Clinical Decision Support Functions and Digitalization of Clinical Documents of Electronic Medical Record Systems

Objectives The objective of this study was to investigate the clinical decision support (CDS) functions and digitalization of clinical documents of Electronic Medical Record (EMR) systems in Korea. This exploratory study was conducted focusing on current status of EMR systems. Methods This study used a nationwide survey on EMR systems conducted from July 25, 2018 to September 30, 2018 in Korea. The unit of analysis was hospitals. Respondents of the survey were mainly medical recorders or staff members in departments of health insurance claims or information technology. This study analyzed data acquired from 132 hospitals that participated in the survey. Results This study found that approximately 80% of clinical documents were digitalized in both general and small hospitals. The percentages of general and small hospitals with 100% paperless medical charts were 33.7% and 38.2%, respectively. The EMR systems of general hospitals are more likely to have CDS functions of warnings regarding drug dosage, reminders of clinical schedules, and clinical guidelines compared to those of small hospitals; this difference was statistically significant. For the lists of digitalized clinical documents, almost 93% of EMR systems in general hospitals have the inpatient progress note, operation records, and discharge summary notes digitalized. Conclusions EMRs are becoming increasingly important. This study found that the functions and digital documentation of EMR systems still have a large gap, which should be improved and made more sophisticated. We hope that the results of this study will contribute to the development of more sophisticated EMR systems

Analysis of Platforms and Functions of Mobile-Based Personal Health Record Systems

ObjectivesLittle is known about the platforms and functionalities of mobile-based personal health record (PHR) applications. The objective of this study was to investigate these two features of PHR systems.MethodsThe unit of analysis was general hospitals with more than 100 beds. This study was based on a PHR survey conducted from May 1 to June 30, 2020 and the National Health Insurance administrative data as of March 31, 2020. The study considered the platform, Android and iPhone operation system (iOS), and types of functionalities of PHR systems. Among the 316 target hospitals, 103 hospitals had adopted PHR systems. A logistic regression analysis was used.ResultsThis study found that 103 hospitals had adopted mobile-based PHR systems for their patients. Sixty-four hospitals (62.1%) were adopting both Android and iOS, but 36 (35.0%) and 3 (2.9%) hospitals were adopting Android only or iOS only, respectively. The PHR systems of hospitals adopting both platforms were more likely to have functions for viewing prescriptions, clinical diagnostic test results, and upcoming appointment status compared to those adopting a single platform (p \u3c 0.001). The number of beds (odds ratio [OR] = 1.004; confidence interval [CI], 1.001–1.007; p = 0.0029) and the number of computed tomography systems (CTs) per 100 beds (OR = 6.350; CI, 1.006–40.084; p = 0.0493) were significantly associated with the adoption of both platforms.ConclusionsMore than 60% of hospitals had adopted both Android and iOS platforms for their patients in Korea. Hospitals adopting both platforms had additional functionalities and significant association with the number of beds and CTs

Structure and Magnetic Fields in the Precessing Jet System SS 433 II. Intrinsic Brightness of the Jets

Deep Very Large Array imaging of the binary X-ray source SS 433, sometimes classified as a microquasar, has been used to study the intrinsic brightness distribution and evolution of its radio jets. The intrinsic brightness of the jets as a function of age at emission of the jet material tau is recovered by removal of the Doppler boosting and projection effects. We find that intrinsically the two jets are remarkably similar when compared for equal tau, and that they are best described by Doppler boosting of the form D^{2+alpha}, as expected for continuous jets. The intrinsic brightnesses of the jets as functions of age behave in complex ways. In the age range 60 < tau < 150 days, the jet decays are best represented by exponential functions of tau, but linear or power law functions are not statistically excluded. This is followed by a region out to tau ~ 250 days during which the intrinsic brightness is essentially constant. At later times the jet decay can be fit roughly as exponential or power law functions of tau.Comment: 30 Pages, 11 Figures, Submitted to Ap

Coastal Ocean and Shelf-Sea Biogeochemical Cycling of Trace Elements and Isotopes: Lessons Learned from GEOTRACES

Continental shelves and shelf seas play a central role in the global carbon cycle. However, their importance with respect to trace element and isotope (TEI) inputs to ocean basins is less well understood. Here, we present major findings on shelf TEI biogeochemistry from the GEOTRACES programme as well as a proof of concept for a new method to estimate shelf TEI fluxes. The case studies focus on advances in our understanding of TEI cycling in the Arctic, transformations within a major river estuary (Amazon), shelf sediment micronutrient fluxes and basin-scale estimates of submarine groundwater discharge. The proposed shelf flux tracer is 228-radium (T1/2 = 5.75 yr), which is continuously supplied to the shelf from coastal aquifers, sediment porewater exchange and rivers. Model-derived shelf 228Ra fluxes are combined with TEI/ 228Ra ratios to quantify ocean TEI fluxes from the western North Atlantic margin. The results from this new approach agree well with previous estimates for shelf Co, Fe, Mn and Zn inputs and exceed published estimates of atmospheric deposition by factors of approximately 3-23. Lastly, recommendations are made for additional GEOTRACES process studies and coastal margin-focused section cruises that will help refine the model and provide better insight on the mechanisms driving shelf-derived TEI fluxes to the ocean.This article is part of the themed issue \u27Biological and climatic impacts of ocean trace element chemistry\u27

