Developing HL7 CDA-Based Data Warehouse for the Use of Electronic Health Record Data for Secondary Purposes

Background The growing availability of clinical and administrative data collected in electronic health records (EHRs) have led researchers and policy makers to implement data warehouses to improve the reuse of EHR data for secondary purposes. This approach can take advantages from a unique source of information that collects data from providers across multiple organizations. Moreover, the development of a data warehouse benefits from the standards adopted to exchange data provided by heterogeneous systems. Objective This article aims to design and implement a conceptual framework that semiautomatically extracts information collected in Health Level 7 Clinical Document Architecture (CDA) documents stored in an EHR and transforms them to be loaded in a target data warehouse. Results The solution adopted in this article supports the integration of the EHR as an operational data store in a data warehouse infrastructure. Moreover, data structure of EHR clinical documents and the data warehouse modeling schemas are analyzed to define a semiautomatic framework that maps the primitives of the CDA with the concepts of the dimensional model. The case study successfully tests this approach. Conclusion The proposed solution guarantees data quality using structured documents already integrated in a large-scale infrastructure, with a timely updated information flow. It ensures data integrity and consistency and has the advantage to be based on a sample size that covers a broad target population. Moreover, the use of CDAs simplifies the definition of extract, transform, and load tools through the adoption of a conceptual framework that load the information stored in the CDA in the data warehouse

Synthetic antigen-conjugated DNA systems for antibody detection and characterization

Antibodies are among the most relevant biomolecular targetsfordiagnostic and clinical applications. In this Perspective, we providea critical overview of recent research efforts focused on the developmentand characterization of devices, switches, and reactions based onthe use of synthetic antigen-conjugated DNA strands designed to beresponsive to specific antibodies. These systems can find applicationsin sensing, drug-delivery, and antibody-antigen binding characterization.The examples described here demonstrate how the programmability andchemical versatility of synthetic nucleic acids can be used to createinnovative analytical tools and target-responsive systems with promisingpotentials

A system of concepts to support the integration of Health and social care and assistive domotics services: the Health@Home project.

The main objective of this work is to define a common shared conceptual model that describes the health care environment using the ContSys standard, harmonizing it with the social care and assistive domotics concepts. The development of this model supports the integration of services, the interoperability among systems and the continuity of care across domains.Starting from the identification and extraction of the portion of the ContSys model suitable for the healthcare part, the article provides the methodology adopted to extend it with social and home automation concepts and to integrate them in a unique framework that supports the continuity of care.The integrated model defined in this paper has been adopted in the design phase of an interoperable open platform, called Health@Home, that organizes the provision of a set of health, social and home automation integrated services provided at home.Our model is a starting point to analyze the various determinants of wellbeing able to guarantee a high-level individual's quality of life. At the moment the Health@Home system is at the implementation phase

A medical device domain analysis model based on HL7 RIM

Clinical investigations (CIs) are carried out to demonstrate safety and efficacy of new Medical Devices (MDs). The presence of many stakeholders participating in CIs makes it necessary to develop a common standard language to achieve semantic interoperability among systems and organizations. In Italy the National Research Council is carrying out a project supported by Ministry of Health aiming to develop an information system (MEDIS) that manages MD clinical investigations. In order to develop a flexible and interoperable system, MEDIS design has been based on the application of HL7 (Health Level 7) v.3 standards. This paper presents the results of the MEDIS design: the MD DAM based on HL7 RIM

Quantum sensors for dynamical tracking of chemical processes

Quantum photonics has demonstrated its potential for enhanced sensing. Current sources of quantum light states tailored to measuring, allow to monitor phenomena evolving on time scales of the order of the second. These are characteristic of product accumulation in chemical reactions of technologically interest, in particular those involving chiral compounds. Here we adopt a quantum multiparameter approach to investigate the dynamic process of sucrose acid hydrolysis as a test bed for such applications. The estimation is made robust by monitoring different parameters at once

Multi-stakeholder collaboration in urban freight consolidation schemes: Drivers and barriers to implementation

© 2018 The Author(s). Published by VGTU Press. Due to the motivations of climate change, the health impacts of poor air quality, and the importance of cities for economic growth, transport policy at all levels of governance places emphasis on reducing and managing urban traffic and congestion. Whilst the majority of urban traffic is created by personal travel, freight vehicles make a relatively large contribution per vehicle to congestion, pollution and severe accidents. The European Commission (EC 2011) estimates that 6% of all EU transport carbon emissions are from urban freight. For these reasons, a well-structured portfolio of measures and policies oriented towards more sustainable and efficient management of supply chain activities carried out in urban areas is needed, in order to reduce negative externalities related to urban mobility and improve economic performance. In recent years, there has been enthusiasm amongst commentators that shared-resource economic models can both create new commercial opportunities and address policy problems, including in the transport sector. Within the city logistics subsector, this new model is exemplified by the emergence of Urban freight Consolidation Centres (UCCs). UCCs replace multiple ‘last-mile’ delivery movements, many of which involving small consignments, by a common receiving point (the consolidation centre), normally on the periphery of a city, with the final part of the delivery being shared by the consignments in a small freight vehicle. Such arrangements can represent a good compromise between the needs of city centre businesses and their customers on the one hand (i.e. high availability of a range of goods) and local and global sustainability objectives on the other. At the same time, by sharing logistics facilities and delivery vehicles, UCCs offer added-value services to both urban economic actors, such as retailers, and network logistics providers. However, UCCs add to the complexity of logistics chains, requiring additional contracts, communications and movement stages. These arrangements also introduce additional actors within the supply of delivery services, notably local authorities present as promoters and funders, rather than simply as regulators, companies specialised in the UCC operation, and companies, which provide specialist technologies, such as electric delivery vehicles. UCCs therefore also represent an example of multi-stakeholder collaboration. Drawing on the results of a 2013 survey in Bristol (United Kingdom) and a further survey carried out in 2015 in Cagliari (Italy), the present paper will provide an in-depth comparison of the differences in the perceptions of urban freight users and stakeholders towards UCCs. Retailers involved in the survey carried out in Bristol showed high satisfaction with the delivery service provided by the UCC. Different topic areas (e.g. timeliness, reliability, safety) are examined through analyses of both qualitative and quantitative data. The survey carried out in Cagliari investigated the inclination of potential users to join a UCC scheme. The comparison between the two cities considers factors such as the nature of business holding (e.g. SME versus multiple retailers), operational practices (e.g. pattern of deliveries) and operating subsector (e.g. food versus no food). An analysis on the barriers to the implementation of UCCs in Bristol and in Cagliari is provided at the end of the paper

