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Sample records for ehr educational portal

  1. Towards Educational Electronic Health Records (EHRs): A Design Process for Integrating EHRs, Simulation, and Video Tutorials.

    PubMed

    Shachak, Aviv; Elamrousy, Samer; Borycki, Elizabeth M; Domb, Sharon; Kushniruk, Andre W

    2016-01-01

    Electronic health records (EHRs) are becoming ubiquitous in healthcare practice. However, their use in medical education has been slower to catch on and a new category of EHRs is beginning to emerge known as eduEHRs. These systems allow learners to explore and experiment with EHRs in the context of medical education. However, current eduEHRs have limitations, such as a lack of dynamic interaction built-in that would mimic real-world use of these tools. To overcome this, the integration of eduEHRs with software and tools such as video simulations and tutorials has considerable promise. In this paper we describe a new design process for integrating EHRs, simulations, and video tutorials. PMID:27577459

  2. Ethical Considerations about EHR-Mediated Results Disclosure and Pathology Information Presented via Patient Portals.

    PubMed

    Davis, Kristina A; Smith, Lauren B

    2016-01-01

    Electronic health records (EHR) now include patient portals where patients can obtain clinical reports, including notes, radiology reports, and laboratory/anatomic pathology results. Although portals increase patient access to information, no guidelines have been developed for hospitals about appropriate delays in posting different types of pathology reports to the EHR. Delays exist as a matter of policy to allow physicians time to answer questions and provide emotional support when discussing sensitive results with patients. Some types of results are more sensitive than others, however, including results of cancer, genetic, and HIV testing. Ethical questions about patient access to test results online are discussed. PMID:27550567

  3. Implementation of Certified EHR, Patient Portal, and "Direct" Messaging Technology in a Radiology Environment Enhances Communication of Radiology Results to Both Referring Physicians and Patients.

    PubMed

    Reicher, Joshua Jay; Reicher, Murray Aaron

    2016-06-01

    Since 2009, the Federal government distributed over $29 billion to providers who were adopting compliant electronic health record (EHR) technology. With a focus on radiology, we explore how EHR technology impacts interoperability with referring clinicians' EHRs and patient engagement. We also discuss the high-level details of contributing supporting frameworks, specifically Direct messaging and health information service provider (HISP) technology. We characterized Direct messaging, a secure e-mail-like protocol built to allow exchange of encrypted health information online, and the new supporting HISP infrastructure. Statistics related to both the testing and active use of this framework were obtained from DirectTrust.org, an organization whose framework supports Direct messaging use by healthcare organizations. To evaluate patient engagement, we obtained usage data from a radiology-centric patient portal between 2014 and 2015, which in some cases included access to radiology reports. Statistics from 2013 to 2015 showed a rise in issued secure Direct addresses from 8724 to 752,496; a rise in the number of participating healthcare organizations from 667 to 39,751; and a rise in the secure messages sent from 122,842 to 27,316,438. Regarding patient engagement, an average of 234,679 patients per month were provided portal access, with 86,400 patients per month given access to radiology reports. Availability of radiology reports online was strongly associated with increased system usage, with a likelihood ratio of 2.63. The use of certified EHR technology and Direct messaging in the practice of radiology allows for the communication of patient information and radiology results with referring clinicians and increases patient use of patient portal technology, supporting bidirectional radiologist-patient communication. PMID:26588906

  4. MedEdPORTAL: Educational Scholarship for Teaching

    ERIC Educational Resources Information Center

    Reynolds, Robby J.; Candler, Christopher S.

    2008-01-01

    MedEdPORTAL is an online publication service provided at no charge by the Association of American Medical Colleges (AAMC). The intent is to promote collaboration and educational scholarship by helping educators publish and share educational resources. With MedEdPORTAL, users can quickly locate high-quality, peer-reviewed teaching materials in both…

  5. Health Literacy, Education Levels, and Patient Portal Usage During Hospitalizations

    PubMed Central

    Davis, Sharon E.; Osborn, Chandra Y.; Kripalani, Sunil; Goggins, Kathryn M.; Jackson, Gretchen Purcell

    2015-01-01

    Patient portal adoption has rapidly increased, and portal usage has been associated with patients’ sociodemographics, health literacy, and education. Research on patient portals has primarily focused on the outpatient setting. We explored whether health literacy and education were associated with portal usage in an inpatient population. Among 60,159 admissions in 2012–2013, 23.3% of patients reported limited health literacy; 50.4% reported some post-secondary education; 34.4% were registered for the portal; and 23.4% of registered patients used the portal during hospitalization. Probability of registration and inpatient portal use increased with educational attainment. Health literacy was associated with registration but not inpatient use. Among admissions with inpatient use, educational attainment was associated with viewing health record data, and health literacy was associated use of appointment and health education tools. The inpatient setting may provide an opportunity to overcome barriers to patient portal adoption and reduce disparities in use of health information technologies. PMID:26958286

  6. Teachers' Acceptance and Use of an Educational Portal

    ERIC Educational Resources Information Center

    Pynoo, Bram; Tondeur, Jo; van Braak, Johan; Duyck, Wouter; Sijnave, Bart; Duyck, Philippe

    2012-01-01

    In this study, teachers' acceptance and use of an educational portal is assessed based on data from two sources: usage data (number of logins, downloads, uploads, reactions and pages viewed) and an online acceptance questionnaire. The usage data is extracted on two occasions from the portal's database: at survey completion (T1) and twenty-two…

  7. The virtual space exploration education portal

    NASA Astrophysics Data System (ADS)

    Oliver, C. A.

    2007-06-01

    New information technologies have evolved from space exploration—3-D visualisation ‘lenses’ and a growing suite of tools that allow access to exploration, analysis and interpretation of often complex information by a range of end users including the public, communicators, and policy makers. These tools have only become viable in the past year or two with the combination of the availability of inexpensive, but powerful, personal computers and widespread use of the Internet. A new study group under Commission 6 has been established, entitled ‘Future Directions of Space Exploration Education’, to build a Virtual Global Space Exploration Education Portal (VGSEEP) to open this revolution to all audiences, not just students. This paper describes the initial stages of VGSEEP. The NASA Learning Technologies suite of ‘lenses’ and tools will be demonstrated: World Wind, a 3-D globe that provides insights into our planet from space and almost down to ground level; the Virtual Field Trip that explores at ground level in 3-D; the Virtual Lab, which allows a range of samples to be examined via a virtual light microscope and/or a Scanning Electron Microscope and What’s the Difference?, which allows users to manipulate information in a multi-graphical interface.

  8. Quantitative Analysis of the Usage of the COSMOS Science Education Portal

    ERIC Educational Resources Information Center

    Sotiriou, Sofoklis; Bogner, Franz X.; Neofotistos, George

    2011-01-01

    A quantitative method of mapping the web usage of an innovative educational portal is applied to analyze the behaviour of users of the COSMOS Science Education Portal. The COSMOS Portal contains user-generated resources (that are uploaded by its users). It has been designed to support a science teacher's search, retrieval and access to both,…

  9. Supporting the education evidence portal via text mining

    PubMed Central

    Ananiadou, Sophia; Thompson, Paul; Thomas, James; Mu, Tingting; Oliver, Sandy; Rickinson, Mark; Sasaki, Yutaka; Weissenbacher, Davy; McNaught, John

    2010-01-01

    The UK Education Evidence Portal (eep) provides a single, searchable, point of access to the contents of the websites of 33 organizations relating to education, with the aim of revolutionizing work practices for the education community. Use of the portal alleviates the need to spend time searching multiple resources to find relevant information. However, the combined content of the websites of interest is still very large (over 500 000 documents and growing). This means that searches using the portal can produce very large numbers of hits. As users often have limited time, they would benefit from enhanced methods of performing searches and viewing results, allowing them to drill down to information of interest more efficiently, without having to sift through potentially long lists of irrelevant documents. The Joint Information Systems Committee (JISC)-funded ASSIST project has produced a prototype web interface to demonstrate the applicability of integrating a number of text-mining tools and methods into the eep, to facilitate an enhanced searching, browsing and document-viewing experience. New features include automatic classification of documents according to a taxonomy, automatic clustering of search results according to similar document content, and automatic identification and highlighting of key terms within documents. PMID:20643679

  10. Supporting the education evidence portal via text mining.

    PubMed

    Ananiadou, Sophia; Thompson, Paul; Thomas, James; Mu, Tingting; Oliver, Sandy; Rickinson, Mark; Sasaki, Yutaka; Weissenbacher, Davy; McNaught, John

    2010-08-28

    The UK Education Evidence Portal (eep) provides a single, searchable, point of access to the contents of the websites of 33 organizations relating to education, with the aim of revolutionizing work practices for the education community. Use of the portal alleviates the need to spend time searching multiple resources to find relevant information. However, the combined content of the websites of interest is still very large (over 500,000 documents and growing). This means that searches using the portal can produce very large numbers of hits. As users often have limited time, they would benefit from enhanced methods of performing searches and viewing results, allowing them to drill down to information of interest more efficiently, without having to sift through potentially long lists of irrelevant documents. The Joint Information Systems Committee (JISC)-funded ASSIST project has produced a prototype web interface to demonstrate the applicability of integrating a number of text-mining tools and methods into the eep, to facilitate an enhanced searching, browsing and document-viewing experience. New features include automatic classification of documents according to a taxonomy, automatic clustering of search results according to similar document content, and automatic identification and highlighting of key terms within documents. PMID:20643679

  11. Some Emphases and Resources for the A.I.D. Education Sector. Network Series: EHR-01.

    ERIC Educational Resources Information Center

    Agency for International Development (Dept. of State), Washington, DC. Office of Education and Human Resources.

    This paper elaborates on the Agency for International Development's (AID) new strategies for educational assistance to developing nations, with special reference to available, centrally funded technical assistance resources and the means for procuring them. Section one provides a brief introduction and lists the kinds of resources available and…

  12. Quantitative Analysis of the Usage of the COSMOS Science Education Portal

    NASA Astrophysics Data System (ADS)

    Sotiriou, Sofoklis; Bogner, Franz X.; Neofotistos, George

    2011-08-01

    A quantitative method of mapping the web usage of an innovative educational portal is applied to analyze the behaviour of users of the COSMOS Science Education Portal. The COSMOS Portal contains user-generated resources (that are uploaded by its users). It has been designed to support a science teacher's search, retrieval and access to both, scientific and educational resources. It also aims to introduce in and familiarize teachers with an innovative methodology for designing, expressing and representing educational practices in a commonly understandable way through the use of user-friendly authoring tools that are available through the portal. As a new science education portal that includes user-generated content, the COSMOS Portal encounters the well-known "new product/service challenge": to convince the users to use its tools, which facilitate quite fast lesson planning and lesson preparation activities. To respond to this challenge, the COSMOS Portal operators implemented a validation process by analyzing the usage data of the portal in a 10 month time-period. The data analyzed comprised: (a) the temporal evolution of the number of contributors and the amount of content uploaded to the COSMOS Portal; (b) the number of portal visitors (categorized as all-visitors, new-visitors, and returning-visitors) and (c) visitor loyalty parameters (such as page-views; pages/visit; average time on site; depth of visit; length of visit). The data is augmented with data associated with the usage context (e.g. the time of day when most of the activities in the portal take place). The quantitative results indicate that the exponential growth of the contributors to the COSMOS Portal is followed by an exponential growth of the uploaded content. Furthermore, the web usage statistics demonstrate significant changes in users' behaviour during the period under study, with returning visitors using the COSMOS Portal more frequently, mainly for lesson planning and preparation (in the

  13. Web Portals & Higher Education: Technologies To Make IT Personal. The Jossey-Bass Higher and Adult Education Series.

    ERIC Educational Resources Information Center

    Katz, Richard N., Ed.

    The chapters of this collection examine a full range of issues that any educational institution must consider before beginning to develop a Web portal, including business challenges, organizational implications, policy choices, and technology concerns. The chapters are: (1) "It's a Bird! It's a Plane! It's a Portal?" (Richard N. Katz); (2)…

  14. Learning from Public Television and the Web: Positioning Continuing Education as a Knowledge Portal.

    ERIC Educational Resources Information Center

    Vedro, Steven R.

    1999-01-01

    Digital convergence--the merging of television and computing--challenges localized monopolies of public television and continuing education. Continuing educators can reposition themselves in the electronic marketplace by serving as an educational portal, bringing their strengths of "brand recognition," local customer base, and access to…

  15. Infobutton usage in Patient Portal MyHealth

    PubMed Central

    Long, Jie; Hulse, Nathan C.; Tao, Cui

    2015-01-01

    Infobuttons have proven to be an important element in modern electronic health records (EHR), providing educational materials to both providers and patients. However, the usage of infobuttons in personalized health records (PHR) is only lightly documented in the literature. Patient-facing infobuttons pose a new challenge because patients have different questions and educational levels than professional users in EHRs. In this paper, we present usage data for patient-facing infobuttons that have recently been integrated in Intermountain Healthcare’s patient portal MyHealth. We summarize use patterns by usage classified in modules, electronic resources (eResource), and infobutton sessions. Based on the analysis, we propose further enhancements to the current implementation of infobuttons in MyHealth. PMID:26306251

  16. Accelerating the ROI of EHRs.

    PubMed

    Arlotto, Pam

    2014-02-01

    Three key strategies can enable an organization to achieve the greatest possible value from electronic health records (EHRs): Meaningful use should be combined with a value realization strategy to ensure that the EHR does more than automate the paper record. Healthcare leaders should work to align IT tools with new business models, care delivery frameworks, and operating processes. Business and clinical goals and desired benefits should drive EHR value realization. PMID:24611229

  17. Quality evaluation of portal sites in health system, as a tool for education and learning

    PubMed Central

    Hejazi, Sayed Mehdi; Sarmadi, Sima

    2013-01-01

    Background: The main objective of creating a portal is to make information service available for users who need them for performance of duties and responsibilities regardless of the sources. This article is attempted to consider the parameters that can evaluate these sites since these criteria can be effective in designing and implementing such portals. On the other hand, portal sites in health systems of every country make it possible for leaders, policy makers, and directors to system education as a tool for new learning technologies. One of the main decisions each manager has to make is precise selection of appropriate portal sites. Materials and Methods: This is a descriptive and qualitative study. The research sample was 53 computer professional working in the area of computer programming and design. In the first part of the study a questionnaire was send to the participants and in the second part of the study based on their response to the questionnaire the participant was interviewed and the main themes of the studies were formulated. The validity and the reliability of the questionnaire were confirmed. Results: The study results were summarized in 10 themes and 50 sub-categories. The main themes included were portal requirements, security, management, and efficiency, user friendliness, built-in applications, portal flexibility, interoperability, and support systems. Conclusion: Portal sites in any education systems make it possible for health system leaders and policy makers to manage their organization information system efficiently and effectively. One of the major decisions each manager has to make is precise selection of an appropriate portal sites design and development. The themes and sub-categories of this study could help health system managers and policy makers and information technology professionals to make appropriate decisions regarding portal design and development. PMID:24520554

  18. Examining the Influence of Personality Traits on Intranet Portal Adoption by Faculty in Higher Education

    ERIC Educational Resources Information Center

    Shambare, Narcissus

    2013-01-01

    The problem examined in the proposed study was the underutilization of the intranet portals (IP) by faculty in institutions of higher education (IHE). Despite the time and investment allocated to the IP, the technology remains underutilized to improve productivity, efficiency, and justify its investment yet there is lack of understanding of why…

  19. Towards a portal and search engine to facilitate academic and research collaboration in engineering and education

    NASA Astrophysics Data System (ADS)

    Bonilla Villarreal, Isaura Nathaly

    While international academic and research collaborations are of great importance at this time, it is not easy to find researchers in the engineering field that publish in languages other than English. Because of this disconnect, there exists a need for a portal to find Who's Who in Engineering Education in the Americas. The objective of this thesis is to built an object-oriented architecture for this proposed portal. The Unified Modeling Language (UML) model developed in this thesis incorporates the basic structure of a social network for academic purposes. Reverse engineering of three social networks portals yielded important aspects of their structures that have been incorporated in the proposed UML model. Furthermore, the present work includes a pattern for academic social networks..

  20. e-meducation.org: an open access medical education web portal

    PubMed Central

    Alexiou, Vangelis G; Falagas, Matthew E

    2008-01-01

    Background Internet can serve in opening the door to a brand new world of high quality medical information. However, the chaotic size of data available in the WWW is often misleading. We sought to provide the world medical community with a web portal that may be used as a clearinghouse providing the outlet for dissemination of high quality WWW educational products. Methods Directories of the relevant WWW resources have been compiled and others are being currently under development to cover most medical fields. A custom-built medical search engine was created. Really Simple Syndication (RSS) feeds and video sharing services were reviewed for their quality and were presented along with case-based educational presentations through a user-friendly web portal interface. A directory of guidelines database is currently under development. Results The educational portal "e-meducation" available at has been launched in December 2006 and at the moment, provides links to more than 800 educational web-pages, more than 2100 clinical practice guidelines, 32 news feeds, and 14 educational videos. The web site also hosts 40 case-based presentations and a custom medical search engine. Conclusion Based on the incorporation of simple and tested educational strategies such as case based instruction and interactive learning, e-meducation.org aims to become a prototype platform that offers a more convenient interface to existing products, resources and medical contents. PMID:18218119

  1. Intelligent Simulation Model To Facilitate EHR Training

    PubMed Central

    Mohan, Vishnu; Scholl, Gretchen; Gold, Jeffrey A.

