Computers in the Intensive Care Unit: A Match Meant To Be!

book chapterBiomedical Informatic

Zora Neale Hurston and the Narrative Aesthetics of Dance Performance

Zora Neale Hurston’s literature involves dance and performance. What makes this a viable topic of inquiry is her texts often exhibit the performative, whether portraying culture or using dance and associated folk rituals to create complex meaning. Hurston’s use of black vernacular and storytelling evokes lyrical expression in Their Eyes Were Watching God. African and Caribbean Diasporas in Hurston’s literature reflects primitive dance performances and folklore. This novel requires lyrical analysis. The storytelling feature of performance arts and reclamations of the body are present in Hurston’s text. In recent academic settings, the body has come to occupy a crucial place in literary and cultural texts and criticism. Hurston’s versatile material and anthropology techniques are instrumental in reshaping dance history. A new archetype for theorizing the body has surfaced, where the body of text is performance and lyrical expression

Surface characterization

The biocompatibility of commercially pure titanium and its alloys is closely related to their surface properties, with both the composition of the protecting oxide film and the surface topography playing an important role. Surfaces of commercially pure titanium and of the two alloys Ti-6Al-7Nb and Ti-6Al-4V (wt %) have been investigated following three different pretreatments: polishing, nitric acid passivation and pickling in nitric acid-hydrogen fluoride. Nitric acid treatment is found to substantially reduce the concentration of surface contaminants present after polishing. The natural 4-6 nm thick oxide layer on commercially pure titanium is composed of titanium oxide in different oxidation states (TiO2, Ti2O3 and TiO), while for the alloys, aluminium and niobium or vanadium are additionally present in oxidized form (Al2O3, Nb2O5 or V-oxides). The concentrations of the alloying elements at the surface are shown to be strongly dependent on the pretreatment process. While pickling increases the surface roughness of both commercially pure titanium and the alloys, different mechanisms appear to be involved. In the case of commercially pure titanium, the dissolution rate depends on grain orientation, whereas in the case of the two alloys, selective α-phase dissolution and enrichment of the β-phase appears to occur. © 1999 Kluwer Academic Publisher

The implant material, Ti6Al7Nb: surface microstructure, composition and properties

The excellent biocompatibility of titanium and its alloys is intimately related with the properties of the surface in contact with the biological environment, and therefore it is closely connected with the stable, passivating oxide layer that forms on its surface. In the present paper, the oxide layer on the alloy Ti6Al7Nb has been characterized using X-ray photoelectron spectroscopy, scanning Auger microscopy and pH-dependent lateral force microscopy. The alloying elements Al and Nb are incorporated in the oxide layer and detected in their most stable oxidized form, as Al2O3 and Nb2O5. Their distribution in the oxide reflects the underlying α-β microstructure, with enrichment of Al in the α- and of Nb in the β-phase (determined by electron microprobe). Friction measurements (lateral force microscopy) indicate slightly different, pH-dependent, lateral forces above the α- and β-phase structures that point to small local variations in surface charges. © 1999 Kluwer Academic Publisher

Музыкальный информационный поиск с запросом по напеву

In this paper the problems of Query by Humming in Music Information Retrieval systems are analyzed. A statistical approach to the problem of retrieval is presented. The processes of segmentation as well as of the extraction of pitch and duration data are described. From the extracted data the characteristic vector is formed for each segment. The method of using the vectors in melodic search if proposed

Notification of abnormal lab test results in an electronic medical record: do any safety concerns remain?

