat cortical astrocytes). METHODS. During the assay period, cells were exposed to one of four experimental configurations: (1) control pressure and control gas tension; (2) high-pressure (7.4 mm Hg) and reduced gas tension; (3) control pressure and reduced gas tension; and (4) high-pressure and control gas tension. RESULTS. Calculations suggested that the cells in configurations 2 and 3 were hypoxic, as confirmed by direct measurements in configuration 2. No effects of hydrostatic pressure were observed on cell migration or α-tubulin architecture. However, cells cultured under low gas tension (configurations 2 and 3) showed increased migration at 48 and 72 hours (P \u3c 0.05). CONCLUSIONS. A hydrostatic pressure of 7.4 mm Hg has no effect on DITNC1 astrocytes cultured on rigid coverslips, whereas hypoxia associated with a fluid column creating this pressure does. These results differ from those in a previous report, the results of which may be explained by altered gas tensions in the culture medium. Steps are recommended for control of secondary effects when testing the effect of pressure on cultured cells