    2015-01-01

    Despite the rapid growth of EHR use, there are currently no standardized protocols for EHR training. A simulation EHR environment may offer significant advantages with respect to EHR training, but optimizing the training paradigm requires careful consideration of the simulation model itself, and how it is to be deployed during training. In this paper, we propose Six Principles that are EHR-agnostic and provide the framework for the development of an intelligent simulation model that can optimize EHR training by replicating real-world clinical conditions and appropriate cognitive loads. PMID:26958229

  2. Challenges to EHR Implementation in Electronic- Versus Paper-based Office Practices

    PubMed Central

    Yoon-Flannery, Kahyun; Kuperman, Gilad J.; Langsam, Daniel J.; Hyman, Daniel; Kaushal, Rainu

    2008-01-01

    Summary Background Challenges in implementing electronic health records (EHRs) have received some attention, but less is known about the process of transitioning from legacy EHRs to newer systems. Objective To determine how ambulatory leaders differentiate implementation approaches between practices that are currently paper-based and those with a legacy EHR system (EHR-based). Design Qualitative study. Participants Eleven practice managers and 12 medical directors all part of an academic ambulatory care network of a large teaching hospital in New York City in January to May of 2006. Approach Qualitative approach comparing and contrasting perceived benefits and challenges in implementing an ambulatory EHR between practice leaders from paper- and EHR-based practices. Content analysis was performed using grounded theory and ATLAS.ti 5.0. Results We found that paper-based leaders prioritized the following: sufficient workstations and printers, a physician information technology (IT) champion at the practice, workflow education to ensure a successful transition to a paperless medical practice, and a high existing comfort level of practitioners and support staff with IT. In contrast, EHR-based leaders prioritized: improved technical training and ongoing technical support, sufficient protection of patient privacy, and open recognition of physician resistance, especially for those who were loyal to a legacy EHR. Unlike paper-based practices, EHR-based leadership believed that comfort level with IT and adjustments to workflow changes would not be difficult challenges to overcome. Conclusions Leadership at paper- and EHR-based practices in 1 academic network has different priorities for implementing a new EHR. Ambulatory practices upgrading their legacy EHR have unique challenges. PMID:18369679

  3. The New Physics and Astronomy Education Portal of the Smithsonian/NASA Astrophysics Data System

    NASA Astrophysics Data System (ADS)

    Kurtz, Michael J.; Eichhorn, G.; Accomazzi, A.; Grant, C.; Henneken, E.; Thompson, D.; Bohlen, E.; Murray, S. S.

    2006-12-01

    The ADS announces the beta release of a new portal into the technical literature for physics and astronomy education. This project is being done in collaboration with ComPADRE. Currently the collection contains about 30,000 articles covering the Science Education literature; key journals in the collection include Research in Science Education, Physical Review Special Topics Physics Education Research, The Physics Teacher, The American Journal of Physics, Physics Education, Journal of Research in Science Teaching, The International Journal of Science Education. Several other journals are also included, including some from nearby fields, such as computer science and chemistry education. The system easily has the ability to include any individual article from the research literature of physics and astronomy (such as from the Physical Review or the Astrophysical Journal) either from current or historical research. We encourage educators to suggest such articles to us. This is the beta release of a new system; we encourage comments, critisms and suggestions.

  4. The SERC K12 Educators Portal to Teaching Activities and Pedagogic Approaches

    NASA Astrophysics Data System (ADS)

    Larsen, K.; Kirk, K. B.; Manduca, C. A.; Ledley, T. S.; Schmitt, L.

    2013-12-01

    The Science Education Resource Center (SERC) has created a portal to information for K12 educators to provide high-quality grade level appropriate materials from a wide variety of projects and topics. These materials were compiled across the SERC site, showcasing materials that were created for, or easily adaptable to, K12 classrooms. This resource will help support implementation of Next Generation Science Standards by assisting educators in finding innovative resources to address areas of instruction that are conceptually different than previous national and state science standards. Specifically, the K12 portal assists educators in learning about approaches that address the cross-cutting nature of science concepts, increasing students quantitative reasoning and numeracy skills, incorporating technology such as GIS in the classroom, and by assisting educators of all levels of K12 instruction in using relevant and meaningful ways to teach science concepts. The K12 portal supports educators by providing access to hundreds of teaching activities covering a wide array of science topics and grade levels many of which have been rigorously reviewed for pedagogic quality and scientific accuracy. The portal also provides access to web pages that enhance teaching practices that help increase student's system thinking skills, make lectures interactive, assist instructors in conducting safe and effective indoor and outdoor labs, providing support for teaching energy and climate literacy principles, assisting educators in addressing controversial content, provide guidance in engaging students affective domain, and provides a collection of tools for making teaching relevant in 21st century classrooms including using GIS, Google Earth, videos, visualizations and simulations to model and describe scientific concepts. The portal also provides access to material for specific content and audiences by (1) Supporting AGIs 'Map your World' week to specifically highlight teaching

  5. Fostering Outreach, Education and Exploration of the Moon Using the Lunar Mapping & Modeling Portal

    NASA Astrophysics Data System (ADS)

    Dodge, K.; Law, E.; Malhotra, S.; Chang, G.; Kim, R. M.; Bui, B.; Sadaqathullah, S.; Day, B. H.

    2014-12-01

    The Lunar Mapping and Modeling Portal (LMMP)[1], is a web-based Portal and a suite of interactive visualization and analysis tools for users to access mapped lunar data products (including image mosaics, digital elevation models, etc.) from past and current lunar missions (e.g., Lunar Reconnaissance Orbiter, Apollo, etc.). Originally designed as a mission planning tool for the Constellation Program, LMMP has grown into a generalized suite of tools facilitating a wide range of activities in support of lunar exploration including public outreach, education, lunar mission planning and scientific research. LMMP fosters outreach, education, and exploration of the Moon by educators, students, amateur astronomers, and the general public. These efforts are enhanced by Moon Tours, LMMP's mobile application, which makes LMMP's information accessible to people of all ages, putting opportunities for real lunar exploration in the palms of their hands. Our talk will include an overview of LMMP and a demonstration of its technologies (web portals, mobile apps), to show how it serves NASA data as commodities for use by advanced visualization facilities (e.g., planetariums) and how it contributes to improving teaching and learning, increasing scientific literacy of the general public, and enriching STEM efforts. References:[1] http://www.lmmp.nasa.gov

  6. EHR Big Data Deep Phenotyping

    PubMed Central

    Lenert, L.; Lopez-Campos, G.

    2014-01-01

    Summary Objectives Given the quickening speed of discovery of variant disease drivers from combined patient genotype and phenotype data, the objective is to provide methodology using big data technology to support the definition of deep phenotypes in medical records. Methods As the vast stores of genomic information increase with next generation sequencing, the importance of deep phenotyping increases. The growth of genomic data and adoption of Electronic Health Records (EHR) in medicine provides a unique opportunity to integrate phenotype and genotype data into medical records. The method by which collections of clinical findings and other health related data are leveraged to form meaningful phenotypes is an active area of research. Longitudinal data stored in EHRs provide a wealth of information that can be used to construct phenotypes of patients. We focus on a practical problem around data integration for deep phenotype identification within EHR data. The use of big data approaches are described that enable scalable markup of EHR events that can be used for semantic and temporal similarity analysis to support the identification of phenotype and genotype relationships. Conclusions Stead and colleagues’ 2005 concept of using light standards to increase the productivity of software systems by riding on the wave of hardware/processing power is described as a harbinger for designing future healthcare systems. The big data solution, using flexible markup, provides a route to improved utilization of processing power for organizing patient records in genotype and phenotype research. PMID:25123744

  7. An educational portal to facilitate statistical literacy for the Malaysian community

    NASA Astrophysics Data System (ADS)

    Bahardin, Nadiah; Ismail, Zaleha; Abidin, Nur Liyana Zainal

    2015-02-01

    In the last decades, a considerable number of studies investigated the teaching and learning of statistics. The implications of these studies have changed the content and structure of statistics. Hence, the applications of statistics to understand the world around us should be followed by the learning of statistical concepts so that the students are aware that statistics is an important tool to solve practical life problems. There must be some platform such as materials or articles that discuss explicitly the applications of statistics in various area that reach of students. An educational web portal by the name of Dunia Matematik has been delegated to meet this need. Apart from the sections which provide numerous articles that portray statistics in real life, the portal also provides articles on history in mathematics, popular mathematicians, online quizzes, technology in mathematics education and arts in mathematics. Based on ARCS model on motivation, the four components of the model, namely attention, relevance, confidence and satisfaction are integrated in the design of the articles and activities. A rich collection of such resources which present authentic data could supplement text book materials which heavily focus onto statistical concepts and procedures. Besides motivating learning, it is expected that the web portal has the potential to develop statistical literacy, an ability to comprehend and infer the data. The final part of the paper will describe some resources that have been developed.

  8. Service quality of Early Childhood Education web portals in Finnish municipalities

    NASA Astrophysics Data System (ADS)

    Koskivaara, Eija; Pihlaja, Päivi

    Increasing number of governmental organizations have transformed material on their web sites as a way of providing users with information about their products and services. In this paper, we apply Yang et al (2005) instrument for analyzing municipal early childhood education (ECE) web sites in Finland. The objective of the study was to find out the quality of ECE web portals as well as to give hints to improve their value from users' point of view. In general the five dimensions, usability, usefulness of content, adequacy of information, accessibility, and interaction, of the Yang et al model seems to be applicable also in the early childhood education environment.

  9. StarBRITE: The Vanderbilt University Biomedical Research Integration, Translation and Education Portal

    PubMed Central

    Harris, Paul A.; Swafford, Jonathan A.; Edwards, Terri L.; Zhang, Minhua; Nigavekar, Shraddha S.; Yarbrough, Tonya R.; Lane, Lynda D.; Helmer, Tara; Lebo, Laurie A.; Mayo, Gail; Masys, Daniel R.; Bernard, Gordon R.; Pulley, Jill M.

    2011-01-01

    StarBRITE is a one-stop, web-based research portal designed to meet the day-to-day needs of the Vanderbilt University and Meharry Medical College research community during the planning and conduct of research studies. StarBRITE serves as the main online location for research support addressing issues such as identification and location of resources, identification of experts, guidance for regulatory applications and approvals, regulatory assistance, funding requests, research data planning and collection, and serves as a central repository for educational offerings. To date, there have been more than 590,038 StarBRITE hits by more than 6582 cumulative users. We present here StarBRITE design objectives, details about technical infrastructure and system components, status report and activity metrics for the first 2.75-years of operation, and a report of lessons learned during organizing, launching and refining the portal. PMID:21310264

  10. Giovanni Data Portals and Resources Support Student Problem-Based Learning for Climate Change Education

    NASA Astrophysics Data System (ADS)

    Acker, J. G.; Zalles, D. R.; Krumhansl, R. A.

    2012-12-01

    The Data-Enhanced Investigations for Climate Change Education (DICCE) project, funded by NASA, is providing dedicated climate data portals in the NASA Giovanni data system for the use of teachers and students. The central content of the DICCE-Giovanni data portals is a reduced set of climate-relevant data parameters drawn from the available Giovanni data sets, with accessible meanings, such as surface temperature, precipitation amount, snow cover, phytoplankton chlorophyll concentration, vegetation indices, and aerosol optical depth. Information resources explain the significance of the data to climate research, how to interpret climate data trends, and address uncertainties in both data visualizations and the interpretation of data plotting output. "How-to" videos and plotting tips facilitate the utilization of the data portals, so that teachers can create problem-based projects based on actual satellite observational data. The use of satellite data in a problem-based framework enhances the relevance and immediacy of the project content to the student, improves their understanding of Earth climate system interrelationships, and also improves pattern recognition, math skills, and interpretation of data representations.;

  11. Quality requirements for EHR archetypes.

    PubMed

    Kalra, Dipak; Tapuria, Archana; Austin, Tony; De Moor, Georges

    2012-01-01

    The realisation of semantic interoperability, in which any EHR data may be communicated between heterogeneous systems and fully understood by computers as well as people on receipt, is a challenging goal. Despite the use of standardised generic models for the EHR and standard terminology systems, too much optionality and variability exists in how particular clinical entries may be represented. Clinical archetypes provide a means of defining how generic models should be shaped and bound to terminology for specific kinds of clinical data. However, these will only contribute to semantic interoperability if libraries of archetypes can be built up consistently. This requires the establishment of design principles, editorial and governance policies, and further research to develop ways for archetype authors to structure clinical data and to use terminology consistently. Drawing on several years of work within communities of practice developing archetypes and implementing systems from them, this paper presents quality requirements for the development of archetypes. Clinical engagement on a wide scale is also needed to help grow libraries of good quality archetypes that can be certified. Vendor and eHealth programme engagement is needed to validate such archetypes and achieve safe, meaningful exchange of EHR data between systems. PMID:22874150

  12. Sharable EHR systems in Finland.

    PubMed

    Harno, Kari; Ruotsalainen, Pekka

    2006-01-01

    In Finland, the shared record is a virtual electronic health record (EHR). It consists of health data generated, maintained and preserved by different health care service providers. Two different kinds of technologies for integrating regional EHR-systems are applied, but mainly by using a common middleware. Services provided by this middleware are EHR location services using a link repository and combining EHR-viewing services with security management services including consent management and identification services for health professionals. The Regional Health Information Organization (UUMA) approach is based on a stepwise implementation of integrated regional healthcare services to create a virtually borderless healthcare organization--a patient centered virtual workspace. In the virtual workspace multi-professional teams and patients collaborate and share information regardless of time and place. Presently the regional health information network (RHIN) is comprised of three integrated services between primary, secondary and tertiary care within the county of Uusimaa. The regional healthcare modules consist of an (1) eReferral network, (2) integrated EHR service between health care professionals and (3) PACS system. The eReferral between primary and secondary care not only speeds up the transfer, but also offers an option for communication in the form of eConsultation between general practitioners and hospital specialists. By sharing information and knowledge remote eConsultations create a new working environment for integrated delivery of eServices between the health care providers. Over 100,000 eReferral messages (40 %) were transferred between health care providers. Interactive eConsultations enable supervised care leading to the reduction of outpatient visits and more timely appointments. One third (10/31) of the municipal health centers are connected to the clinics in the Helsinki University Central Hospital by the eReferral system. The link directory

  13. The portal of geriatrics online education: a 21st-century resource for teaching geriatrics.

    PubMed

    Ramaswamy, Ravishankar; Leipzig, Rosanne M; Howe, Carol L; Sauvigne, Karen; Usiak, Craig; Soriano, Rainier P

    2015-02-01

    The way students are taught and evaluated is changing, with greater emphasis on flexible, individualized, learner-centered education, including the use of technology. The goal of assessment is also shifting from what students know to how they perform in practice settings. Developing educational materials for teaching in these ways is time-consuming and can be expensive. The Portal of Geriatrics Online Education (POGOe) was developed to aid educators in meeting these needs and become quicker, better-prepared teachers of geriatrics. POGOe contains more than 950 geriatrics educational materials that faculty at 45% of allopathic and 7% of osteopathic U.S. medical schools and the Centers for Geriatric Nursing Excellence have created. These materials include various instructional and assessment methodologies, including virtual and standardized patients, games, tutorials, case-based teaching, self-directed learning, and traditional lectures. Materials with common goals and resource types are available as selected educational series. Learner assessments comprise approximately 10% of the educational materials. POGOe also includes libraries of videos, images, and questions extracted from its educational materials to encourage educators to repurpose content components to create new resources and to align their teaching better with their learners' needs. Web-Geriatric Education Modules, a peer-reviewed online modular curriculum for medical students, is a prime example of this repurposing. The existence of a robust compendium of instructional and assessment materials allows educators to concentrate more on improving learner performance in practice and not simply on knowledge acquisition. It also makes it easier for nongeriatricians to teach the care of older adults in their respective disciplines. PMID:25644187

  14. eHR: An Introduction. IES Report.

    ERIC Educational Resources Information Center

    Kettley, P.; Reilly, P.

    This document introduces the concept of electronic human resources (eHR) and its application. Chapter 1 presents a brief overview of the guide's development, purpose, and structure. Chapter 2 defines the concept of eHR as "the application of conventional, Web, and voice technologies to improve HR administration, transactions, and process…

  15. Improving EHR Usability Using LEAN Methodology.

    PubMed

    Bosse, Corbin; Kelly, Kandace

    2016-01-01

    Electronic health record (EHR) usability concerns continue to reduce EHR effectiveness. LEAN methodology, which focuses on waste elimination, may provide an effective method to address efficiency related usability deficiencies. We aimed to improve the usability of an inpatient seclusion and restraint (SR) EHR module using LEAN methodology. A multidisciplinary team convened to evaluate and redesign clinical and technological SR workflows using LEAN techniques, including process mapping and time-series analyses. SR module modifications addressed 40 of the 60 efficiency related usability deficiencies identified in the initial SR module. Usability enhancements included elimination of 10 nonessential inputs, 21 redundancies, and nine overhead functions. Process steps were reduced from 74 to 47. Improving EHR usability is critical to assure safe, effective, and efficient care1. We demonstrated that LEAN methodology is an effective method to address efficiency related EHR usability deficiencies. More research is needed to determine how these improvements impact care quality. PMID:27332384

  16. West Texas nursing education portal project: developing a regional centralized application system.

    PubMed

    Allen, Patricia; Billings, Lynda; Cannon, Sharon; Majors, Jennifer; Sportsman, Susan; Ballesteros, Pauline A; Bezinque, Kim; Bolton, Cathy; Cottenoir, Marla; Edwards, Carmen; Louder, Justin; O'Neal, Cynthia; Morgan, Jackolyn; Reyes, Helen; Ross, Linda

    2011-01-01

    Because of the nursing shortage and a demand for maximum enrollment, a group of five baccalaureate and seven associate degree nursing programs in West Texas first met in 2007 to form the West Texas Nursing Education Consortium (WTNEC). To emphasize the importance of scale and distance, the West Texas region is larger than all of the northeastern states combined. The founding group agreed that the first mission of WTNEC should be to pool resources in order to increase admission and graduation rates for WTNEC schools. Two years later, this mission is being accomplished by the implementation of a plan designed to increase participating schools' admissions, retention, and graduation rates. A grant proposal was written and funded to develop a central regionalization of the application process for entry into WTNEC generic programs (associates degree in nursing and bachelor of science in nursing), with the goal of decreasing and possibly eliminating student vacancy rates in member schools and perhaps reducing the resources needed by each school for the admission process. The implemented centralized application system allowed prospective students to apply online to the centralized admission portal. Students maintained the freedom to choose the nursing program(s) they wanted to attend, but they were also made aware of possible openings in other participating schools. The admission portal also saved potential students time and money by submitting one centralized application, resulting in consolidation of the nursing school application process. Eleven of the 12 consortium schools participated in the centralized application system. PMID:21596353

  17. WormClassroom.org: An Inquiry-Rich Educational Web Portal for Research Resources of "Caenorhabditis elegans"

    ERIC Educational Resources Information Center

    Lu, Fong-Mei; Eliceiri, Kevin W.; Stewart, James; White, John G.