BACKGROUND: Follow-up of abnormal outpatient laboratory test results is a major patient safety concern. Electronic medical records can potentially address this concern through automated notification. We examined whether automated notifications of abnormal laboratory results (alerts) in an integrated electronic medical record resulted in timely follow-up actions. METHODS: We studied 4 alerts: hemoglobin A1c \u3e or =15%, positive hepatitis C antibody, prostate-specific antigen \u3e or =15 ng/mL, and thyroid-stimulating hormone \u3e or =15 mIU/L. An alert tracking system determined whether the alert was acknowledged (ie, provider clicked on and opened the message) within 2 weeks of transmission; acknowledged alerts were considered read. Within 30 days of result transmission, record review and provider contact determined follow-up actions (eg, patient contact, treatment). Multivariable logistic regression models analyzed predictors for lack of timely follow-up. RESULTS: Between May and December 2008, 78,158 tests (hemoglobin A1c, hepatitis C antibody, thyroid-stimulating hormone, and prostate-specific antigen) were performed, of which 1163 (1.48%) were transmitted as alerts; 10.2% of these (119/1163) were unacknowledged. Timely follow-up was lacking in 79 (6.8%), and was statistically not different for acknowledged and unacknowledged alerts (6.4% vs 10.1%; P =.13). Of 1163 alerts, 202 (17.4%) arose from unnecessarily ordered (redundant) tests. Alerts for a new versus known diagnosis were more likely to lack timely follow-up (odds ratio 7.35; 95% confidence interval, 4.16-12.97), whereas alerts related to redundant tests were less likely to lack timely follow-up (odds ratio 0.24; 95% confidence interval, 0.07-0.84). CONCLUSIONS: Safety concerns related to timely patient follow-up remain despite automated notification of non-life-threatening abnormal laboratory results in the outpatient setting

Timely follow-up of abnormal diagnostic imaging test results in an outpatient setting: are electronic medical records achieving their potential?

BACKGROUND: Given the fragmentation of outpatient care, timely follow-up of abnormal diagnostic imaging results remains a challenge. We hypothesized that an electronic medical record (EMR) that facilitates the transmission and availability of critical imaging results through either automated notification (alerting) or direct access to the primary report would eliminate this problem. METHODS: We studied critical imaging alert notifications in the outpatient setting of a tertiary care Department of Veterans Affairs facility from November 2007 to June 2008. Tracking software determined whether the alert was acknowledged (ie, health care practitioner/provider [HCP] opened the message for viewing) within 2 weeks of transmission; acknowledged alerts were considered read. We reviewed medical records and contacted HCPs to determine timely follow-up actions (eg, ordering a follow-up test or consultation) within 4 weeks of transmission. Multivariable logistic regression models accounting for clustering effect by HCPs analyzed predictors for 2 outcomes: lack of acknowledgment and lack of timely follow-up. RESULTS: Of 123 638 studies (including radiographs, computed tomographic scans, ultrasonograms, magnetic resonance images, and mammograms), 1196 images (0.97%) generated alerts; 217 (18.1%) of these were unacknowledged. Alerts had a higher risk of being unacknowledged when the ordering HCPs were trainees (odds ratio [OR], 5.58; 95% confidence interval [CI], 2.86-10.89) and when dual-alert (\u3e1 HCP alerted) as opposed to single-alert communication was used (OR, 2.02; 95% CI, 1.22-3.36). Timely follow-up was lacking in 92 (7.7% of all alerts) and was similar for acknowledged and unacknowledged alerts (7.3% vs 9.7%; P = .22). Risk for lack of timely follow-up was higher with dual-alert communication (OR, 1.99; 95% CI, 1.06-3.48) but lower when additional verbal communication was used by the radiologist (OR, 0.12; 95% CI, 0.04-0.38). Nearly all abnormal results lacking timely follow-up at 4 weeks were eventually found to have measurable clinical impact in terms of further diagnostic testing or treatment. CONCLUSIONS: Critical imaging results may not receive timely follow-up actions even when HCPs receive and read results in an advanced, integrated electronic medical record system. A multidisciplinary approach is needed to improve patient safety in this area

Surface activation of polyetheretherketone (PEEK) and formation of calcium phosphate coatings by precipitation

Plasma activation of polyetheretherketone (PEEK) surfaces and the influence on coating formation in a supersaturated calcium phosphate solution was investigated in this study. It was observed that plasma treatment in a N2/O2 plasma had a significant effect on the wettability of the PEEK surface. The contact angle decreased from 85° to 25° after plasma treatment. Cell culture testing with osteoblastic cell lines showed plasma activation not to be disadvantageous to cell viability. X-ray photoelectron spectroscopy (XPS) analysis was performed to characterize the chemical composition of the PEEK surfaces. It was observed that the O1s intensity increased with plasma activation time. At the C1s peak the appearance of a shoulder at higher binding energies was observed. Coating of PEEK was performed in a supersaturated calcium phosphate solution. Coating thicknesses of up to 50 μm were achieved after 24 days of immersion. Plasma activation followed by nucleation in a highly saturated hydroxyapatite solution had a positive effect on the growth rate of the layer on PEEK. Chemical analysis revealed that the coating consists of a carbonate-containing calcium phosphat