La evolución del precio de las materias primas durante la primera década del siglo XXI. Expectativas para América Latina después de la crisis financiera del 2008

Según la teoría clásica de la dependencia1 desarrollada en América Latina durante la década de los sesenta, y otras teorías complementarias con la diferencia de la relación de la distribución del ingreso entre el norte y el sur, las crisis económicas van aparejadas con una caída del precio de las materias primas, acentuando así las diferencias en los términos de intercambio que favorecen enormemente a las economías centrales de producción industrial y alto valor agregado. La variación de precios de los productos básicos es importante para la economía y el mercado mundiales debido a su peso en las canastas de consumo, y a su uso como insumos básicos en buena parte de los procesos de producción industrial. En el caso de la mayoría de países de América Latina esta importancia se hace más evidente porque, por un lado, la región históricamente se ha caracterizado por una canasta exportadora bastante concentrada en bienes primarios

Towards a clinical trial ontology using a concern-oriented approach

Not yet availablePer ridurre i costi e migliorare la qualita\u27 della ricerca nei trial clinici (CT) e\u27 necessario un approccio piu\u27 sistematico all\u27automazione dei CT per rinforzare l\u27interoperabilita\u27 a vari livelli del processo di ricerca. Per questo scopo e\u27 stato sviluppato un modello concettuale di CT. Alla base di ogni approccio di modellizzazione ci sono criteri di partizione che ci permettono di dominare la complessita\u27 dell\u27universo da modellare. In questo rapporto noi introduciamo un metodo originale di analisi basato sui concern degli stakeholder per partizionare il domino concettuale dei CT in sotto-domini orientati agli stakeholder. Le rappresentazioni mentali degli stakeholder relative a ciascun concern sono identificati come cluster di concetti collegati ad altri concetti. Noi consideriamo ciascun cluster come una base razionale per il relativo concern. I concetti trovati nelle basi razionali popolano l\u27universo del discorso specifico per ogni stakeholder e compongono il vocabolario degli stakeholder. Alcuni concetti sono condivisi con altri stakeholder, mentre altri sono specifici di uno stakehoder; alcuni concetti sono specifici dei CT, mentre altri sono concetti medici o generali. In questo modo un\u27ontologia orientata ai concern per i CT puo\u27 essere creata. Il metodo e\u27 illustrato utilizzando i criteri di selezione dei soggetti, una componente di un progetto di CT, ma puo\u27 essere usato per ogni altra componente del protocollo del CT. La tassonomia del vocabolario dei concetti dei CT e la rete delle relative basi razionali ci fornisce una struttura possibile per lo sviluppo del software specialmente se si adotta una soluzione basata su architetture orientate ai servizi

Different polyubiquitinated bodies in human dendritic cells: IL-4 causes PaCS during differentiation while LPS or IFNα induces DALIS during maturation

Two types of polyubiquitin-reactive cytoplasmic bodies, particulate cytoplasmic structures (PaCS) and dendritic cell (DC) aggresome-like induced structures (DALIS), were analyzed by electron microscopy, immunocytochemistry, immunoblotting, and flow cytometry in DC obtained from human blood monocytes incubated with GM-CSF plus IL-4 (IL4-DC), GM-CSF plus IFNα (IFN-DC), or GM-CSF alone (GM-DC), with or without LPS maturation. PaCS developed as monomorphic aggregates of proteasome-reactive barrel-like particles only in ribosomes-rich cytoplasmic areas of differentiating IL4-DC. In contrast, DALIS formed as vesicular bodies storing K63-linked ubiquitinated proteins by coalescence of increased endosomal structures, in IFN-DC or after LPS maturation of GM-DC. DALIS-forming cells showed incomplete morphological and functional DC-type differentiation when compared to PaCS-forming IL4-DC. PaCS and DALIS may have different function as well as different origin and cytochemistry. DALIS may be a transient accumulation site of potentially antigenic polyubiquitinated proteins during their processing and presentation. PaCS are found under physiologic or pathologic conditions associated with increased/deranged protein synthesis and increased ubiquitin– proteasome activity. Given its high heat-shock protein content PaCS may work as a quality control structure for newly synthesized, cytosolic proteins. This comparative analysis suggests that PaCS and DALIS have distinctive roles in DC