    2007-01-01

    The utilization of biology research resources, coupled with a "learning by inquiry" approach, has great potential to aid students in gaining an understanding of fundamental biological principles. To help realize this potential, we have developed a Web portal for undergraduate biology education, WormClassroom.org, based on current research…

  18. Portability and Usability of Open Educational Resources on Mobile Devices: A Study in the Context of Brazilian Educational Portals and Android-Based Devices

    ERIC Educational Resources Information Center

    da Silva, André Constantino; Freire, Fernanda Maria Pereira; Mourão, Vitor Hugo Miranda; da Cruz, Márcio Diógenes de Oliveira; da Rocha, Heloísa Vieira

    2014-01-01

    Open Educational Resources (OER) are freely accessible, openly licensed hypertext, audio, video, simulations, games and animations that are useful for teaching and learning purposes. In order to facilitate the location of such resources, educational content portals are being created, crowding contents that were produced by different teams with…

  19. Portal Hypertension

    MedlinePlus

    ... Chronic Hepatitis C Additional Content Medical News Portal Hypertension By Steven K. Herrine, MD NOTE: This is ... Hepatic Encephalopathy Jaundice in Adults Liver Failure Portal Hypertension Portal hypertension is abnormally high blood pressure in ...

  20. EHR adopters vs. non-adopters: Impacts of, barriers to, and federal initiatives for EHR adoption

    PubMed Central

    Jamoom, Eric W.; Patel, Vaishali; Furukawa, Michael F.; King, Jennifer

    2016-01-01

    While adoption of electronic health record (EHR) systems has grown rapidly, little is known about physicians’ perspectives on its adoption and use. Nationally representative survey data from 2011 are used to compare the perspectives of physicians who have adopted EHRs with those that have yet to do so across three key areas: the impact of EHRs on clinical care, practice efficiency and operations; barriers to EHR adoption; and factors that influence physicians to adopt EHRs. Despite significant differences in perspectives between adopters and non-adopters, the majority of physicians perceive that EHR use yields overall clinical benefits, more efficient practices and financial benefits. Purchase cost and productivity loss are the greatest barriers to EHR adoption among both adopters and non-adopters; although non-adopters have significantly higher rates of reporting these as barriers. Financial incentives and penalties, technical assistance, and the capability for electronic health information exchange are factors with the greatest influence on EHR adoption among all physicians. However, a substantially higher proportion of non-adopters regard various national health IT policies, and in particular, financial incentives or penalties as a major influence in their decision to adopt an EHR system. Contrasting these perspectives provides a window into how national policies have shaped adoption thus far; and how these policies may shape adoption in the near future. PMID:26250087

  1. Disparities in Primary Care EHR Adoption Rates

    PubMed Central

    Mack, Dominic; Zhang, Shun; Douglas, Megan; Sow, Charles; Strothers, Harry; Rust, George

    2016-01-01

    This study evaluates electronic health record (EHR) adoption by primary care providers in Georgia to assess adoption disparities according to practice size and type, payer mix, and community characteristics. Frequency variances of EHR “Go Live” status were estimated. Odds ratios were calculated by univariate and multivariate logistic regression models. Large practices and community health centers (CHCs) were more likely to Go Live (>80% EHR adoption) than rural health clinics and other underserved settings (53%). A significantly lower proportion (68.9%) of Medicaid predominant providers had achieved Go Live status and had a 47% higher risk of not achieving Go Live status than private insurance predominant practices. Disparities in EHR adoption rates may exacerbate existing disparities in health outcomes of patients served by these practices. Targeted support such as that provided to CHCs would level the playing field for practices now at a disadvantage. PMID:27587942

  2. Improving Rates of Influenza Vaccination Through Electronic Health Record Portal Messages, Interactive Voice Recognition Calls and Patient-Enabled Electronic Health Record Updates: Protocol for a Randomized Controlled Trial

    PubMed Central

    Sreedhara, Meera; Goff, Sarah L; Fisher, Lloyd D; Preusse, Peggy; Jackson, Madeline; Sundaresan, Devi; Garber, Lawrence D; Mazor, Kathleen M

    2016-01-01

    Background Clinical decision support (CDS), including computerized reminders for providers and patients, can improve health outcomes. CDS promoting influenza vaccination, delivered directly to patients via an electronic health record (EHR) patient portal and interactive voice recognition (IVR) calls, offers an innovative approach to improving patient care. Objective To test the effectiveness of an EHR patient portal and IVR outreach to improve rates of influenza vaccination in a large multispecialty group practice in central Massachusetts. Methods We describe a nonblinded, randomized controlled trial of EHR patient portal messages and IVR calls designed to promote influenza vaccination. In our preparatory phase, we conducted qualitative interviews with patients, providers, and staff to inform development of EHR portal messages with embedded questionnaires and IVR call scripts. We also provided practice-wide education on influenza vaccines to all physicians and staff members, including information on existing vaccine-specific EHR CDS. Outreach will target adult patients who remain unvaccinated for more than 2 months after the start of the influenza season. Using computer-generated randomization and a factorial design, we will assign 20,000 patients who are active users of electronic patient portals to one of the 4 study arms: (1) receipt of a portal message promoting influenza vaccines and offering online appointment scheduling; (2) receipt of an IVR call with similar content but without appointment facilitation; (3) both (1) and (2); or (4) neither (1) nor (2) (usual care). We will randomize patients without electronic portals (10,000 patients) to (1) receipt of IVR call or (2) usual care. Both portal messages and IVR calls promote influenza vaccine completion. Our primary outcome is percentage of eligible patients with influenza vaccines administered at our group practice during the 2014-15 influenza season. Both outreach methods also solicit patient self

  3. The Power in the Portal

    ERIC Educational Resources Information Center

    Chamberlain, Cathy

    2005-01-01

    Educational portals put together links to sites and resources educators would be interested in viewing. They eliminate the hours of searching that might be invested if typical search engines were used. Educational portals feature lessons, units, printable resources, creative ideas, and more. Many of these sites are free, while others are…

  4. Cost Effective Staffing for an EHR Implementation.

    PubMed

    Bullard, Katherine L

    2016-01-01

    This case study explores costs of electronic health record (EHR) implementation with the nursing super-user role in a metropolitan, not-for-profit health care system. Tapping the local pool of unemployed newly graduated nurses as half the required super-user workforce leveraged the technology skills of novice registered nurses (RNs) as trainers of experienced nurses in five hospitals. The novel workforce migrated from hospital to hospital, thereby reducing the number of experienced nurses reassigned to super-user duties in each hospital. This strategy reduced the amount of contract labor required to backfill nurse super-users' clinical shifts. Employment of the recently graduated nurses as RN residents upon completion of the EHR implementation enabled the organization to augment its clinical workforce with expert users of its EHR. The proposed innovative model increases super-users, minimizes disruption of core staffing, and dramatically reduces expense. PMID:27265948

  5. Dynamic CDM strategies in an EHR environment.

    PubMed

    Bieker, Michael; Bailey, Spencer

    2012-02-01

    A dynamic charge description master (CDM) integrates information from clinical ancillary systems into the charge-capture process, so an organization can reduce its reliance on the patient accounting system as the sole source of billing information. By leveraging the information from electronic ancillary systems, providers can eliminate the need for paper charge-capture forms and see increased accuracy and efficiency in the maintenance of billing information. Before embarking on a dynamic CDM strategy, organizations should first determine their goals for implementing an EHR system, include revenue cycle leaders on the EHR implementation team, and carefully weigh the pros and cons of CDM design decisions. PMID:22372294

  6. EHR Learning - It's about Nursing, Leadership and Long-Term Commitments.

    PubMed

    Furlong, Karen E

    2016-01-01

    Despite a global commitment to the adoption of technologies, such as electronic health records (EHRs), to support the delivery of health services, there is little empirical guidance to support effective planning for the integration of these tools into practice settings (Suter et al. 2009). In particular, although EHR learning is known to positively influence integration (Byrne 2012), individual perspectives are often overlooked because of investigative designs that devalue such viewpoints by exploring the utility of technologies rather than the lived experiences of individual users of the technology. Therefore, this qualitative study offered nurse participants opportunities to make sense of EHR learning through talking about their experiences. This narrative inquiry was a collaborative interpretive method of discovery: stories and thematic analysis were the two separate yet complementary frames used to support data analysis. Finally, several practice implications and recommendations about EHR learning are presented with an emphasis placed upon patient safety as a way to impart accountability on behalf of learners, educators and those charged with governing responsibilities during times of EHR integration. PMID:27122089

  7. 42 CFR 495.210 - Meaningful EHR user attestation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Meaningful EHR user attestation. 495.210 Section... INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.210 Meaningful EHR... EHR user. (b) Qualifying MA organizations are required to attest within 60 days after the close of...

  8. Developing a Web 2.0 telemedical education system: the AJAX-Cocoon portal.

    PubMed

    Mohammed, S; Orabi, A; Fiaidhi, J; Orabi, M

    2008-01-01

    Web 2.0 technologies such as wikis, podcasts/vodcasting, blogs and semantic portals could be quite effective tools in e-learning for health professionals. If effectively deployed, such tools can offer a way to enhance students', clinicians' and patients' learning experiences, and deepens levels of learners' engagement and collaboration within medical learning environments. However, Web 2.0 requires simplicity of use as well as integration with modern web technologies. This article presents a Web 2.0 telemedical portal, which provides a social community-learning paradigm from the desk of the physician, the student, the hospital administrator, or the insurer. The presented portal utilises RESTful web services and techniques like content syndication, mushups and Asynchronous JavaScript API and XML (AJAX). The designed portal is based on the Apache Cocoon RESTful framework for sharing Digital Imaging and Communications in Medicine (DICOM) medical case studies. Central to this article is the integration between Cocoon and AJAX. The proposed AJAX-Cocoon portal utilises a JSP portlet architecture, which manages the interaction dynamics and overcomes the shortcomings of the JSR 168 and WSRP 1.0 standards. PMID:18583294

  9. Using the ResearchEHR platform to facilitate the practical application of the EHR standards.

    PubMed

    Maldonado, José Alberto; Costa, Catalina Martínez; Moner, David; Menárguez-Tortosa, Marcos; Boscá, Diego; Miñarro Giménez, José Antonio; Fernández-Breis, Jesualdo Tomás; Robles, Montserrat

    2012-08-01

    Possibly the most important requirement to support co-operative work among health professionals and institutions is the ability of sharing EHRs in a meaningful way, and it is widely acknowledged that standardization of data and concepts is a prerequisite to achieve semantic interoperability in any domain. Different international organizations are working on the definition of EHR architectures but the lack of tools that implement them hinders their broad adoption. In this paper we present ResearchEHR, a software platform whose objective is to facilitate the practical application of EHR standards as a way of reaching the desired semantic interoperability. This platform is not only suitable for developing new systems but also for increasing the standardization of existing ones. The work reported here describes how the platform allows for the edition, validation, and search of archetypes, converts legacy data into normalized, archetypes extracts, is able to generate applications from archetypes and finally, transforms archetypes and data extracts into other EHR standards. We also include in this paper how ResearchEHR has made possible the application of the CEN/ISO 13606 standard in a real environment and the lessons learnt with this experience. PMID:22142945

  10. A reference architecture for integrated EHR in Colombia.

    PubMed

    de la Cruz, Edgar; Lopez, Diego M; Uribe, Gustavo; Gonzalez, Carolina; Blobel, Bernd

    2011-01-01

    The implementation of national EHR infrastructures has to start by a detailed definition of the overall structure and behavior of the EHR system (system architecture). Architectures have to be open, scalable, flexible, user accepted and user friendly, trustworthy, based on standards including terminologies and ontologies. The GCM provides an architectural framework created with the purpose of analyzing any kind of system, including EHR system´s architectures. The objective of this paper is to propose a reference architecture for the implementation of an integrated EHR in Colombia, based on the current state of system´s architectural models, and EHR standards. The proposed EHR architecture defines a set of services (elements) and their interfaces, to support the exchange of clinical documents, offering an open, scalable, flexible and semantically interoperable infrastructure. The architecture was tested in a pilot tele-consultation project in Colombia, where dental EHR are exchanged. PMID:21893762

  11. Electronic Health Record Patient Portal Adoption by Health Care Consumers: An Acceptance Model and Survey

    PubMed Central

    2016-01-01

    Background The future of health care delivery is becoming more citizen centered, as today’s user is more active, better informed, and more demanding. Worldwide governments are promoting online health services, such as electronic health record (EHR) patient portals and, as a result, the deployment and use of these services. Overall, this makes the adoption of patient-accessible EHR portals an important field to study and understand. Objective The aim of this study is to understand the factors that drive individuals to adopt EHR portals. Methods We applied a new adoption model using, as a starting point, Ventkatesh's Unified Theory of Acceptance and Use of Technology in a consumer context (UTAUT2) by integrating a new construct specific to health care, a new moderator, and new relationships. To test the research model, we used the partial least squares (PLS) causal modelling approach. An online questionnaire was administrated. We collected 360 valid responses. Results The statistically significant drivers of behavioral intention are performance expectancy (beta=.200; t=3.619), effort expectancy (beta=.185; t=2.907), habit (beta=.388; t=7.320), and self-perception (beta=.098; t=2.285). The predictors of use behavior are habit (beta=0.206; t=2.752) and behavioral intention (beta=0.258; t=4.036). The model explained 49.7% of the variance in behavioral intention and 26.8% of the variance in use behavior. Conclusions Our research helps to understand the desired technology characteristics of EHR portals. By testing an information technology acceptance model, we are able to determine what is more valued by patients when it comes to deciding whether to adopt EHR portals or not. The inclusion of specific constructs and relationships related to the health care consumer area also had a significant impact on understanding the adoption of EHR portals. PMID:26935646

  12. Archetype Model-Driven Development Framework for EHR Web System

    PubMed Central

    Kimura, Eizen; Ishihara, Ken

    2013-01-01

    Objectives This article describes the Web application framework for Electronic Health Records (EHRs) we have developed to reduce construction costs for EHR sytems. Methods The openEHR project has developed clinical model driven architecture for future-proof interoperable EHR systems. This project provides the specifications to standardize clinical domain model implementations, upon which the ISO/CEN 13606 standards are based. The reference implementation has been formally described in Eiffel. Moreover C# and Java implementations have been developed as reference. While scripting languages had been more popular because of their higher efficiency and faster development in recent years, they had not been involved in the openEHR implementations. From 2007, we have used the Ruby language and Ruby on Rails (RoR) as an agile development platform to implement EHR systems, which is in conformity with the openEHR specifications. Results We implemented almost all of the specifications, the Archetype Definition Language parser, and RoR scaffold generator from archetype. Although some problems have emerged, most of them have been resolved. Conclusions We have provided an agile EHR Web framework, which can build up Web systems from archetype models using RoR. The feasibility of the archetype model to provide semantic interoperability of EHRs has been demonstrated and we have verified that that it is suitable for the construction of EHR systems. PMID:24523991

  13. Designing and implementing medical web portals: spreading educational and research materials on the Internet.

    PubMed Central

    Joubert, M.; Aymard, S.; Staccini, P.; Fieschi, M.

    2001-01-01

    OBJECTIVES: To design and implement a medical web portal providing access to well qualified and high-quality information in the framework of universities and hospitals. METHOD: Based on the authors experience and the published literature, a model is proposed which describes the properties of documents in an object-oriented way. This model clearly separates from usual properties: the subject of a document as keywords, and information concerning its type, format, and location. RESULTS: An implementation has been done with an existing software that allows the capability to organize and index a web site according to the model. Experiments have been conducted which demonstrate the feasibility and the utility of such an approach. DISCUSSION: The benefits for the users, both designers and end users, of using such a portal are discussed. Forthcoming works are described. PMID:11825199

  14. Protection of electronic health records (EHRs) in cloud.

    PubMed

    Alabdulatif, Abdulatif; Khalil, Ibrahim; Mai, Vu

    2013-01-01

    EHR technology has come into widespread use and has attracted attention in healthcare institutions as well as in research. Cloud services are used to build efficient EHR systems and obtain the greatest benefits of EHR implementation. Many issues relating to building an ideal EHR system in the cloud, especially the tradeoff between flexibility and security, have recently surfaced. The privacy of patient records in cloud platforms is still a point of contention. In this research, we are going to improve the management of access control by restricting participants' access through the use of distinct encrypted parameters for each participant in the cloud-based database. Also, we implement and improve an existing secure index search algorithm to enhance the efficiency of information control and flow through a cloud-based EHR system. At the final stage, we contribute to the design of reliable, flexible and secure access control, enabling quick access to EHR information. PMID:24110656

  15. Toward a Natural Language Interface for EHR Questions

    PubMed Central

    Roberts, Kirk; Demner-Fushman, Dina

    2015-01-01

    This paper presents a pilot study on the process of manually annotating natural language EHR questions with a formal meaning representation. This formal representation could then be used as a structured query as part of a natural language interface for electronic health records. This study analyzes the challenges of representing EHR questions as structured queries as well as the feasibility of creating a sufficiently large corpus of manually annotated structured queries for EHR questions. A set of 100 EHR questions, sampled from actual questions asked by ICU physicians[1], is used to perform the analysis. The ultimate goal of this research is to enable automatic methods for understanding EHR questions for use in a natural language EHR interface. PMID:26306260

  16. Comparing the Certification Criteria for CCHIT-Certified Ambulatory EHR with the SNUBH's EHR Functionalities

    PubMed Central

    Heo, Eun Young; Hwang, Hee; Kim, Eun Hye; Cho, Eun Young; Lee, Kee Hyuck; Kim, Tae Hun; Kim, Ki Dong; Baek, Rong Min

