Towards the interoperability of computerised guidelines and electronic health records: an experiment with openEHR archetypes and a chronic heart failure guideline

Clinical guidelines contain recommendations based on the best empirical evidence available at the moment. There is a wide consensus about the benefits of guidelines and about the fact that they should be deployed through clinical information systems, making them available during clinical consultations. However, one of the main obstacles to this integration is the interaction with the electronic healthrecord system. With the aim of solving the interoperability problems of guideline systems, we have investigated the utilisation of the openEHR standardisation proposal in the context of one of the existing guideline representation languages. Concretely, we have designed a collection of archetypes to be used within a chronic heart failure guideline. The main contribution of our work is the utilisation of openEHR archetypes in the framework of guideline representation languages. Other contributions include both the concrete set of archetypes that we have selected and the methodological approach that we have followed to obtain itThis work has been supported by Fundaci´o Caixa Castell´o-Bancaixa, through the research project P11B2009-3

Fluctuations of water near extended hydrophobic and hydrophilic surfaces

We use molecular dynamics simulations of the SPC-E model of liquid water to derive probability distributions for water density fluctuations in probe volumes of different shapes and sizes, both in the bulk as well as near hydrophobic and hydrophilic surfaces. To obtain our results, we introduce a biased sampling of coarse-grained densities, which in turn biases the actual solvent density. The technique is easily combined with molecular dynamics integration algorithms. Our principal result is that the probability for density fluctuations of water near a hydrophobic surface, with or without surface-water attractions, is akin to density fluctuations at the water-vapor interface. Specifically, the probability of density depletion near the surface is significantly larger than that in bulk. In contrast, we find that the statistics of water density fluctuations near a model hydrophilic surface are similar to that in the bulk

Modeling healthcare authorization and claim submissions using the openEHR dual-model approach

<p>Abstract</p> <p>Background</p> <p>The TISS standard is a set of mandatory forms and electronic messages for healthcare authorization and claim submissions among healthcare plans and providers in Brazil. It is not based on formal models as the new generation of health informatics standards suggests. The objective of this paper is to model the TISS in terms of the openEHR archetype-based approach and integrate it into a patient-centered EHR architecture.</p> <p>Methods</p> <p>Three approaches were adopted to model TISS. In the first approach, a set of archetypes was designed using ENTRY subclasses. In the second one, a set of archetypes was designed using exclusively ADMIN_ENTRY and CLUSTERs as their root classes. In the third approach, the openEHR ADMIN_ENTRY is extended with classes designed for authorization and claim submissions, and an ISM_TRANSITION attribute is added to the COMPOSITION class. Another set of archetypes was designed based on this model. For all three approaches, templates were designed to represent the TISS forms.</p> <p>Results</p> <p>The archetypes based on the openEHR RM (Reference Model) can represent all TISS data structures. The extended model adds subclasses and an attribute to the COMPOSITION class to represent information on authorization and claim submissions. The archetypes based on all three approaches have similar structures, although rooted in different classes. The extended openEHR RM model is more semantically aligned with the concepts involved in a claim submission, but may disrupt interoperability with other systems and the current tools must be adapted to deal with it.</p> <p>Conclusions</p> <p>Modeling the TISS standard by means of the openEHR approach makes it aligned with ISO recommendations and provides a solid foundation on which the TISS can evolve. Although there are few administrative archetypes available, the openEHR RM is expressive enough to represent the TISS standard. This paper focuses on the TISS but its results may be extended to other billing processes. A complete communication architecture to simulate the exchange of TISS data between systems according to the openEHR approach still needs to be designed and implemented.</p

Universal trend of the information entropy of a fermion in a mean field

We calculate the information entropy of single-particle states in position-space $S_{r}$ and momentum-space $S_{k}$ for a nucleon in a nucleus, a $\Lambda$ particle in a hypernucleus and an electron in an atomic cluster. It is seen that $S_{r}$ and $S_{k}$ obey the same approximate functional form as functions of the number of particles, $S_{r}$ ({\rm or} $S_{k}) = a+bN^{1/3}$ in all of the above many-body systems in position- and momentum- space separately. The net information content $S_{r}+S_{k}$ is a slowly varying function of $N$ of the same form as above. The entropy sum $S_{r}+S_{k}$ is invariant to uniform scaling of coordinates and a characteristic of the single-particle states of a specific system. The order of single-particle states according to $S_r +S_k$ is the same as their classification according to energy keeping the quantum number $n$ constant. The spin-orbit splitting is reproduced correctly. It is also seen that $S_{r}+S_{k}$ enhances with excitation of a fermion in a quantum-mechanical system. Finally, we establish a relationship of $S_r +S_k$ with the energy of the corresponding single-particle state i.e. $S_r +S_k = k \ln (\mu E +\nu)$. This relation holds for all the systems under consideration.Comment: 9 pages, latex, 6 figure