High biomass, low export regimes in the Southern Ocean

Author Posting. © Elsevier B.V., 2007. This is the author's version of the work. It is posted here by permission of Elsevier B.V. for personal use, not for redistribution. The definitive version was published in Deep Sea Research Part II: Topical Studies in Oceanography 54 (2007): 601-638, doi:10.1016/j.dsr2.2007.01.013.This paper investigates ballasting and remineralization controls of carbon sedimentation in the twilight zone (100-1000 m) of the Southern Ocean. Size-fractionated (<1 μm, 1-51 μm, >51 μm) suspended particulate matter was collected by large volume in-situ filtration from the upper 1000 m in the Subantarctic (55°S, 172°W) and Antarctic (66°S, 172°W) zones of the Southern Ocean during the Southern Ocean Iron Experiment (SOFeX) in January-February 2002. Particles were analyzed for major chemical constituents (POC, P, biogenic Si, CaCO3), and digital and SEM image analyses of particles were used to aid in the interpretation of the chemical profiles. Twilight zone waters at 66°S in the Antarctic had a steeper decrease in POC with depth than at 55°S in the Subantarctic, with lower POC concentrations in all size fractions at 66°S than at 55°S, despite up to an order of magnitude higher POC in surface waters at 66°S. The decay length scale of >51 μm POC was significantly shorter in the upper twilight zone at 66°S (δe=26 m) compared to 55°S (δe=81 m). Particles in the carbonate-producing 55°S did not have higher excess densities than particles from the diatom-dominated 66°S, indicating that there was no direct ballast effect that accounted for deeper POC penetration at 55°S. An indirect ballast effect due to differences in particle packaging and porosities cannot be ruled out, however, as aggregate porosities were high (~97%) and variable. Image analyses point to the importance of particle loss rates from zooplankton grazing and remineralization as determining factors for the difference in twilight zone POC concentrations at 55°S and 66°S, with stronger and more focused shallow remineralization at 66°S. At 66°S, an abundance of large (several mm long) fecal pellets from the surface to 150 m, and almost total removal of large aggregates by 200 m, reflected the actions of a single or few zooplankton species capable of grazing diatoms in the euphotic zone, coupled with a more diverse particle feeding zooplankton community immediately below. Surface waters with high biomass levels and high proportion of biomass in the large size fraction were associated with low particle loading at depth, with all indications implying conditions of low export. The 66°S region exhibits this “High Biomass, Low Export” (HBLE) condition, with very high >51 μm POC concentrations at the surface (~2.1 μM POC), but low concentrations below 200 m (<0.07 μM POC). The 66°S region remained HBLE after iron fertilization. Iron addition at 55°S caused a ten fold increase in >51 μm biomass concentrations in the euphotic zone, bringing surface POC concentrations to levels found at 66°S (~3.8 μM), and a concurrent decrease in POC concentrations below 200 m. The 55°S region, which began with moderate levels of biomass and stronger particle export, transitioned to being HBLE after iron fertilization. We propose that iron addition to already HBLE waters will not cause mass sedimentation events. The stability of an iron-induced HBLE condition is unknown. Better understanding of biological pump processes in non-HBLE Subantarctic waters is needed.This work was supported by the DOE Office of Science, Biological and Environmental Research Program. Shiptime for SOFeX was funded by NSF

Association of Habitual Dietary Fiber Intake and Fecal Microbiome Gene Abundance with Gastrointestinal Symptoms in an Irritable Bowel Syndrome Cohort

peer-reviewedObjectives: Dietary fibre supplementation is recognised as important for functional gastrointestinal disorders (FGID). The exact role of the microbiome in this relationship remains unclear. We explored differences in dietary fibre intake, GI symptoms and the fecal microbiome in those with FGID

High incidence of injuries at the Pyeongchang 2018 paralympic winter games: A prospective cohort study of 6804 athlete days

Given the increase in health surveillance research in the sporting arena, the International Paralympic Committee (IPC) seeks to preserve the health of the para athlete in several ways including high-quality epidemiological research on injury and illness in the Paralympic Games.1–5 Web-based studies began at the London 2012 Summer Paralympic Games1 and have continued at the Rio 20165 Summer Games and at Paralympic Winter Games at the Sochi 20144 and Pyeongchang 2018 Game