    2012-01-01

    Objectives This study aims to investigate the suitability of electronic health record (EHR) systems in Korea for global certification and to propose functions for future global systems by comparing and analyzing the certification criteria for Certification Commission for Health Information Technology (CCHIT) Certified Ambulatory EHR with BESTCare, which is the EHR system at Seoul National University Bundang hospital. Methods Domain expert groups were formed to analyze the inclusion of BESTCare functions and the types of differences for each of the CCHIT Certified 2011 Ambulatory EHR Certification Criteria. The types of differences were divided into differences in functions (F), differences in business processes (B), and differences in government policies (P). Results Generally, the criteria that showed differences in functions pertained to the connection between the diagnosis/problem list and order, the alert and warning functions for medication-diagnosis interactions, and the reminder/instruction/notification messages related to the patient's immunization status; these absent functions were enhanced clinical decision support system (CDSS) functions related to patient safety and healthcare quality. Differences in government policies were found in the pharmacy's electronic prescription functions, while differences in business processes were found in the functions constrained by the local workflow or internal policy, which require some customization. Conclusions Functions that differed between the CCHIT certification criteria and the BESTCare system in this study should be considered when developing a global EHR system. Such a system will need to be easily customizable to adapt to various government policies and local business processes. These functions should be considered when developing a global EHR system certified by CCHIT in the future. PMID:22509474

  17. Patient Access to Their Health Record Using Open Source EHR.

    PubMed

    Chelsom, John; Dogar, Naveed

    2015-01-01

    In both Europe and North America, patients are beginning to gain access to their health records in electronic form. Using the open source cityEHR as an example, we have focussed on the needs of clinical users to gather requirements for patient access and have implemented these requirements in a new application called cityEHR-PA. The development of a separate application for patient access was necessary to address requirements for security and ease of use. The use of open standards throughout the design of the EHR allows the possibility of third parties to develop applications for patient access, consuming the individual patient record extracted from the full EHR. PMID:25676956

  18. Towards the Implementation of an openEHR-based Open Source EHR Platform (a vision paper).

    PubMed

    Pazos Gutiérrez, Pablo

    2015-01-01

    Healthcare Information Systems are a big business. Currently there is an explosion of EHR/EMR products available on the market, and the best tools are really expensive. Many developing countries and healthcare providers cannot access such tools, and for those who can, there is not a clear strategy for the evolution, scaling, and cost of these electronic health products. The lack of standard-based implementations conduct to the creation of isolated information silos that cannot be exploited (i.e. shared between providers to promote a holistic view of each patient's medical history). This paper exposes the main elements behind a Standard-based Open Source EHR Platform that is future-proof and allows to evolve and scale with minimal cost. The proposed EHR Architecture is based on openEHR specifications, adding elements emerged from research and development experiences, leading to a design that can be implemented in any modern technology. Different implementations will be interoperable by design. This Platform will leverage contexts of scarce resources, reusing clinical knowledge, a common set of software components and services. PMID:26262007

  19. EHR based Genetic Testing Knowledge Base (iGTKB) Development

    PubMed Central

    2015-01-01

    Background The gap between a large growing number of genetic tests and a suboptimal clinical workflow of incorporating these tests into regular clinical practice poses barriers to effective reliance on advanced genetic technologies to improve quality of healthcare. A promising solution to fill this gap is to develop an intelligent genetic test recommendation system that not only can provide a comprehensive view of genetic tests as education resources, but also can recommend the most appropriate genetic tests to patients based on clinical evidence. In this study, we developed an EHR based Genetic Testing Knowledge Base for Individualized Medicine (iGTKB). Methods We extracted genetic testing information and patient medical records from EHR systems at Mayo Clinic. Clinical features have been semi-automatically annotated from the clinical notes by applying a Natural Language Processing (NLP) tool, MedTagger suite. To prioritize clinical features for each genetic test, we compared odds ratio across four population groups. Genetic tests, genetic disorders and clinical features with their odds ratios have been applied to establish iGTKB, which is to be integrated into the Genetic Testing Ontology (GTO). Results Overall, there are five genetic tests operated with sample size greater than 100 in 2013 at Mayo Clinic. A total of 1,450 patients who was tested by one of the five genetic tests have been selected. We assembled 243 clinical features from the Human Phenotype Ontology (HPO) for these five genetic tests. There are 60 clinical features with at least one mention in clinical notes of patients taking the test. Twenty-eight clinical features with high odds ratio (greater than 1) have been selected as dominant features and deposited into iGTKB with their associated information about genetic tests and genetic disorders. Conclusions In this study, we developed an EHR based genetic testing knowledge base, iGTKB. iGTKB will be integrated into the GTO by providing relevant

  20. A qualitative analysis of EHR clinical document synthesis by clinicians.

    PubMed

    Farri, Oladimeji; Pieckiewicz, David S; Rahman, Ahmed S; Adam, Terrence J; Pakhomov, Serguei V; Melton, Genevieve B

    2012-01-01

    Clinicians utilize electronic health record (EHR) systems during time-constrained patient encounters where large amounts of clinical text must be synthesized at the point of care. Qualitative methods may be an effective approach for uncovering cognitive processes associated with the synthesis of clinical documents within EHR systems. We utilized a think-aloud protocol and content analysis with the goal of understanding cognitive processes and barriers involved as medical interns synthesized patient clinical documents in an EHR system to accomplish routine clinical tasks. Overall, interns established correlations of significance and meaning between problem, symptom and treatment concepts to inform hypotheses generation and clinical decision-making. Barriers identified with synthesizing EHR documents include difficulty searching for patient data, poor readability, redundancy, and unfamiliar specialized terms. Our study can inform recommendations for future designs of EHR clinical document user interfaces to aid clinicians in providing improved patient care. PMID:23304398

  1. The Wired Patient: Patterns of Electronic Patient Portal Use Among Patients With Cardiac Disease or Diabetes

    PubMed Central

    Weiner, Jonathan P; Shah, Nirav R; Stewart, Walter F

    2015-01-01

    Background As providers develop an electronic health record–based infrastructure, patients are increasingly using Web portals to access their health information and participate electronically in the health care process. Little is known about how such portals are actually used. Objective In this paper, our goal was to describe the types and patterns of portal users in an integrated delivery system. Methods We analyzed 12 months of data from Web server log files on 2282 patients using a Web-based portal to their electronic health record (EHR). We obtained data for patients with cardiovascular disease and/or diabetes who had a Geisinger Clinic primary care provider and were registered “MyGeisinger” Web portal users. Hierarchical cluster analysis was applied to longitudinal data to profile users based on their frequency, intensity, and consistency of use. User types were characterized by basic demographic data from the EHR. Results We identified eight distinct portal user groups. The two largest groups (41.98%, 948/2258 and 24.84%, 561/2258) logged into the portal infrequently but had markedly different levels of engagement with their medical record. Other distinct groups were characterized by tracking biometric measures (10.54%, 238/2258), sending electronic messages to their provider (9.25%, 209/2258), preparing for an office visit (5.98%, 135/2258), and tracking laboratory results (4.16%, 94/2258). Conclusions There are naturally occurring groups of EHR Web portal users within a population of adult primary care patients with chronic conditions. More than half of the patient cohort exhibited distinct patterns of portal use linked to key features. These patterns of portal access and interaction provide insight into opportunities for electronic patient engagement strategies. PMID:25707036

  2. Higher Education Web Portals: Serving State and Student Transfer Needs. Research Brief

    ERIC Educational Resources Information Center

    McGill, Mollie

    2010-01-01

    Students need access to web-based resources where they can easily learn about the transfer options available to them--so they can save time and money as they strive to meet their educational goals. This study, conducted by the Western Interstate Commission for Higher Education Cooperative for Educational Technologies (WCET), is one component of…

  3. Supporting Geoscientists in Partnerships for K-12 Education at NSF

    NASA Astrophysics Data System (ADS)

    Leinen, M.

    2001-12-01

    NSF Directorate for Geosciences (GEO) education activities have evolved over the last decade based on advice from a broad segment of the geosciences community. These activities gained momentum when a Geosciences Education Working Group (GEWG, 1996) recognized the shift from traditional priorities that emphasized only research, to those that support education in geosciences as well. The GEWG report embraced this increased emphasis on education as a component of NSF's role in assuring the long-term health of the geosciences and endorsed the principle that research and education should be well integrated. While many geosciences education activities are funded by the Education and Human Resources Directorate (EHR) of NSF, the GEWG report highlighted the need to have more active participation by research geoscientists in K-12 education activities, and the need to train them to be able to do so. While some roles in education are clearly best left to educational professionals (e.g. large-scale systemic reform projects, pedagogical development at the K-12 level, and many teacher enhancement projects), activities such as undergraduate research, technology advancement, curriculum content development and informal science are ones in which GEO should actively seek to collaborate with programs in EHR. The GEO education program has expanded over the last decade. Our first education activity, Awards to Facilitate Geoscience Education (AFGE), was very successful in attracting some of the leading researchers in geosciences. This program evolved to become the Geoscience Education Program. An important program funded by GEO that developed from community activity is the Digital Library for Earth System Education (DLESE). This program grew out of a joint EHR/GEO award and a series of community workshops. The program will establish an Internet portal for geoscience curricular materials and other teacher resources that will enable further collaboration between the research and education

  4. Building a Personalized Education Portal: Get a Behind-the-Scenes Look at LSU's Award-Winning System.

    ERIC Educational Resources Information Center

    Ethridge, Robin R.; Hadden, Cynthia M; Smith, Michael P.

    2000-01-01

    Describes the Personal Access Web Services (PAWS) at Louisiana State University, a portal application which offers enterprise, workgroup, and personal services. The paper highlights: PAWS project planning; PAWS as a portal; PAWS implementation; account accreditation; user authentication; legacy integration; mapping credentials; transmission of…

  5. Temoa: An Open Educational Resources Portal to Seek, Investigate and Inquire

    ERIC Educational Resources Information Center

    Gómez-Zermeño, Marcela Georgina; de la Garza, Lorena Yadira Alemán

    2015-01-01

    Temoa is a distributor of knowledge that provides a multilingual public catalog of collections of Open Educational Resources (OER). Temoa seeks to support the educational community to find the resources and materials that meet their needs for teaching and learning, through a specialized search system and collaborative social tools. Temoa was…

  6. The NUCLEONICA Nuclear Science Portal

    SciTech Connect

    Magill, Joseph; Dreher, Raymond

    2009-08-19

    NUCLEONICA (www.nucleonica.net) is a new nuclear science web portal which provides a customisable, integrated environment and collaboration platform using the latest internet 'Web 2.0' technology. NUCLEONICA is aimed at professionals, academics and students working in nuclear power, health physics and radiation protection, nuclear and radio-chemistry, and astrophysics. A unique feature of the portal is the wide range of user friendly web-based nuclear science applications. The portal is also ideal for education and training purposes and as a knowledge management platform to preserve nuclear knowledge built up over many decades.

  7. Secure portal.

    SciTech Connect

    Nelson, Cynthia Lee

    2007-09-01

    There is a need in security systems to rapidly and accurately grant access of authorized personnel to a secure facility while denying access to unauthorized personnel. In many cases this role is filled by security personnel, which can be very costly. Systems that can perform this role autonomously without sacrificing accuracy or speed of throughput are very appealing. To address the issue of autonomous facility access through the use of technology, the idea of a ''secure portal'' is introduced. A secure portal is a defined zone where state-of-the-art technology can be implemented to grant secure area access or to allow special privileges for an individual. Biometric technologies are of interest because they are generally more difficult to defeat than technologies such as badge swipe and keypad entry. The biometric technologies selected for this concept were facial and gait recognition. They were chosen since they require less user cooperation than other biometrics such as fingerprint, iris, and hand geometry and because they have the most potential for flexibility in deployment. The secure portal concept could be implemented within the boundaries of an entry area to a facility. As a person is approaching a badge and/or PIN portal, face and gait information can be gathered and processed. The biometric information could be fused for verification against the information that is gathered from the badge. This paper discusses a facial recognition technology that was developed for the purposes of providing high verification probabilities with low false alarm rates, which would be required of an autonomous entry control system. In particular, a 3-D facial recognition approach using Fisher Linear Discriminant Analysis is described. Gait recognition technology, based on Hidden Markov Models has been explored, but those results are not included in this paper. Fusion approaches for combining the results of the biometrics would be the next step in realizing the secure portal

  8. 45 CFR 170.550 - EHR Module certification.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Public Welfare Department of Health and Human Services HEALTH INFORMATION TECHNOLOGY HEALTH INFORMATION TECHNOLOGY STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA AND CERTIFICATION PROGRAMS FOR HEALTH INFORMATION TECHNOLOGY ONC HIT Certification Program § 170.550 EHR Module...

  9. 45 CFR 170.550 - EHR Module certification.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH INFORMATION TECHNOLOGY HEALTH INFORMATION TECHNOLOGY STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA AND CERTIFICATION PROGRAMS FOR HEALTH INFORMATION TECHNOLOGY Permanent Certification Program for HIT § 170.550 EHR...

  10. 45 CFR 170.550 - EHR Module certification.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH INFORMATION TECHNOLOGY HEALTH INFORMATION TECHNOLOGY STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA AND CERTIFICATION PROGRAMS FOR HEALTH INFORMATION TECHNOLOGY Permanent Certification Program for HIT § 170.550 EHR...

  11. 45 CFR 170.550 - EHR Module certification.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH INFORMATION TECHNOLOGY HEALTH INFORMATION TECHNOLOGY STANDARDS, IMPLEMENTATION SPECIFICATIONS, AND CERTIFICATION CRITERIA AND CERTIFICATION PROGRAMS FOR HEALTH INFORMATION TECHNOLOGY ONC HIT Certification Program § 170.550 EHR Module certification....

  12. Patient opinion--EHR assessment from the users perspective.

    PubMed

    Zurita, Laura; Nøhr, Christian

    2004-01-01

    Electronic Health Records (EHR) are becoming an integrated part of modern health care. The introduction of EHR in healthcare has been evaluated by many actors and from many perspectives. However, there is hardly any study exploring the opinion of the ultimate users of the system, the patients. This study aims to provide information about patient values and communication that will be useful in the design of a more patient friendly health system. We have asked patients in three different hospitals about their opinions about EHR, using semi structured individual interviews and focus groups. The patients are open to the use of EHR, but they have some concerns: they want their privacy to be respected, and the systems to be safe from the intrusion from outsiders. These results underline the general societal tendencies of citizen accepting the use of new technology, but being very keen to protect their privacy. PMID:15361031

  13. A Portal of Educational Resources: Providing Evidence for Matching Pedagogy with Technology

    ERIC Educational Resources Information Center

    Di Blas, Nicoletta; Fiore, Alessandro; Mainetti, Luca; Vergallo, Roberto; Paolini, Paolo

    2014-01-01

    The TPACK (Technology, Pedagogy and Content Knowledge) model presents the three types of knowledge that are necessary to implement a successful technology-based educational activity. It highlights how the intersections between TPK (Technological Pedagogical Knowledge), PCK (Pedagogical Content Knowledge) and TCK (Technological Content Knowledge)…

  14. Toward the Knowledge Portal: Public Broadcasting and University Continuing Education in the Internet Age.

    ERIC Educational Resources Information Center

    Vedro, Steven R.

    1999-01-01

    Discusses digital technology convergence and its effects on the information and entertainment industries and on public television. Highlights include media-based educational organizations and their place in the knowledge marketplace; relationships between content providers and their suppliers and customers; competition; distance and continuing…

  15. The education on landslides through the "BE-SAFE-NET" web-portal on Disaster Awareness.

    NASA Astrophysics Data System (ADS)

    Maquaire, O.; Castaldini, D.; Malet, J.-P.; von Elverfeldt, K.; Pla, F.; Soldati, M.; Greco, R.; Pasuto, A.

    2009-04-01

    The website on Disaster Awareness with the use of the internet "BE-SAFE-NET" is developed within the framework of the FORM-OSE programme (European Training Programme for South, East and West) of the EUR-OPA Major Hazards Agreement, hosted by the European Centre for Disaster Awareness with the use of the internet (BE-SAFE-NET, Nicosia, Cyprus). The website is dedicated for school actors (school-level children, teachers, administrative and technical staff, families and local authorities) in order to: - Inform on regulations, on tools for raising awareness for natural and man-made risks and on preventative measures; - Train children, teachers, administrative and technical staff and local authorities; - Produce interactive figures, photographs, videos and games; - Interact with newsgroups and electronic conferences. Together with the EUR-OPA Centre of Nicosia, the project associates several centres of the Major Hazards Agreement network: the European University for the Cultural Heritage (CUEBC) of Ravello (Italy) the European Centre for Risk Prevention (ECRP) of Sofia (Bulgaria), and the European Centre on Geomorphological Hazards (CERG) of Strasbourg (France). "BE-SAFE-NET" is defined as a network among European countries in order to provide e-learning material on natural hazards and risks primarily for schools (secondary school teachers), but also for the public in general. On the webpage, teachers, pupils and the interested public should find information on disaster prevention, preparation, immediate reaction and rehabilitation. The aim of the paper is to present the structure and the organisation of the web-portal following the pilot project focused on landslides and managed by CERG. Some examples of landslides pedagogical material are also presented. The website is structured in five main sections: 1. About the initiative; 2. Definition of common concepts (e.g. hazard (natural and man made), vulnerability, risk, disaster); 3. Pedagogical material (e.g. case

  16. Assessing the relationship between patient safety culture and EHR strategy.

    PubMed

    Ford, Eric W; Silvera, Geoffrey A; Kazley, Abby S; Diana, Mark L; Huerta, Timothy R

    2016-07-11

    Purpose - The purpose of this paper is to explore the relationship between hospitals' electronic health record (EHR) adoption characteristics and their patient safety cultures. The "Meaningful Use" (MU) program is designed to increase hospitals' adoption of EHR, which will lead to better care quality, reduce medical errors, avoid unnecessary cost, and promote a patient safety culture. To reduce medical errors, hospital leaders have been encouraged to promote safety cultures common to high-reliability organizations. Expecting a positive relationship between EHR adoption and improved patient safety cultures appears sound in theory, but it has yet to be empirically demonstrated. Design/methodology/approach - Providers' perceptions of patient safety culture and counts of patient safety incidents are explored in relationship to hospital EHR adoption patterns. Multi-level modeling is employed to data drawn from the Agency for Healthcare Research and Quality's surveys on patient safety culture (level 1) and the American Hospital Association's survey and healthcare information technology supplement (level 2). Findings - The findings suggest that the early adoption of EHR capabilities hold a negative association to the number of patient safety events reported. However, this relationship was not present in providers' perceptions of overall patient safety cultures. These mixed results suggest that the understanding of the EHR-patient safety culture relationship needs further research. Originality/value - Relating EHR MU and providers' care quality attitudes is an important leading indicator for improved patient safety cultures. For healthcare facility managers and providers, the ability to effectively quantify the impact of new technologies on efforts to change organizational cultures is important for pinpointing clinical areas for process improvements. PMID:27298060

  17. Improving HIV/AIDS Knowledge Management Using EHRs

    PubMed Central

    Malmberg, Erik D.; Phan, Thao M.; Harmon, Glynn; Nauert, Richard F.