The NIKA2 instrument, a dual-band kilopixel KID array for millimetric astronomy

NIKA2 (New IRAM KID Array 2) is a camera dedicated to millimeter wave astronomy based upon kilopixel arrays of Kinetic Inductance Detectors (KID). The pathfinder instrument, NIKA, has already shown state-of-the-art detector performance. NIKA2 builds upon this experience but goes one step further, increasing the total pixel count by a factor $\sim$10 while maintaining the same per pixel performance. For the next decade, this camera will be the resident photometric instrument of the Institut de Radio Astronomie Millimetrique (IRAM) 30m telescope in Sierra Nevada (Spain). In this paper we give an overview of the main components of NIKA2, and describe the achieved detector performance. The camera has been permanently installed at the IRAM 30m telescope in October 2015. It will be made accessible to the scientific community at the end of 2016, after a one-year commissioning period. When this happens, NIKA2 will become a fundamental tool for astronomers worldwide.Comment: Proceedings of the 16th Low Temperature Detectors workshop. To be published in the Journal of Low Temperature Physics. 8 pages, 4 figures, 1 tabl

Prophylactic properties of a Leishmania-specific hypothetical protein in a murine model of visceral leishmaniasis

In this work, the effect of vaccination of a newly described Leishmania infantum antigenic protein has been studied in BALB/c mice infected with this parasite species. The LiHyD protein was characterized after a proteomic screening performed with the sera from dogs suffering visceral leishmaniasis (VL). Its recombinant version was expressed, purified and administered to BALB/c mice in combination with saponin. As a result of vaccination and 10 weeks after challenge using an infective dose of L. infantum stationary promastigotes, vaccinated mice showed lower parasite burdens in different organs (liver, spleen, bone marrow and footpads' draining lymph nodes) than mice inoculated with the adjuvant alone or the vaccine diluent. Protected mice showed anti-Leishmania IgG2a antibodies and a predominant IL-12-driven IFN-γ production (mainly produced by CD4 T cells) against parasite proteins, whereas unprotected controls showed anti-Leishmania IgG1 antibodies and parasite-mediated IL-4 and IL-10 responses. Vaccinated mice showed an anti-LiHyD IgG2a humoral response, and their spleen cells were able to secrete LiHyD-specific IFN-γ, IL-12 and GM-CSF cytokines before and after infection. The protection was correlated with the Leishmania-specific production on nitric oxide. Altogether, the results indicate that the new LiHyD protein could be considered in vaccine formulations against VL.Instituto Nacional de Ci^encia e Tecnologia em Nano-biofarmac^eutica (INCT-NanoBiofar), FAPEMIG (CBB-APQ-00819-12 and CBB-APQ-01778-2014) and CNPq (APQ-482976/2012-8, APQ-488237/2013-0 and APQ-467640/2014-9). In addition, this study was partially funded by the Spanish grant from Ministerio de Economía y Competitividad-FEDER (FIS PI14/00366 from the Instituto de Salud Carlos III)Peer Reviewe

Magnetic anisotropy, first-order-like metamagnetic transitions and large negative magnetoresistance in the single crystal of Gd2_{2}PdSi3_3

Electrical resistivity ($\rho$), magnetoresistance (MR), magnetization, thermopower and Hall effect measurements on the single crystal Gd$_{2}$PdSi$_3$, crystallizing in an AlB$_2$-derived hexagonal structure are reported. The well-defined minimum in $\rho$ at a temperature above N\'eel temperature (T$_N$= 21 K) and large negative MR below $\sim$ 3T$_N$, reported earlier for the polycrystals, are reproducible even in single crystals. Such features are generally uncharacteristic of Gd alloys. In addition, we also found interesting features in other data, e.g., two-step first-order-like metamagnetic transitions for the magnetic field along [0001] direction. The alloy exhibits anisotropy in all these properties, though Gd is a S-state ion.Comment: RevTeX, 5 pages, 6 encapsulated postscript figures; scheduled to be published in Phy. Rev. B (01 November 1999, B1