The Promise of Information and Communication Technology In Health Care: Extracting Value from the Chaos

Healthcare is an information business with expanding use of information and communication technologies (ICTs). Current ICT tools are immature, but a brighter future looms. We examine 7 areas of ICT in healthcare: electronic health records (EHRs), health information exchange (HIE), patient portals, telemedicine, social media, mobile devices and wearable sensors and monitors, and privacy and security. In each of these areas, we examine the current status and future promise, highlighting how each might reach its promise. Steps to better EHRs include a universal programming interface, universal patient identifiers, improved documentation and improved data analysis. HIEs require federal subsidies for sustainability and support from EHR vendors, targeting seamless sharing of EHR data. Patient portals must bring patients into the EHR with better design and training, greater provider engagement and leveraging HIEs. Telemedicine needs sustainable payment models, clear rules of engagement, quality measures and monitoring. Social media needs consensus on rules of engagement for providers, better data mining tools and approaches to counter disinformation. Mobile and wearable devices benefit from a universal programming interface, improved infrastructure, more rigorous research and integration with EHRs and HIEs. Laws for privacy and security need updating to match current technologies, and data stewards should share information on breaches and standardize best practices. ICT tools are evolving quickly in healthcare and require a rational and well-funded national agenda for development, use and assessment

U.S. Accounting Education: Misalignment With The Needs Of Small And Medium Companies

This study looks to answer the question, “Does the current accounting educational system in the United States focus too heavily on the requirements of large (and SEC registered) companies at the expense of small companies and individuals who comprise the primary clientele of most practicing CPAs?” This investigation surveys CPAs regarding their perceptions of the focus of their accounting education. The results of the survey suggest that the current accounting curriculum does not focus enough on the accounting needs of small businesses. Suggestions for improvement in the curriculum include adding small business coverage in accounting courses, including more general business courses, requiring more hands-on practice with the material and adding internships with smaller firms

Mountains of Maize, Persistent Poverty

The past two years are a tribute to Zambian farmers; they have responded admirably to government efforts to promote maize production. But ironically, rural poverty remains stubbornly high despite the fact that the government has spent over 2% of the nation’s gross domestic product in supporting maize production and subsidizing inputs for farmers. Why is it that maize production has increased so impressively without making a serious dent in rural poverty? And what are the lessons for the new government?maize, poverty, Zambia, Agricultural and Food Policy, Food Security and Poverty,

Flooding of December 29, 1984 Through January 2, 1985, in Northern New York State, With Flood Profiles of the Black and Salmon Rivers

Precipitation, snowmelt, and resultant flooding throughout northern New York from December 28 through January 2, 1985, were investigated through a detailed analysis of 56 precipitation stations, 101 stage and/or discharge gaging stations, and 9 miscellaneous measurement sites. Flood damage to property and roads and bridges exceeded $5 million. Lewis and Oswego Counties were declared Federal disaster areas, primarily a result of flooding of the Black River and Salmon River. Storm-precipitation and runoff maps show the storms \u27 greatest intensity to have been over the Tug Hill and southwest Adirondack areas. Total rainfall from December 28 through January 2 was 6.90 inches at Stillwater Reservoir but only 0.69 inches at Lake Placid. New peak discharges of record occurred at 17 gaging stations throughout northern New York, and the maximum discharge at 17 sites had recurrence intervals equal to or greater than 100 years. Computed inflows to 11 major lakes and reservoirs in northern New York indicate that significant volumes of water (as much as 5 inches of storm runoff at Stillwater Reservoir) were stored during the storm-runoff period. Maximum 1-day flood volumes at two gaging stations on the Black River had recurrence intervals greater than 100 years. To help evaluate the extent of flooding, 67 floodmarks were obtained along a 94-mile reach of the Black River from Dexter to Forestport, and several floodmarks were surveyed within major communities along the Salmon River. The floodmarks were obtained primarily near major bridges and dams along these rivers. (Author \u27s abstract

The Phases Differential Astrometry Data Archive. IV. The Triple Star Systems 63 Gem A and HR 2896