    2012-01-01

    Background A primary goal for the development of EHRs and EHR-related technologies should be to facilitate greater knowledge management for improving individual and community health outcomes associated with HIV / AIDS. Most of the current developments of EHR have focused on providing data for research, patient care and prioritization of healthcare provider resources in other areas. More attention should be paid to using information from EHRs to assist local, state, national, and international entities engaged in HIV / AIDS care, research and prevention strategies. Unfortunately the technology and standards for HIV-specific reporting modules are still being developed. Methods: A literature search and review supplemented by the author’s own experiences with electronic health records and HIV / AIDS prevention strategies will be used. This data was used to identify both opportunities and challenges for improving public health informatics primarily through the use of latest innovations in EHRs. Qualitative analysis and suggestions are offered for how EHRs can support knowledge management and prevention strategies associated with HIV infection. Results: EHR information, including demographics, medical history, medication and allergies, immunization status, and other vital statistics can help public health practitioners to more quickly identify at-risk populations or environments; allocate scarce resources in the most efficient way; share information about successful, evidenced-based prevention strategies; and increase longevity and quality of life. Conclusion: Local, state, and federal entities need to work more collaboratively with NGOs, community-based organizations, and the private sector to eliminate barriers to implementation including cost, interoperability, accessibility, and information security. PMID:23569643

  18. A pilot project for improving paediatric diabetes outcomes using a website: the Pediatric Diabetes Education Portal.

    PubMed

    Pinsker, Jordan E; Nguyen, Charles; Young, Susan; Fredericks, Gregory J; Chan, Debora

    2011-01-01

    We created a website for patients and families that allowed them to review clinic test results, review educational materials related to these results and post questions to their diabetes educator. Fingerstick haemoglobin A(1c) (HbA(1c)) testing and periodic use of a continuous glucose monitoring system (CGMS) were offered to all patients. The HbA(1c) and CGMS results were posted to the website after each clinic visit. A total of 52 patients with type 1 diabetes were enrolled in the study. There were 16 patients with HbA(1c) values within ADA guidelines and 16 with HbA(1c) values above guidelines; 20 patients were excluded for various reasons. Users of the website were defined as families who logged in four or more times over the six-month study period. For patients whose HbA(1c) started above ADA guidelines, the mean HbA(1c) for website users decreased from 10.5% (SD 2.2) at baseline to 9.1% (SD 1.2) after six months. In the non-users, the mean HbA(1c) increased from 9.5% (SD 1.5) at baseline to 10.4% (SD 2.5). However, these changes were not significant. A between groups comparison (users versus non-users) showed a significant improvement in HbA(1c) for website users (P = 0.03). This change in HbA(1c) was clinically relevant. Further studies with more patients are needed to see if these improvements can be sustained over a longer period. PMID:21565846

  19. Educational Web Portals: Guidelines for Selection and Use. A Guide To Help School District Administrators Assess the Quality, Usefulness and Reliability of Commercially Provided Educational Web Portals Designed for Schools.

    ERIC Educational Resources Information Center

    Burke, Jennifer

    This document describes what a Web portal is (i.e., a Web site that allows access to many resources and services, such as instructional materials, lessons plans, news about current events, instant messaging and e-mail, and the ability to conduct controlled searches). Several questions that school administrators need to consider related to the…

  20. Analysis of the process of representing clinical statements for decision-support applications: a comparison of openEHR archetypes and HL7 virtual medical record.

    PubMed

    González-Ferrer, A; Peleg, M; Marcos, M; Maldonado, J A

    2016-07-01

    Delivering patient-specific decision-support based on computer-interpretable guidelines (CIGs) requires mapping CIG clinical statements (data items, clinical recommendations) into patients' data. This is most effectively done via intermediate data schemas, which enable querying the data according to the semantics of a shared standard intermediate schema. This study aims to evaluate the use of HL7 virtual medical record (vMR) and openEHR archetypes as intermediate schemas for capturing clinical statements from CIGs that are mappable to electronic health records (EHRs) containing patient data and patient-specific recommendations. Using qualitative research methods, we analyzed the encoding of ten representative clinical statements taken from two CIGs used in real decision-support systems into two health information models (openEHR archetypes and HL7 vMR instances) by four experienced informaticians. Discussion among the modelers about each case study example greatly increased our understanding of the capabilities of these standards, which we share in this educational paper. Differing in content and structure, the openEHR archetypes were found to contain a greater level of representational detail and structure while the vMR representations took fewer steps to complete. The use of openEHR in the encoding of CIG clinical statements could potentially facilitate applications other than decision-support, including intelligent data analysis and integration of additional properties of data items from existing EHRs. On the other hand, due to their smaller size and fewer details, the use of vMR potentially supports quicker mapping of EHR data into clinical statements. PMID:27209183

  1. Considering User Satisfaction in Designing Web-Based Portals.

    ERIC Educational Resources Information Center

    Zazelenchuk, Todd W.; Boling, Elizabeth

    2003-01-01

    Discusses how Web portals can best serve higher education institutions if portal designers first understand and satisfy user needs. Shares findings from a usability study of an Indiana University enterprise portal application, which indicated that many existing interaction design principles still apply. (EV)

  2. Factors Influencing Student Acceptance and Use of Academic Portals

    ERIC Educational Resources Information Center

    Presley, Adrien; Presley, Theresa

    2009-01-01

    Institutions of higher education have increasing turned to web portals as a way to connect with students. These portals are designed to provide students a centralized point of access to information and services. In spite of the efforts put into developing and maintaining these portals, their use by students can be disappointing. The study…

  3. Don't take your EHR to heaven, donate it to science: legal and research policies for EHR post mortem

    PubMed Central

    Huser, Vojtech; Cimino, James J

    2014-01-01

    Recently, an important public debate emerged about the digital afterlife of any personal data stored in the cloud. Such debate brings also to attention the importance of transparent management of electronic health record (EHR) data of deceased patients. In this perspective paper, we look at legal and regulatory policies for EHR data post mortem. We analyze observational research situations using EHR data that do not require institutional review board approval. We propose creation of a deceased subject integrated data repository (dsIDR) as an effective tool for piloting certain types of research projects. We highlight several dsIDR challenges in proving death status, informed consent, obtaining data from payers and healthcare providers and the involvement of next of kin. PMID:23966483

  4. Funding alternatives in EHR adoption: beyond HITECH incentives and traditional approaches.

    PubMed

    Wang, Tiankai; Wang, Yangmei; Biedermann, Sue

    2013-05-01

    The meaningful use incentives under HITECH may be inadequate to address the financial challenges many hospitals face in implementing electronic health records (EHRs). Hospitals can fill the capital gap between EHR costs and available funds by exploring other potential funding sources. These sources include additional grants, funding permissible under EHR regulations, vendor financing, and tax benefits under IRS Section 179. PMID:23678695

  5. 42 CFR 495.210 - Meaningful EHR user attestation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.210 Meaningful EHR user attestation. (a) Qualifying MA organizations are required to attest, in a form and manner specified by CMS, that each qualifying MA EP and qualifying MA-affiliated eligible hospitals is a...

  6. 42 CFR 495.210 - Meaningful EHR user attestation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.210 Meaningful EHR user attestation. (a) Qualifying MA organizations are required to attest, in a form and manner specified by CMS, that each qualifying MA EP and qualifying MA-affiliated eligible hospitals is a...

  7. 42 CFR 495.210 - Meaningful EHR user attestation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.210 Meaningful EHR user attestation. (a) Qualifying MA organizations are required to attest, in a form and manner specified by CMS, that each qualifying MA EP and qualifying MA-affiliated eligible hospitals is a...

  8. 42 CFR 495.210 - Meaningful EHR user attestation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... INCENTIVE PROGRAM Requirements Specific to Medicare Advantage (MA) Organizations § 495.210 Meaningful EHR user attestation. (a) Qualifying MA organizations are required to attest, in a form and manner specified by CMS, that each qualifying MA EP and qualifying MA-affiliated eligible hospitals is a...

  9. Analysis of Search on Clinical Narrative within the EHR

    ERIC Educational Resources Information Center

    Natarajan, Karthik

    2012-01-01

    Electronic Health Records (EHRs) are used increasingly in the hospital and outpatient settings, and patients are amassing digitized clinical information. On one hand, aggregating all the patient's clinical information can greatly assist health care workers in making sound decisions. On the other hand, it can result in information overload,…

  10. A Graph Based Methodology for Temporal Signature Identification from EHR

    PubMed Central

    Wang, Fei; Liu, Chuanren; Wang, Yajuan; Hu, Jianying; Yu, Guoqiang

    2015-01-01

    Data driven technology is believed to be a promising technique for transforming the current status of healthcare. Electronic Health Records (EHR) is one of the main carriers for conducting the data driven healthcare research, where the goal is to derive insights from healthcare data and utilize such insights to improve the quality of care delivery. Due to the progression nature of human disease, one important aspect for analyzing healthcare data is temporality, which suggests the temporal relationships among different healthcare events and how their values evolve over time. Sequential pattern mining is a popular tool to extract time-invariant patterns from discrete sequences and has been applied in analyzing EHR before. However, due to the complexity of EHR, those approaches usually suffers from the pattern explosion problem, which means that a huge number of patterns will be detected with improper setting of the support threshold. To address this challenge, in this paper, we develop a novel representation, namely the temporal graph, for event sequences like EHR, wherein the nodes are medical events and the edges indicate the temporal relationships among those events in patient EHRs. Based on the temporal graph representation, we further develop an approach for temporal signature identification to identify the most significant and interpretable graph bases as temporal signatures, and the expressing coefficients can be treated as the embeddings of the patients in such temporal signature space. Our temporal signature identification framework is also flexible to incorporate semi-supervised/supervised information. We validate our framework on two real-world tasks. One is predicting the onset risk of heart failure. The other is predicting the risk of heart failure related hospitalization for patients with COPD pre-condition. Our results show that the prediction performance in both tasks can be improved by the proposed approaches. PMID:26958267

  11. EHR query language (EQL)--a query language for archetype-based health records.

    PubMed

    Ma, Chunlan; Frankel, Heath; Beale, Thomas; Heard, Sam

    2007-01-01

    OpenEHR specifications have been developed to standardise the representation of an international electronic health record (EHR). The language used for querying EHR data is not as yet part of the specification. To fill in this gap, Ocean Informatics has developed a query language currently known as EHR Query Language (EQL), a declarative language supporting queries on EHR data. EQL is neutral to EHR systems, programming languages and system environments and depends only on the openEHR archetype model and semantics. Thus, in principle, EQL can be used in any archetype-based computational context. In the EHR context described here, particular queries mention concepts from the openEHR EHR Reference Model (RM). EQL can be used as a common query language for disparate archetype-based applications. The use of a common RM, archetypes, and a companion query language, such as EQL, semantic interoperability of EHR information is much closer. This paper introduces the EQL syntax and provides example clinical queries to illustrate the syntax. Finally, current implementations and future directions are outlined. PMID:17911747

  12. Strategies for Primary Care Stakeholders to Improve Electronic Health Records (EHRs).

    PubMed

    Olayiwola, J Nwando; Rubin, Ashley; Slomoff, Theo; Woldeyesus, Tem; Willard-Grace, Rachel

    2016-01-01

    The use of electronic health records (EHRs) and the vendors that develop them have increased exponentially in recent years. While there continues to emerge literature on the challenges EHRs have created related to primary care provider satisfaction and workflow, there is sparse literature on the perspective of the EHR vendors themselves. We examined the role of EHR vendors in optimizing primary care practice through a qualitative study of vendor leadership and developers representing 8 companies. We found that EHR vendors apply a range of strategies to elicit feedback from their clinical users and to engage selected users in their development and design process, but priorities are heavily influenced by the macroenvironment and government regulations. To improve the "marriage" between primary care and the EHR vendor community, we propose 6 strategies that may be most impactful for primary care stakeholders seeking to influence EHR development processes. PMID:26769884

  13. Benefiting from ambulatory EHR implementation: solidarity, six sigma, and willingness to strive.

    PubMed

    Zaroukian, Michael H; Sierra, Arlene

    2006-01-01

    Ambulatory electronic health record systems have the potential to improve healthcare quality. Optimizing the value of EHR implementation requires that providers and staff become effective and efficient EHR users so paper charts are no longer required or desired. Transitioning from paper charts to EHR systems requires new learning, significant effort, and workflow changes associated with an initial adverse effect on provider efficiency. This case study describes how timely EHR implementation and regular use in a large academic internal medicine clinic was encouraged, achieved, and demonstrated. Critical success factors included readiness to change, solidarity in EHR use, a commitment to striving, and process improvement strategies that used the EHR system to repair suboptimal clinic workflows. Observed benefits include improvements in patient access, workflow efficiency, communication, decision support use, and financial performance. These success factors and implementation strategies may help others seeking to encourage greater adoption and use of EHRs. PMID:16429959

  14. Portal radiation monitor

    DOEpatents

    Kruse, L.W.

    1982-03-23

    A portal radiation monitor combines .1% FAR with high sensitivity to special nuclear material. The monitor utilizes pulse shape discrimination, dynamic compression of the photomultiplier output and scintillators sized to maintain efficiency over the entire portal area.

  15. Cirrhosis and Portal Hypertension

    MedlinePlus

    MENU Return to Web version Cirrhosis and Portal Hypertension Overview What is cirrhosis? In people who have ... lead to coma and death. What is portal hypertension? Normally, blood is carried to the liver by ...

  16. Portal radiation monitor

    DOEpatents

    Kruse, Lyle W.

    1985-01-01

    A portal radiation monitor combines 0.1% FAR with high sensitivity to special nuclear material. The monitor utilizes pulse shape discrimination, dynamic compression of the photomultiplier output and scintillators sized to maintain efficiency over the entire portal area.

  17. The Advent of Portals.

    ERIC Educational Resources Information Center

    Jackson, Mary E.

    2002-01-01

    Explains portals as tools that gather a variety of electronic information resources, including local library resources, into a single Web page. Highlights include cross-database searching; integration with university portals and course management software; the ARL (Association of Research Libraries) Scholars Portal Initiative; and selected vendors…

  18. Evaluating Open Source Portals

    ERIC Educational Resources Information Center

    Goh, Dion; Luyt, Brendan; Chua, Alton; Yee, See-Yong; Poh, Kia-Ngoh; Ng, How-Yeu

    2008-01-01

    Portals have become indispensable for organizations of all types trying to establish themselves on the Web. Unfortunately, there have only been a few evaluative studies of portal software and even fewer of open source portal software. This study aims to add to the available literature in this important area by proposing and testing a checklist for…

  19. The Effect of a Learning Environment Using an Electronic Health Record (EHR) on Undergraduate Nursing Students' Behaviorial Intention to Use an EHR

    ERIC Educational Resources Information Center

    Foley, Shawn

    2011-01-01

    The purpose of this study was to explore the effect of a learning environment using an Electronic Health Record (EHR) on undergraduate nursing students' behavioral intention (BI) to use an EHR. BI is defined by Davis (1989) in the Technology Acceptance Model (TAM) as the degree to which a person has formulated conscious plans to perform or not…

  20. Automated Transformation of openEHR Data Instances to OWL.

    PubMed

    Haarbrandt, Birger; Jack, Thomas; Marschollek, Michael

    2016-01-01

    Standard-based integration and semantic enrichment of clinical data originating from electronic medical records has shown to be critical to enable secondary use. To facilitate the utilization of semantic technologies on clinical data, we introduce a methodology to enable automated transformation of openEHR-based data to Web Ontology Language (OWL) individuals. To test the correctness of the implementation, de-identified data of 229 patients of the pediatric intensive care unit of Hannover Medical School has been transformed into 2.983.436 individuals. Querying of the resulting ontology for symptoms of the systemic inflammatory response syndrome (SIRS) yielded the same result set as a SQL query on an openEHR-based clinical data repository. PMID:27139386

  1. The EHR evolution: new priorities and implementation challenges.

    PubMed

    Daly, Rich

    2016-02-01

    Five types of key leadership decisions can help smooth the process of selecting and implementing EHR systems and upgrades: Balancing choices with population health priorities. Considering approaches to reduce costs and ease implementation. Prioritizing steps to ease physicians' first six months with the system. Implementing all at once to eliminate "clunky" workflows. Staggering a launch to identify quick-to-value features and functions. PMID:26999976

  2. Remote Sensing, New Media and Scientific Literacy for Competence Oriented School Education - A New Integrated Learning Portal

    NASA Astrophysics Data System (ADS)

    Hodam, H.; Goetzke, R.; Rinow, A.; Voß, K.

    2012-04-01

    The project FIS - Fernerkundung in Schulen (German for "Remote Sensing in Schools") - aims at a better integration of remote sensing in school lessons. Respectively, the overall ob-jective is to teach pupils from primary school up to high-school graduation basics and fields of application of remote sensing. Working with remote sensing data opens up new and modern ways of teaching. Therefore many teachers have great interest in the subject "remote sensing", being motivated to integrate this topic into teaching, provided that the curriculum is con-sidered. In many cases, this encouragement fails because of confusing information, which ruins all good intentions. For this reason, a comprehensive and well structured learning portal on the subject remote sensing is developed. This will allow teachers and pupils to have a structured initial understanding of the topic. Recognizing that in-depth use of satellite imagery can only be achieved by the means of computer aided learning methods, a sizeable number of e-Learning contents have been created throughout the last 5 years since the project's kickoff which are now integrated into the learning portal. Three main sections form the backbone of the developed learning portal. 1. The "Teaching Materials" section provides registered teachers with interactive lessons to convey curriculum relevant topics through remote sensing. They are able to use the implemented management system to create classes and enregister pupils, keep track of their progresses and control results of the conducted lessons. Abandoning the functio-nalities of the management system the lessons are also available to non-registered us-ers. 2. Pupils and Teachers can investigate further into remote sensing in the "Research" sec-tion, where a knowledge base alongside a satellite image gallery offer general back-ground information on remote sensing and the provided lessons in a semi interactive manner. 3. The "Analysis Tools" section offers means to further

  3. Semantic processing of EHR data for clinical research.

    PubMed

    Sun, Hong; Depraetere, Kristof; De Roo, Jos; Mels, Giovanni; De Vloed, Boris; Twagirumukiza, Marc; Colaert, Dirk

    2015-12-01

    There is a growing need to semantically process and integrate clinical data from different sources for clinical research. This paper presents an approach to integrate EHRs from heterogeneous resources and generate integrated data in different data formats or semantics to support various clinical research applications. The proposed approach builds semantic data virtualization layers on top of data sources, which generate data in the requested semantics or formats on demand. This approach avoids upfront dumping to and synchronizing of the data with various representations. Data from different EHR systems are first mapped to RDF data with source semantics, and then converted to representations with harmonized domain semantics where domain ontologies and terminologies are used to improve reusability. It is also possible to further convert data to application semantics and store the converted results in clinical research databases, e.g. i2b2, OMOP, to support different clinical research settings. Semantic conversions between different representations are explicitly expressed using N3 rules and executed by an N3 Reasoner (EYE), which can also generate proofs of the conversion processes. The solution presented in this paper has been applied to real-world applications that process large scale EHR data. PMID:26515501

  4. Using EHRs and Machine Learning for Heart Failure Survival Analysis

    PubMed Central

    Panahiazar, Maryam; Taslimitehrani, Vahid; Pereira, Naveen; Pathak, Jyotishman

    2016-01-01

    “Heart failure (HF) is a frequent health problem with high morbidity and mortality, increasing prevalence and escalating healthcare costs” [1]. By calculating a HF survival risk score based on patient-specific characteristics from Electronic Health Records (EHRs), we can identify high-risk patients and apply individualized treatment and healthy living choices to potentially reduce their mortality risk. The Seattle Heart Failure Model (SHFM) is one of the most popular models to calculate HF survival risk that uses multiple clinical variables to predict HF prognosis and also incorporates impact of HF therapy on patient outcomes. Although the SHFM has been validated across multiple cohorts [1–5], these studies were primarily done using clinical trials databases that do not reflect routine clinical care in the community. Further, the impact of contemporary therapeutic interventions, such as beta-blockers or defibrillators, was incorporated in SHFM by extrapolation from external trials. In this study, we assess the performance of SHFM using EHRs at Mayo Clinic, and sought to develop a risk prediction model using machine learning techiniques that applies routine clinical care data. Our results shows the models which were built using EHR data are more accurate (11% improvement in AUC) with the convenience of being more readily applicable in routine clinical care. Furthermore, we demonstrate that new predictive markers (such as co-morbidities) when incorporated into our models improve prognostic performance significantly (8% improvement in AUC). PMID:26262006

  5. Noncirrhotic Portal Hypertension

    PubMed Central

    Rajekar, Harshal; Vasishta, Rakesh K; Chawla, Yogesh K; Dhiman, Radha K

    2011-01-01

    Portal hypertension is characterized by an increase in portal pressure (> 10 mmHg) and could be a result of cirrhosis of the liver or of noncirrhotic diseases. When portal hypertension occurs in the absence of liver cirrhosis, noncirrhotic portal hypertension (NCPH) must be considered. The prognosis of this disease is much better than that of cirrhosis. Noncirrhotic diseases are the common cause of portal hypertension in developing countries, especially in Asia. NCPH is a heterogeneous group of diseases that is due to intrahepatic or extrahepatic etiologies. In general, the lesions in NCPH are vascular in nature and can be classified based on the site of resistance to blood flow. In most cases, these disorders can be explained by endothelial cell lesions, intimal thickening, thrombotic obliterations, or scarring of the intrahepatic portal or hepatic venous circulation. Many different conditions can determine NCPH through the association of these various lesions in various degrees. Many clinical manifestations of NCPH result from the secondary effects of portal hypertension. Patients with NCPH present with upper gastrointestinal bleeding, splenomegaly, ascites after gastrointestinal bleeding, features of hypersplenism, growth retardation, and jaundice due to portal hypertensive biliopathy. Other sequelae include hyperdynamic circulation, pulmonary complications, and other effects of portosystemic collateral circulation like portosystemic encephalopathy. At present, pharmacologic and endoscopic treatments are the treatments of choice for portal hypertension. The therapy of all disorders causing NCPH involves the reduction of portal pressure by pharmacotherapy or portosystemic shunting, apart from prevention and treatment of complications of portal hypertension. PMID:25755321

  6. Process-aware EHR BPM systems: two prototypes and a conceptual framework.

    PubMed

    Webster, Charles; Copenhaver, Mark

    2010-01-01

    Systematic methods to improve the effectiveness and efficiency of electronic health record-mediated processes will be key to EHRs playing an important role in the positive transformation of healthcare. Business process management (BPM) systematically optimizes process effectiveness, efficiency, and flexibility. Therefore BPM offers relevant ideas and technologies. We provide a conceptual model based on EHR productivity and negative feedback control that links EHR and BPM domains, describe two EHR BPM prototype modules, and close with the argument that typical EHRs must become more process-aware if they are to take full advantage of BPM ideas and technology. A prediction: Future extensible clinical groupware will coordinate delivery of EHR functionality to teams of users by combining modular components with executable process models whose usability (effectiveness, efficiency, and user satisfaction) will be systematically improved using business process management techniques. PMID:20841659

  7. EHR prescription for small, medium, and large hospitals: an exploratory study of Texas acute care hospitals.

    PubMed

    Mitchell, Stacy; Yaylacicegi, Ulku

    2012-01-01

    Hospitals invest in information technology to lower costs and to improve quality of care. With presidential leaders backing an in place policy that requires Electronic Health Records (EHRs) to be implemented in all hospitals by 2014 and the unveiling of a $1.2 billion grant for these systems, it is essential to understand the operational impacts of EHRs. This study explores EHRs in a hospital environment and investigates their relationship to quality of care and patient safety. EHRs are categorised into four functional groups: patient information data, results management, order entry, and decision support. This new knowledge will provide a better understanding of the relationship between EHRs and operational outcomes by showing the impact of various EHR functions on patient safety and quality of care. PMID:23079027

  8. Top 10 questions to ask when looking at an EHR license agreement.

    PubMed

    Shay, Daniel F

    2006-01-01

    Electronic health records (EHRs) offer medical practices the potential for increased efficiency and profits. The license agreement controls the practice's relationship with the vendor. Understanding the implications of the license agreement will help a practice to evaluate an EHR that the practice may adopt. This article will focus on 10 specific questions to ask while evaluating the EHR license and which portions of the license answer the questions. PMID:17260908

  9. The Association between EHRs and Care Coordination Varies by Team Cohesion

    PubMed Central

    Graetz, Ilana; Reed, Mary; Shortell, Stephen M; Rundall, Thomas G; Bellows, Jim; Hsu, John

    2014-01-01

    Objective To examine whether primary care team cohesion changes the association between using an integrated outpatient-inpatient electronic health record (EHR) and clinician-rated care coordination across delivery sites. Study Design Self-administered surveys of primary care clinicians in a large integrated delivery system, collected in 2005 (N = 565), 2006 (N = 678), and 2008 (N = 626) during the staggered implementation of an integrated EHR (2005–2010), including validated questions on team cohesion. Using multivariable regression, we examined the combined effect of EHR use and team cohesion on three dimensions of care coordination across delivery sites: access to timely and complete information, treatment agreement, and responsibility agreement. Principal Findings Among clinicians working in teams with higher cohesion, EHR use was associated with significant improvements in reported access to timely and complete information (53.5 percent with EHR vs. 37.6 percent without integrated-EHR), agreement on treatment goals (64.3 percent vs. 50.6 percent), and agreement on responsibilities (63.9 percent vs. 55.2 percent, all p < .05). We found no statistically significant association between use of the integrated-EHR and reported care coordination in less cohesive teams. Conclusion The association between EHR use and reported care coordination varied by level of team cohesion. EHRs may not improve care coordination in less cohesive teams. PMID:24359592

  10. Intercomprehension: A Portal to Teachers' Intercultural Sensitivity

    ERIC Educational Resources Information Center

    Pinho, Ana Sofia

    2015-01-01

    The development of opportunities for teachers' professional development in plurilingual and intercultural education is a key issue in language teacher education and "intercomprehension" (IC) can provide a potential portal for the development of teachers' intercultural sensitivity. Particularly relevant to this is the creation of powerful…

  11. Meeting EHR security requirements: SeAAS approach.

    PubMed

    Katt, Basel; Trojer, Thomas; Breu, Ruth; Schabetsberger, Thomas; Wozak, Florian

    2010-01-01

    In the last few years, Electronic Health Record (EHR) systems have received a great attention in the literature, as well as in the industry. They are expected to lead to health care savings, increase health care quality and reduce medical errors. This interest has been accompanied by the development of different standards and frameworks to meet EHR challenges. One of the most important initiatives that was developed to solve problems of EHR is IHE (Integrating the Healthcare Enterprise), which adapts the distributed approach to store and manage healthcare data. IHE aims at standardizing the way healthcare systems exchange information in distributed environments. For this purpose it defines several so called Integration Profiles that specify the interactions and the interfaces (Transactions) between various healthcare systems (Actors) or entities. Security was considered also in few profiles that tackled the main security requirements, mainly authentication and audit trails. The security profiles of IHE currently suffer two drawbacks. First, they apply end point security methodology, which has been proven recently to be insufficient and cumbersome in distributed and heterogeneous environment. Second, the current security profiles for more complex security requirements are oversimplified, vague and do not consider architectural design. This recently changed to some extend e.g., with the introduction of newly published white papers regarding privacy [5] and access control [9]. In order to solve the first problem we utilize results of previous studies conducted in the area of security-aware IHE-based systems and the state-of-the-art Security-as-a-Service approach as a convenient methodology to group domain-wide security needs and overcome the end point security shortcomings. PMID:20543314

  12. EHR in the perspective of security, integrity and ethics.

    PubMed

    Nordberg, Ragnar

    2006-01-01

    Success stories of modern applications in healthcare and welfare, like the electronic health record, are always linked to end user awareness, confidence, and acceptance. Reports and surveys have given proof of these dependencies. Knowing about existing and emerging concerns and weaknesses right in advance allows to taking actions on an ethical, social, and societal level. This paper gives a review of specific observations regarding security, privacy, authentication, integrity and ethical aspects when operating an electronic health record (EHR) system in a hospital, an open care department and in a wider community of the health care sector. A reference is given to existing and emerging international standards related to the aforementioned aspects. PMID:17095827

  13. Validating EHR documents: automatic schematron generation using archetypes.

    PubMed

    Pfeiffer, Klaus; Duftschmid, Georg; Rinner, Christoph

    2014-01-01

    The goal of this study was to examine whether Schematron schemas can be generated from archetypes. The openEHR Java reference API was used to transform an archetype into an object model, which was then extended with context elements. The model was processed and the constraints were transformed into corresponding Schematron assertions. A prototype of the generator for the reference model HL7 v3 CDA R2 was developed and successfully tested. Preconditions for its reusability with other reference models were set. Our results indicate that an automated generation of Schematron schemas is possible with some limitations. PMID:24825691

  14. The Sydney West Knowledge Portal: Evaluating the Growth of a Knowledge Portal to Support Translational Research

    PubMed Central

    2016-01-01

    Background The Sydney West Translational Cancer Research Centre is an organization funded to build capacity for translational research in cancer. Translational research is essential for ensuring the integration of best available evidence into practice and for improving patient outcomes. However, there is a low level of awareness regarding what it is and how to conduct it optimally. One solution to addressing this gap is the design and deployment of web-based knowledge portals to disseminate new knowledge and engage with and connect dispersed networks of researchers. A knowledge portal is an web-based platform for increasing knowledge dissemination and management in a specialized area. Objective To measure the design and growth of an web-based knowledge portal for increasing individual awareness of translational research and to build organizational capacity for the delivery of translational research projects in cancer. Methods An adaptive methodology was used to capture the design and growth of an web-based knowledge portal in cancer. This involved stakeholder consultations to inform initial design of the portal. Once the portal was live, site analytics were reviewed to evaluate member usage of the portal and to measure growth in membership. Results Knowledge portal membership grew consistently for the first 18 months after deployment, before leveling out. Analysis of site metrics revealed members were most likely to visit portal pages with community-generated content, particularly pages with a focus on translational research. This was closely followed by pages that disseminated educational material about translational research. Conclusions Preliminary data from this study suggest that knowledge portals may be beneficial tools for translating new evidence and fostering an environment of communication and collaboration. PMID:27357641

  15. Portal: Your Door to World Languages and Cultures

    ERIC Educational Resources Information Center

    Elliott, Don; Lawton, Rachele

    2009-01-01

    Portal: Your Door to World Languages and Cultures was a series of public cultural events, in a variety of formats, created through a new partnership between the credit and continuing education (noncredit) foreign language programs at the Community College of Baltimore County (CCBC). Portal was designed to cultivate interest in foreign languages…

  16. Portal Vein Thrombosis

    PubMed Central

    Mallet, Thierry; Soltys, Remigiusz; Loarte, Pablo

    2015-01-01

    Portal vein thrombosis (PVT) is the blockage or narrowing of the portal vein by a thrombus. It is relatively rare and has been linked with the presence of an underlying liver disease or prothrombotic disorders. We present a case of a young male who presented with vague abdominal symptoms for approximately one week. Imaging revealed the presence of multiple nonocclusive thrombi involving the right portal vein, the splenic vein, and the left renal vein, as well as complete occlusion of the left portal vein and the superior mesenteric vein. We discuss pathogenesis, clinical presentation, and management of both acute and chronic thrombosis. The presence of PVT should be considered as a clue for prothrombotic disorders, liver disease, and other local and general factors that must be carefully investigated. It is hoped that this case report will help increase awareness of the complexity associated with portal vein thrombosis among the medical community. PMID:25802795

  17. Reading and Writing: Qualitative Analysis of Pharmacists’ Use of the EHR when Preparing for Team Rounds

    PubMed Central

    Nelson, Scott D.; LaFleur, Joanne; Fiol, Guilherme Del; Evans, R. Scott; Weir, Charlene R.

    2015-01-01

    In the collaborative hospital environment, pharmacists are important members of the healthcare team, yet compared to physicians and nurses, little is known about pharmacists’ information needs or how they interact with the electronic health record (EHR). We directly observed seven clinical inpatient pharmacists as they interacted with the EHR preparing for clinical rounds using an eye-tracking camera and contextual inquiry. Pharmacists spent 50% of their time reading information from the EHR, such as notes and medication lists, and 27% of their time copying EHR data onto paper, such as patient history and laboratory results. In an environment where minutes count, the results of this study can help inform the development of CDS tools and/or EHR designs to facilitate the information needs of the pharmacists in providing care for their patients. PMID:26958231

  18. The CEOS Water Portal

    NASA Astrophysics Data System (ADS)

    Miura, Satoko; Sekioka, Shinichi; Kuroiwa, Kaori; Kudo, Yoshiyuki; Koide, Michihiro

    2014-05-01

    The CEOS Water is a one of the DIAS (Data Integration and Analysis System, http://www.editoria.u-tokyo.ac.jp/projects/dias/?locale=en_US) data distributed systems. The CEOS Water Portal system is distributed in the sense that, while the portal system is located in Tokyo, the data is located in archive centers which are globally distributed. For example, some in-situ data is archived at the National Center for Atmospheric Research (NCAR) Earth Observing Laboratory in Boulder, Colorado, USA. The NWP station time series and global gridded model output data is archived at the Max Planck Institute for Meteorology (MPIM) in cooperation with the World Data Centerfor Climate in Hamburg, Germany. Part of satellite data is archived at DIAS storage at the University of Tokyo, Japan. This portal does not store data. Instead, according to requests made by users on the web page, it retrieves data from distributed data centers on-the-fly and lets them download and see rendered images/plots. Considering the popularity among water related data centers, OpenDAP protocol is mainly being used between this portal and most of data centers. And this portal also is connected to a kind of data brokering system, which is already connected to multiple data centers. For this interface, OpenSearch protocol is being used. The CEOS Water Portal intends to extend its users to include decision makers and officers like river administrators by facilitating a feedback loop. One example of data and information flow centered on the CEOS Water Portal is shown below. (1)Scientists get various data needed for Model Calculation (WEB-DHM, for example) via the portal. (2)Scientists use Model output data and do analysis. (3)Scientists register their use cases into the portal. (4)Decision makers and officers can refer and acquire use cases and data easily. Users can access the CEOS Water Portal system at http://waterportal.ceos.org/.

  19. Electronic Health Records: Applying Diffusion of Innovation Theory to the Relationship between Multifactor Authentication and EHR Adoption

    ERIC Educational Resources Information Center

    Lockett, Daeron C.