Differential astrometry measurements from the Palomar High-precision Astrometric Search for Exoplanet Systems (PHASES) are used to constrain the astrometric orbit of the previously known ≾2 day subsystem in the triple system 63 Gem A and have detected a previously unknown two-year Keplerian wobble superimposed on the visual orbit of the much longer period (213 years) binary system HR 2896. 63 Gem A was already known to be triple from spectroscopic work, and absorption lines from all three stars can be identified and their individual Doppler shifts measured; new velocities for all three components are presented to aid in constraining the orbit and measuring the stellar masses. In fact, 63 Gem itself is a sextuple system: the hierarchical triple (Aa1-Aa2)-Ab (in which Aa1 and Aa2 orbit each other with a rapid period just under 2 days, and Ab orbits these every two years), plus three distant common proper motion companions. The very small astrometric perturbation caused by the inner pair in 63 Gem A stretches the limits of current astrometric capabilities, but PHASES observations are able to constrain the orientation of the orbit. The two bright stars comprising the HR 2896 long-period (213 year) system have a combined spectral type of K0III and the newly detected object's mass estimate places it in the regime of being an M dwarf. The motion of the stars are slow enough that their spectral features are always blended, preventing Doppler studies. The PHASES measurements and radial velocities (when available) have been combined with lower precision single-aperture measurements covering a much longer time frame (from eyepiece measurements, speckle interferometry, and adaptive optics) to improve the characterization of the long-period orbits in both binaries. The visual orbits of the short- and long-period systems are presented for both systems and used to calculate two possible values of the mutual inclinations between inner and outer orbits of 152° ± 12° or a less likely value of 31° ± 11° for 63 Gem A and 10.°2 ± 2.°4 or 171.°2 ± 2.°8 for HR 2896. The first is not coplanar, whereas the second is either nearly coplanar or anti-coplanar

Endometrioma Complicated by Tubo-Ovarian Abscess in a Woman With Bacterial Vaginosis

Background. Tubo-ovarian abscess involvement of an endometrioma has been reported in cases of patients with polymicrobial sources such as Neisseria gonorrhoeae, Chlamydia trachomatis, and obligate anaerobic bacteria; however, bacterial vaginosis (BV) predisposing to abscess formation in an endometrioma has not been reported to date. Case. Superinfection of an endometrioma was surgically diagnosed in a patient with known advanced-stage endometriosis after she presented with acute pelvic inflammatory disease symptoms and was unresponsive to antibiotic therapy. Gram-negative rods were cultured from the endometrioma. On admission, cervical, blood, and urine cultures were negative; BV was diagnosed on normal saline wet prep and gram stain. Conclusion. This case raises the possibility of BV ascension to the upper genital tract predisposing to abscess formation in endometriomas. Therefore, aggressive treatment of BV in patients with known advanced-stage endometriosis may be considered to prevent superinfected endometriomas

Evolutionary relationships in Panicoid grasses based on plastome phylogenomics (Panicoideae; Poaceae)

Background: Panicoideae are the second largest subfamily in Poaceae (grass family), with 212 genera and approximately 3316 species. Previous studies have begun to reveal relationships within the subfamily, but largely lack resolution and/or robust support for certain tribal and subtribal groups. This study aims to resolve these relationships, as well as characterize a putative mitochondrial insert in one linage. Results: 35 newly sequenced Panicoideae plastomes were combined in a phylogenomic study with 37 other species: 15 Panicoideae and 22 from outgroups. A robust Panicoideae topology largely congruent with previous studies was obtained, but with some incongruences with previously reported subtribal relationships. A mitochondrial DNA (mtDNA) to plastid DNA (ptDNA) transfer was discovered in the Paspalum lineage. Conclusions: The phylogenomic analysis returned a topology that largely supports previous studies. Five previously recognized subtribes appear on the topology to be non-monophyletic. Additionally, evidence for mtDNA to ptDNA transfer was identified in both Paspalum fimbriatum and P. dilatatum, and suggests a single rare event that took place in a common progenitor. Finally, the framework from this study can guide larger whole plastome sampling to discern the relationships in Cyperochloeae, Steyermarkochloeae, Gynerieae, and other incertae sedis taxa that are weakly supported or unresolved.Fil: Burke, Sean V.. Northern Illinois University; Estados UnidosFil: Wysocki, William P.. Northern Illinois University; Estados UnidosFil: Zuloaga, Fernando Omar. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Botánica Darwinion. Academia Nacional de Ciencias Exactas, Físicas y Naturales. Instituto de Botánica Darwinion; ArgentinaFil: Craine, Joseph M.. Jonah Ventures; Estados UnidosFil: Pires, J. Chris. University of Missouri; Estados UnidosFil: Edger, Patrick P.. Michigan State University; Estados UnidosFil: Mayfield Jones, Dustin. Donald Danforth Plant Science Center; Estados UnidosFil: Clark, Lynn G.. Iowa State University; Estados UnidosFil: Kelchner, Scot A.. University of Idaho; Estados UnidosFil: Duvall, Melvin R.. Northern Illinois University; Estados Unido