    2014-01-01

    Electronic Health Record (EHR) systems are increasingly becoming accepted as future direction of medical record management systems. Programs such as the American Recovery and Reinvestment Act have provided incentives to hospitals that adopt EHR systems. In spite of these incentives, the perception of EHR adoption is that is has not achieved the…

  20. Understanding Patient Portal Use: Implications for Medication Management

    PubMed Central

    Mayberry, Lindsay Satterwhite; Wallston, Kenneth A; Johnson, Kevin B; Elasy, Tom A

    2013-01-01

    Background The Internet can be leveraged to provide disease management support, including medication adherence promotion that, when tailored, can effectively improve adherence to medications. The growing adoption of patient portals represents an opportunity to support medication management and adherence more broadly, but virtually no data exist about the real and potential impact of existing portals on these outcomes. Objective We sought to (1) understand who uses an existing patient portal and reasons for use and nonuse, (2) understand how portal users are using a portal to manage their medications, and (3) explore participants’ ideas for improving portal functionality for medication management and adherence support. Methods A total of 75 adults with type 2 diabetes participated in a mixed-methods study involving focus groups, a survey, and a medical chart review. We used quantitative data to identify differences between portal users and nonusers, and to test the relationship between the frequency of portal use and glycemic control among users. We used qualitative methods to understand how and why participants use a portal and their ideas for improving its medication management functionality. Results Of the enrolled participants, 81% (61/75) attended a focus group and/or completed a survey; portal users were more likely than nonusers to participate in that capacity (Fisher exact test; P=.01). Users were also more likely than nonusers to be Caucasian/white (Fisher exact test; P<.001), have higher incomes (Fisher exact test; P=.005), and be privately insured (Fisher exact test; P<.001). Users also tended to have more education than nonusers (Mann–Whitney U; P=.05), although this relationship was not significant at P<.05. Among users, more frequent use of a portal was associated with better A1C (Spearman rho =–0.30; P=.02). Reasons for nonuse included not knowing about the portal (n=3), not having access to a computer (n=3), or having a family member serve as

  1. Portal vein thrombosis.

    PubMed

    Chawla, Yogesh K; Bodh, Vijay

    2015-03-01

    Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. PMID:25941431

  2. Portal Vein Thrombosis

    PubMed Central

    Chawla, Yogesh K.; Bodh, Vijay

    2015-01-01

    Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. PMID:25941431

  3. The quail anatomy portal.

    PubMed

    Ruparelia, Avnika A; Simkin, Johanna E; Salgado, David; Newgreen, Donald F; Martins, Gabriel G; Bryson-Richardson, Robert J

    2014-01-01

    The Japanese quail is a widely used model organism for the study of embryonic development; however, anatomical resources are lacking. The Quail Anatomy Portal (QAP) provides 22 detailed three-dimensional (3D) models of quail embryos during development from embryonic day (E)1 to E15 generated using optical projection tomography. The 3D models provided can be virtually sectioned to investigate anatomy. Furthermore, using the 3D nature of the models, we have generated a tool to assist in the staging of quail samples. Volume renderings of each stage are provided and can be rotated to allow visualization from multiple angles allowing easy comparison of features both between stages in the database and between images or samples in the laboratory. The use of JavaScript, PHP and HTML ensure the database is accessible to users across different operating systems, including mobile devices, facilitating its use in the laboratory.The QAP provides a unique resource for researchers using the quail model. The ability to virtually section anatomical models throughout development provides the opportunity for researchers to virtually dissect the quail and also provides a valuable tool for the education of students and researchers new to the field. DATABASE URL: http://quail.anatomyportal.org (For review username: demo, password: quail123). PMID:24715219

  4. National Science Foundation Facilitation of AGU Scientists' K-14 Education and Outreach Activities

    NASA Astrophysics Data System (ADS)

    Leinen, M.; Prendeville, J.

    2002-12-01

    The National Science Foundation encourages the participation of geoscientists in K-14 education and outreach and provides support for that participation through a wide variety of programs. At the most general level, NSF requires that scientists describe the broader impacts of their research in their proposals. While broader impacts are not restricted to education and outreach, this requirement has encouraged many scientists to consider opportunities for K-14 education and outreach. Many NSF-wide programs provide financial support for K-14 education and outreach. Some are long-standing programs like Research Experiences for Undergraduates (REU), which have been used effectively by the geoscience community to introduce undergraduates to our field. Other programs, like CAREER, encourage faculty to develop innovative teaching and curricular approaches and to relate them to their research program. The Education and Human Resources Directorate (EHR) of NSF provides funds for a variety of undergraduate education improvements, and for elementary and secondary education activities. EHR also provides opportunities for informal education that have been used by the geoscience community to develop museum exhibits, IMAX films, television programs, and other high visibility outreach activities. The Directorate for Geosciences (GEO) holds competitions in the Geoscience Education Program and Opportunities to Enhance Diversity in the Geosciences that provide funds focused on development in our own field. Other specialized competitions, like awards associated with the Center for Ocean Science Education Excellence, have targeted the specific K-14 education and outreach needs of portions of our community. Finally, GEO has facilitated the development of the Digital Library for Earth System Education (DLESE) that has established a digital portal to age-appropriate, peer-reviewed curricular material for teachers.

  5. Monte Carlo portal dosimetry

    SciTech Connect

    Chin, P.W. . E-mail: mary.chin@physics.org

    2005-10-15

    This project developed a solution for verifying external photon beam radiotherapy. The solution is based on a calibration chain for deriving portal dose maps from acquired portal images, and a calculation framework for predicting portal dose maps. Quantitative comparison between acquired and predicted portal dose maps accomplishes both geometric (patient positioning with respect to the beam) and dosimetric (two-dimensional fluence distribution of the beam) verifications. A disagreement would indicate that beam delivery had not been according to plan. The solution addresses the clinical need for verifying radiotherapy both pretreatment (without the patient in the beam) and on treatment (with the patient in the beam). Medical linear accelerators mounted with electronic portal imaging devices (EPIDs) were used to acquire portal images. Two types of EPIDs were investigated: the amorphous silicon (a-Si) and the scanning liquid ion chamber (SLIC). The EGSnrc family of Monte Carlo codes were used to predict portal dose maps by computer simulation of radiation transport in the beam-phantom-EPID configuration. Monte Carlo simulations have been implemented on several levels of high throughput computing (HTC), including the grid, to reduce computation time. The solution has been tested across the entire clinical range of gantry angle, beam size (5 cmx5 cm to 20 cmx20 cm), and beam-patient and patient-EPID separations (4 to 38 cm). In these tests of known beam-phantom-EPID configurations, agreement between acquired and predicted portal dose profiles was consistently within 2% of the central axis value. This Monte Carlo portal dosimetry solution therefore achieved combined versatility, accuracy, and speed not readily achievable by other techniques.

  6. Improving diagnostic accuracy using EHR in emergency departments: A simulation-based study.

    PubMed

    Ben-Assuli, Ofir; Sagi, Doron; Leshno, Moshe; Ironi, Avinoah; Ziv, Amitai

    2015-06-01

    It is widely believed that Electronic Health Records (EHR) improve medical decision-making by enabling medical staff to access medical information stored in the system. It remains unclear, however, whether EHR indeed fulfills this claim under the severe time constraints of Emergency Departments (EDs). We assessed whether accessing EHR in an ED actually improves decision-making by clinicians. A simulated ED environment was created at the Israel Center for Medical Simulation (MSR). Four different actors were trained to simulate four specific complaints and behavior and 'consulted' 26 volunteer ED physicians. Each physician treated half of the cases (randomly) with access to EHR, and their medical decisions were compared to those where the physicians had no access to EHR. Comparison of diagnostic accuracy with and without access showed that accessing the EHR led to an increase in the quality of the clinical decisions. Physicians accessing EHR were more highly informed and thus made more accurate decisions. The percentage of correct diagnoses was higher and these physicians were more confident in their diagnoses and made their decisions faster. PMID:25817921

  7. Reasons (Not) to Spend a Few Billions More on EHRs: How Human Factors Research Can Help

    PubMed Central

    Aimé, X.

    2014-01-01

    Summary Objectives To select best medical informatics research works published in 2013 on electronic health record (EHR) adoption, design, and impact, from the perspective of human factors and organizational issues (HFOI). Methods We selected 2,764 papers by querying PubMed (Mesh and TIAB) as well as using a manual search. Papers were evaluated based on pre-defined exclusion and inclusion criteria from their title, keywords, and abstract to select 15 candidate best papers, finally reviewed by 4 external reviewers using a standard evaluation grid. Results Five papers were selected as best papers to illustrate how human factors approaches can improve EHR adoption and design. Among other contributions, these works: (i) make use of the observational and analysis methodologies of social and cognitive sciences to understand clinicians’ attitudes towards EHRs, EHR use patterns, and impact on care processes, workflows, information exchange, and coordination of care; (ii) take into account macro- (environmental) and meso- (organizational) level factors to analyze EHR adoption or lack thereof; (iii) highlight the need for qualitative studies to analyze the unexpected side effects of EHRs on cognitive and work processes as well as the persistent use of paper. Conclusion Selected papers tend to demonstrate that HFOI approaches and methodologies are essential to bridge the gap between EHR systems and end users, and to reduce regularly reported adoption failures and unexpected consequences. PMID:25123727

  8. Architecture and tools for open, interoperable and portable EHRs.

    PubMed

    Blobel, Bernd

    2003-01-01

    Electronic Health Record (EHR) systems provide the kernel application of health information systems and health networks which should be independent of complexity, localisation constraints, platforms, protocols, etc. Based on shared care information systems' requirements for high level interoperability, a generic component architecture has been introduced. For implementing, running and maintaining acceptable and useable health information systems components, all views of the ISO Reference Model--Open Distributed Processing have to be considered. Following the Model Driven Architecture paradigm, a reference model as well as concept-representing domain models both independent of platforms must be specified, which are combined and harmonised as well as automatically transferred into platform-specific models using appropriate tools. PMID:15537227

  9. Space Development Grid Portal

    NASA Technical Reports Server (NTRS)

    Vaziri, Arsi

    2004-01-01

    This viewgraph presentation provides information on the development of a portal to provide secure and distributed grid computing for Payload Operations Integrated Center and Mission Control Center ground services.

  10. Building Your Campus Portal: Advice from the Field.

    ERIC Educational Resources Information Center

    Krebs, Arlene

    2001-01-01

    Discusses portal technology in higher education, including planning, design, technical, and financial issues. Highlights include determining the customers; marketing possibilities for the university; ownership issues; data design; effective cost structuring; security issues; adaptability; content; and customer input and feedback. (LRW)

  11. How to successfully select and implement electronic health records (EHR) in small ambulatory practice settings

    PubMed Central

    2009-01-01

    Background Adoption of EHRs by U.S. ambulatory practices has been slow despite the perceived benefits of their use. Most evaluations of EHR implementations in the literature apply to large practice settings. While there are similarities relating to EHR implementation in large and small practice settings, the authors argue that scale is an important differentiator. Focusing on small ambulatory practices, this paper outlines the benefits and barriers to EHR use in this setting, and provides a "field guide" for these practices to facilitate successful EHR implementation. Discussion The benefits of EHRs in ambulatory practices include improved patient care and office efficiency, and potential financial benefits. Barriers to EHRs include costs; lack of standardization of EHR products and the design of vendor systems for large practice environments; resistance to change; initial difficulty of system use leading to productivity reduction; and perceived accrual of benefits to society and payers rather than providers. The authors stress the need for developing a flexible change management strategy when introducing EHRs that is relevant to the small practice environment; the strategy should acknowledge the importance of relationship management and the role of individual staff members in helping the entire staff to manage change. Practice staff must create an actionable vision outlining realistic goals for the implementation, and all staff must buy into the project. The authors detail the process of implementing EHRs through several stages: decision, selection, pre-implementation, implementation, and post-implementation. They stress the importance of identifying a champion to serve as an advocate of the value of EHRs and provide direction and encouragement for the project. Other key activities include assessing and redesigning workflow; understanding financial issues; conducting training that is well-timed and meets the needs of practice staff; and evaluating the

  12. e-Learning Object Portals: a new resource that offers new opportunities for librarians.

    PubMed

    Sheffield, Cindy

    2006-01-01

    e-Learning Object Portals are emerging as a new form of electronic information. Four portals most effective in providing health care information are identified: The Medical Library Association's Center of Research and Education (CORE), the Health Education Assets Library (HEAL), the American Academy of Medical College's MedEDPortal, and the Multimedia Education Resource for Learning and Online Teaching (MERLOT). Various user groups such as librarians, educators, and students are discussed, as well as their reasons for using e-learning object portals. New roles for librarians in promoting and developing these portals are also reviewed. PMID:17135153

  13. Standard-based EHR-enabled applications for clinical research and patient safety: CDISC – IHE QRPH – EHR4CR & SALUS collaboration

    PubMed Central

    Daniel, Christel; Sinaci, Anil; Ouagne, David; Sadou, Eric; Declerck, Gunnar; Kalra, Dipak; Charlet, Jean; Forsberg, Kerstin; Bain, Landen; Mead, Charlie; Hussain, Sajjad; Laleci Erturkmen, Gokce B.

    2014-01-01

    Integration profiles collaboratively developed by CDISC and IHE for integrating data from Electronic Health Records (EHRs) with clinical research and pharmacovigilance are limited to resolving lexical/syntactic data integration issues and do not address semantic barriers. This paper describes the collaboration between two European projects – EHR4CR and SALUS – in implementing ISO/IEC 11179-based metadata registries (MDRs) and semantically integrated cross-platform data access. A common “semantic MDR” provides a framework for bidirectional/cross-MDR mapping and federated queries are enabled using the newly-defined IHE Data Exchange (DEX) profile. In the pilot implementation, mappings for 178 EHR4CR and 199 SALUS metadata elements were persisted in the semantic MDR. The DEX profile was then used to access semantically equivalent data elements in SALUS or EHR4CR participating EHR systems. ISO/IEC 11179-based MDRs and DEX integration profile address the goal of developing pan-EU computable semantic integration of data from clinical care, clinical research, and patient safety platforms. PMID:25954572

  14. It's a Bird. It's a Plane. It's a...Portal?: What Is a Campus Portal Strategy and Why Do You Need One?

    ERIC Educational Resources Information Center

    Katz, Richard N.

    2000-01-01

    Describes the results of a recent forum, and subsequent conference, on the subject of portals and e-business in higher education. Participants, who included financial and information technology professionals, agreed that implementation of portal strategy is necessary, perilous, and difficult in higher education. Colleges and universities will have…

  15. Shared Medical Appointments: A Portal for Nutrition and Culinary Education in Primary Care—A Pilot Feasibility Project

    PubMed Central

    Hauser, Michelle E.; Burgess, Jonathan D.; Eisenberg, David M.

    2015-01-01

    Introduction: Diseases linked to obesity such as cardiovascular disease, diabetes, degenerative joint disease, gastroesophageal reflux, and sleep apnea constitute a large portion of primary care visits. Patients with these conditions often lack knowledge, skills, and support needed to maintain health. Shared medical appointments (SMAs) that include culinary skills and nutrition education offer a novel, cost-effective way to address these diseases in primary care. Methods: Adult patients in a primary care practice at a large academic hospital in Boston, Massachusetts, who had at least 1 cardiovascular risk factor were invited to participate in SMAs that included cooking demonstrations and teaching about nutrition in addition to medical management of their conditions. Sessions were conducted by a physician and an assistant in a conference room of a traditional primary care practice as part of a pilot feasibility project. Results: Seventy patients, contributing a total of 156 patient visits, attended 17 nutrition-focused SMAs over a 4-year period. Patients were surveyed after each visit and indicated that they enjoyed the SMAs, would consider alternating SMAs with traditional one-on-one visits, and would recommend SMAs to others. Half would pay out of pocket or a higher copay to attend SMAs. Financially, the practice broke even compared with traditional one-onone office visits. Conclusion: In this feasibility study, chronic disease SMAs conducted with a culinary/nutrition focus were feasible, cost-effective, and well received by patients. Follow-up studies are needed to evaluate short- and long-term outcomes of this SMA model on obesity-related diseases. PMID:26665019

  16. A framework for privacy-preserving access to next-generation EHRs.

    PubMed

    Koufi, Vassiliki; Malamateniou, Flora; Tsohou, Aggeliki; Vassilacopoulos, George

    2014-01-01

    Although personalized medicine is optimizing the discovery, development and application of therapeutic advances, its full impact on patient and population healthcare management has yet to be realized. Electronic health Records (EHRs), integrated with data from other sources, such as social care data, Personal Healthcare Record (PHR) data and genetic information, are envisaged as having a pivotal role in realizing this individualized approach to healthcare. Thus, a new generation of EHRs will emerge which, in addition to supporting healthcare professionals in making well-informed clinical decisions, shows potential for novel discovery of associations between disease and genetic, environmental or process measures. However, a broad range of ethical, legal and technical reasons may hinder the realization of future EHRs due to potential security and privacy breaches. This paper presents a HIPAA-compliant framework that enables privacy-preserving access to next-generation EHRs. PMID:25160285

  17. Implementing EHRs: An Exploratory Study to Examine Current Practices in Migrating Physician Practice

    PubMed Central

    Dolezel, Diane; Moczygemba, Jackie

    2015-01-01

    Implementation of electronic health record (EHR) systems in physician practices is challenging and complex. In the past, physicians had little incentive to move from paper-based records. With the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, Medicare and Medicaid incentive payments are now available for physicians who implement EHRs for meaningful use. The Office of the National Coordinator for Health Information Technology (ONC) has ample detail on clinical data needed for meaningful use in order to assess the quality of patient care. Details are lacking, however, on how much clinical data, if any, should be transferred from the old paper records during an EHR implementation project. The purpose of this exploratory study was to investigate and document the elements of longitudinal clinical data that are essential for inclusion in the EHR of physicians in a clinical practice setting, as reported by the office managers of the physicians in the study group. PMID:26807077

  18. Cross border semantic interoperability for clinical research: the EHR4CR semantic resources and services.

    PubMed

    Daniel, Christel; Ouagne, David; Sadou, Eric; Forsberg, Kerstin; Gilchrist, Mark Mc; Zapletal, Eric; Paris, Nicolas; Hussain, Sajjad; Jaulent, Marie-Christine; Md, Dipka Kalra

    2016-01-01

    With the development of platforms enabling the use of routinely collected clinical data in the context of international clinical research, scalable solutions for cross border semantic interoperability need to be developed. Within the context of the IMI EHR4CR project, we first defined the requirements and evaluation criteria of the EHR4CR semantic interoperability platform and then developed the semantic resources and supportive services and tooling to assist hospital sites in standardizing their data for allowing the execution of the project use cases. The experience gained from the evaluation of the EHR4CR platform accessing to semantically equivalent data elements across 11 European participating EHR systems from 5 countries demonstrated how far the mediation model and mapping efforts met the expected requirements of the project. Developers of semantic interoperability platforms are beginning to address a core set of requirements in order to reach the goal of developing cross border semantic integration of data. PMID:27570649

  19. Implementing EHRs: An Exploratory Study to Examine Current Practices in Migrating Physician Practice.

    PubMed

    Dolezel, Diane; Moczygemba, Jackie

    2015-01-01

    Implementation of electronic health record (EHR) systems in physician practices is challenging and complex. In the past, physicians had little incentive to move from paper-based records. With the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, Medicare and Medicaid incentive payments are now available for physicians who implement EHRs for meaningful use. The Office of the National Coordinator for Health Information Technology (ONC) has ample detail on clinical data needed for meaningful use in order to assess the quality of patient care. Details are lacking, however, on how much clinical data, if any, should be transferred from the old paper records during an EHR implementation project. The purpose of this exploratory study was to investigate and document the elements of longitudinal clinical data that are essential for inclusion in the EHR of physicians in a clinical practice setting, as reported by the office managers of the physicians in the study group. PMID:26807077

  20. Method to integrate clinical guidelines into the electronic health record (EHR) by applying the archetypes approach.

    PubMed

    Garcia, Diego; Moro, Claudia Maria Cabral; Cicogna, Paulo Eduardo; Carvalho, Deborah Ribeiro

    2013-01-01

    Clinical guidelines are documents that assist healthcare professionals, facilitating and standardizing diagnosis, management, and treatment in specific areas. Computerized guidelines as decision support systems (DSS) attempt to increase the performance of tasks and facilitate the use of guidelines. Most DSS are not integrated into the electronic health record (EHR), ordering some degree of rework especially related to data collection. This study's objective was to present a method for integrating clinical guidelines into the EHR. The study developed first a way to identify data and rules contained in the guidelines, and then incorporate rules into an archetype-based EHR. The proposed method tested was anemia treatment in the Chronic Kidney Disease Guideline. The phases of the method are: data and rules identification; archetypes elaboration; rules definition and inclusion in inference engine; and DSS-EHR integration and validation. The main feature of the proposed method is that it is generic and can be applied toany type of guideline. PMID:23920682

  1. Case Study: Applying OpenEHR Archetypes to a Clinical Data Repository in a Chinese Hospital.

    PubMed

    Min, Lingtong; Wang, Li; Lu, Xudong; Duan, Huilong

    2015-01-01

    openEHR is a flexible and scalable modeling methodology for clinical information and has been widely adopted in Europe and Australia. Due to the reasons of differences in clinical process and management, there are few research projects involving openEHR in China. To investigate the feasibility of openEHR methodology for clinical information modelling in China, this paper carries out a case study to apply openEHR archetypes to Clinical Data Repository (CDR) in a Chinese hospital. The results show that a set of 26 archetypes are found to cover all the concepts used in the CDR. Of all these, 9 (34.6%) are reused without change, 10 are modified and/or extended, and 7 are newly defined. The reasons for modification, extension and newly definition have been discussed, including granularity of archetype, metadata-level versus data-level modelling, and the representation of relationships between archetypes. PMID:26262040

  2. Cross border semantic interoperability for clinical research: the EHR4CR semantic resources and services

    PubMed Central

    Daniel, Christel; Ouagne, David; Sadou, Eric; Forsberg, Kerstin; Gilchrist, Mark Mc; Zapletal, Eric; Paris, Nicolas; Hussain, Sajjad; Jaulent, Marie-Christine; MD, Dipka Kalra

    2016-01-01

    With the development of platforms enabling the use of routinely collected clinical data in the context of international clinical research, scalable solutions for cross border semantic interoperability need to be developed. Within the context of the IMI EHR4CR project, we first defined the requirements and evaluation criteria of the EHR4CR semantic interoperability platform and then developed the semantic resources and supportive services and tooling to assist hospital sites in standardizing their data for allowing the execution of the project use cases. The experience gained from the evaluation of the EHR4CR platform accessing to semantically equivalent data elements across 11 European participating EHR systems from 5 countries demonstrated how far the mediation model and mapping efforts met the expected requirements of the project. Developers of semantic interoperability platforms are beginning to address a core set of requirements in order to reach the goal of developing cross border semantic integration of data. PMID:27570649

  3. The Cosmos Portal and the IYA2009 Project

    NASA Astrophysics Data System (ADS)

    Haisch, Bernard M.; Sims, M.; Lindblom, J.

    2009-01-01

    In 2007 the non-profit Digital Universe Foundation (DUF) launched the Earth Portal as a comprehensive resource for timely, objective, science-based information about the environment. There are currently over 1000 scholars from 60 countries engaged in this rapidly growing web-based collaboration. The Cosmos Portal is the second major DUF initiative (digitaluniverse.net/cosmos). In support of the IYA2009 effort, the Cosmos Portal is recruiting astronomy professionals to make use of easy online tools to publish articles, blogs, news items, image galleries, class notes, lectures, powerpoint presentations, links to other high quality websites or other educational material. In parallel we intend to bring hundreds of amateur astronomy organizations and thousands of amateur astronomers and telescope makers together in a community of portals (digitaluniverse.net/cosmoscommunity). This will allow vibrant online collaboration and information sharing. We encourage you to start a portal on your favorite topic or join an existing topic as a contributor.

  4. 8. EAST PORTAL AND DECK VIEW, FROM EAST, SHOWING PORTAL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. EAST PORTAL AND DECK VIEW, FROM EAST, SHOWING PORTAL CONFIGURATION AND LATERAL BRACING, STEEL MESH FLOOR, METAL RAILINGS, AND PORTION OF EAST APPROACH - Glendale Road Bridge, Spanning Deep Creek Lake on Glendale Road, McHenry, Garrett County, MD

  5. 7. WEST PORTAL AND DECK VIEW, FROM WEST, SHOWING PORTAL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. WEST PORTAL AND DECK VIEW, FROM WEST, SHOWING PORTAL CONFIGURATION AND LATERAL BRACING, STEEL MESH FLOOR, AND METAL RAILINGS - Glendale Road Bridge, Spanning Deep Creek Lake on Glendale Road, McHenry, Garrett County, MD

  6. Radioisotopic flow scanning for portal blood flow and portal hypertension

    SciTech Connect

    Hesdorffer, C.S.; Bezwoda, W.R.; Danilewitz, M.D.; Esser, J.D.; Tobias, M.

    1987-08-01

    The use of a simple, noninvasive, isotope scanning technique for the determination of relative portal blood flow and detection of portal hypertension is described. Using this technique the presence of portal hypertension was demonstrated in seven of nine patients known to have elevated portal venous pressure. By contrast, esophageal varices were demonstrated in only five of these patients, illustrating the potential value of the method. Furthermore, this technique has been adapted to the study of portal blood flow in patients with myeloproliferative disorders with splenomegaly but without disturbances in hepatic architecture. Results demonstrate that the high relative splenic flow resulting from the presence of splenomegaly may in turn be associated with elevated relative portal blood flow and portal hypertension. The theoretic reasons for the development of flow-related portal hypertension and its relationship to splenic blood flow are discussed.

  7. Perspective view of south portal. Note how portal angles about ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Perspective view of south portal. Note how portal angles about 5' forward over the approach. - Red Oak Creek Bridge, Spanning (Big) Red Oak Creek, Huel Brown Road (Covered Bridge Road), Woodbury, Meriwether County, GA

  8. Elevation, west portal. Sign on portal reads Watson Mill Bridge, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Elevation, west portal. Sign on portal reads Watson Mill Bridge, est. 1885. - Watson Mill Bridge, Spanning South Fork Broad River, Watson Mill Road, Watson Mill Bridge State Park, Comer, Madison County, GA

  9. Pregnancy with Portal Hypertension

    PubMed Central

    Aggarwal, Neelam; Negi, Neha; Aggarwal, Aakash; Bodh, Vijay; Dhiman, Radha K.

    2014-01-01

    Even though pregnancy is rare with cirrhosis and advanced liver disease, but it may co-exist in the setting of non-cirrhotic portal hypertension as liver function is preserved but whenever encountered together is a complex clinical dilemma. Pregnancy in a patient with portal hypertension presents a special challenge to the obstetrician as so-called physiological hemodynamic changes associated with pregnancy, needed for meeting demands of the growing fetus, worsen the portal hypertension thereby putting mother at risk of potentially life-threatening complications like variceal hemorrhage. Risks of variceal bleed and hepatic decompensation increase many fold during pregnancy. Optimal management revolves round managing the portal hypertension and its complications. Thus management of such cases requires multi-speciality approach involving obstetricians experienced in dealing with high risk cases, hepatologists, anesthetists and neonatologists. With advancement in medical field, pregnancy is not contra-indicated in these women, as was previously believed. This article focuses on the different aspects of pregnancy with portal hypertension with special emphasis on specific cause wise treatment options to decrease the variceal bleed and hepatic decompensation. Based on extensive review of literature, management from pre-conceptional period to postpartum is outlined in order to have optimal maternal and perinatal outcomes. PMID:25755552

  10. Importance-satisfaction analysis for primary care physicians' perspective on EHRs in Taiwan.

    PubMed

    Ho, Cheng-Hsun; Wene, Hsyien-Chia; Chu, Chi-Ming; Wu, Yi-Syuan; Wang, Jen-Leng

    2014-06-01

    The Taiwan government has been promoting Electronic Health Records (EHRs) to primary care physicians. How to extend EHRs adoption rate by measuring physicians' perspective of importance and performance of EHRs has become one of the critical issues for healthcare organizations. We conducted a comprehensive survey in 2010 in which a total of 1034 questionnaires which were distributed to primary care physicians. The project was sponsored by the Department of Health to accelerate the adoption of EHRs. 556 valid responses were analyzed resulting in a valid response rate of 53.77%. The data were analyzed based on a data-centered analytical framework (5-point Likert scale). The mean of importance and satisfaction of four dimensions were 4.16, 3.44 (installation and maintenance), 4.12, 3.51 (product effectiveness), 4.10, 3.31 (system function) and 4.34, 3.70 (customer service) respectively. This study provided a direction to government by focusing on attributes which physicians found important but were dissatisfied with, to close the gap between actual and expected performance of the EHRs. The authorities should emphasize the potential advantages in meaningful use and provide training programs, conferences, technical assistance and incentives to enhance the national level implementation of EHRs for primary physicians. PMID:24914640

  11. Electronic Health Record (EHR) As a Vehicle for Successful Health Care Best Practice

    PubMed Central

    Ghazisaeedi, Marjan; Mohammadzadeh, Niloofar; Safdari, Reza

    2014-01-01

    Objective: application of EHR in journey toward the development and adaptation of best practice approach in health care has particular importance. The aim of this review article is survey of successful best practice through EHR. Methods: In this literature review articles were searched with keywords like Electronic Health Record, Best Practice in Science Direct, Google Scholar and Pub Med databases since 1999. Results: best practice in health care through some services like utilization management, case management, and information technology tools can perform. Utilization management in combination with evidence based medicine facilitate determine best decision. Health records are based on evidence medicine and be the richest source of health information. Definitely use of EHR has play pivotal role in journey toward the development and adaptation of best practice approach. Conclusion: Because of potential capabilities, EHR can be regarded as a main core and fundamental element in best practice approach. Success implementation of EHR relies on many factors that should be considered. Some critical success factors for EHR implementation that should be noted are change management, Physicians, nurses and key stakeholders involvement, leadership, provide reliable information technology infrastructure, system design, privacy and security, right budget, support high level management, clear communicate, determine goals and user needs, and define roles and responsibilities, interoperability standards. PMID:25648601

  12. Using High-Fidelity Simulation and Eye Tracking to Characterize EHR Workflow Patterns among Hospital Physicians

    PubMed Central

    Doberne, Julie W.; He, Ze; Mohan, Vishnu; Gold, Jeffrey A.; Marquard, Jenna; Chiang, Michael F.

    2015-01-01

    Modern EHR systems are complex, and end-user behavior and training are highly variable. The need for clinicians to access key clinical data is a critical patient safety issue. This study used a mixed methods approach employing a high-fidelity EHR simulation environment, eye and screen tracking, surveys, and semi-structured interviews to characterize typical EHR usage by hospital physicians (hospitalists) as they encounter a new patient. The main findings were: 1) There were strong similarities across the groups in the information types the physicians looked at most frequently, 2) While there was no overall difference in case duration between the groups, we observed two distinct workflow types between the groups with respect to gathering information in the EHR and creating a note, and 3) A majority of the case time was devoted to note composition in both groups. This has implications for EHR interface design and raises further questions about what individual user workflows exist in the EHR. PMID:26958287

  13. Importance-Satisfaction Analysis for Primary Care Physicians’ Perspective on EHRs in Taiwan †

    PubMed Central

    Ho, Cheng-Hsun; Wen, Hsyien-Chia; Chu, Chi-Ming; Wu, Yi-Syuan; Wang, Jen-Leng

    2014-01-01

    The Taiwan government has been promoting Electronic Health Records (EHRs) to primary care physicians. How to extend EHRs adoption rate by measuring physicians’ perspective of importance and performance of EHRs has become one of the critical issues for healthcare organizations. We conducted a comprehensive survey in 2010 in which a total of 1034 questionnaires which were distributed to primary care physicians. The project was sponsored by the Department of Health to accelerate the adoption of EHRs. 556 valid responses were analyzed resulting in a valid response rate of 53.77%. The data were analyzed based on a data-centered analytical framework (5-point Likert scale). The mean of importance and satisfaction of four dimensions were 4.16, 3.44 (installation and maintenance), 4.12, 3.51 (product effectiveness), 4.10, 3.31 (system function) and 4.34, 3.70 (customer service) respectively. This study provided a direction to government by focusing on attributes which physicians found important but were dissatisfied with, to close the gap between actual and expected performance of the EHRs. The authorities should emphasize the potential advantages in meaningful use and provide training programs, conferences, technical assistance and incentives to enhance the national level implementation of EHRs for primary physicians. PMID:24914640

  14. [Portal vein thrombosis].

    PubMed

    Seijo-Ríos, Susana; García-Pagán, Juan Carlos

    2010-03-01

    Thrombosis of the splenoportal axis not associated with liver cirrhosis or tumoral disease is the second cause of portal hypertension in the western world. In up to 60% of cases, an underlying systemic prothrombotic disorder can be identified as an etiological factor. One third of cases are caused by local factors and the coexistence of several entities is not unusual. Therefore, an etiologic diagnosis is essential in these patients. Early anticoagulation therapy in the acute phase of thrombosis of the splenoportal axis significantly affects the probability of recanalization and consequently the prognosis of these patients. In the chronic phase of splenoportal thrombosis (or portal cavernoma), the symptoms are caused by the complications of established portal hypertension. To date, anticoagulation therapy is limited to patients in whom an underlying prothrombotic disorder has been demonstrated. PMID:19733938

  15. Target detection portal

    DOEpatents

    Linker, Kevin L.; Brusseau, Charles A.

    2002-01-01

    A portal apparatus for screening persons or objects for the presence of trace amounts of target substances such as explosives, narcotics, radioactive materials, and certain chemical materials. The portal apparatus can have a one-sided exhaust for an exhaust stream, an interior wall configuration with a concave-shape across a horizontal cross-section for each of two facing sides to result in improved airflow and reduced washout relative to a configuration with substantially flat parallel sides; air curtains to reduce washout; ionizing sprays to collect particles bound by static forces, as well as gas jet nozzles to dislodge particles bound by adhesion to the screened person or object. The portal apparatus can be included in a detection system with a preconcentrator and a detector.

  16. Inferring the Interactions of Risk Factors from EHRs.

    PubMed

    Goodwin, Travis; Harabagiu, Sanda M

    2016-01-01

    The wealth of clinical information provided by the advent of electronic health records offers an exciting opportunity to improve the quality of patient care. Of particular importance are the risk factors, which indicate possible diagnoses, and the medications which treat them. By analysing which risk factors and medications were mentioned at different times in patients' EHRs, we are able to construct a patient's clinical chronology. This chronology enables us to not only predict how new patient's risk factors may progress, but also to discover patterns of interactions between risk factors and medications. We present a novel probabilistic model of patients' clinical chronologies and demonstrate how this model can be used to (1) predict the way a new patient's risk factors may evolve over time, (2) identify patients with irregular chronologies, and (3) discovering the interactions between pairs of risk factors, and between risk factors and medications over time. Moreover, the model proposed in this paper does not rely on (nor specify) any prior knowledge about any interactions between the risk factors and medications it represents. Thus, our model can be easily applied to any arbitrary set of risk factors and medications derived from a new dataset. PMID:27595044

  17. Inferring the Interactions of Risk Factors from EHRs

    PubMed Central

    Goodwin, Travis; Harabagiu, Sanda M.

    2016-01-01

    The wealth of clinical information provided by the advent of electronic health records offers an exciting opportunity to improve the quality of patient care. Of particular importance are the risk factors, which indicate possible diagnoses, and the medications which treat them. By analysing which risk factors and medications were mentioned at different times in patients’ EHRs, we are able to construct a patient’s clinical chronology. This chronology enables us to not only predict how new patient’s risk factors may progress, but also to discover patterns of interactions between risk factors and medications. We present a novel probabilistic model of patients’ clinical chronologies and demonstrate how this model can be used to (1) predict the way a new patient’s risk factors may evolve over time, (2) identify patients with irregular chronologies, and (3) discovering the interactions between pairs of risk factors, and between risk factors and medications over time. Moreover, the model proposed in this paper does not rely on (nor specify) any prior knowledge about any interactions between the risk factors and medications it represents. Thus, our model can be easily applied to any arbitrary set of risk factors and medications derived from a new dataset. PMID:27595044

  18. A Librarian's Perspective on Portals.

    ERIC Educational Resources Information Center

    Little, John R.

    2001-01-01

    Explains what Web portals are and discusses the benefits of a strategic alliance in portal building among campus information technology, libraries, and other campus groups. Suggests that by using robust channel capabilities, an enterprise portal can provide content from various parts of the university and promote resource discovery. (EV)

  19. Ten Keys to the Portal

    ERIC Educational Resources Information Center

    Schaffhauser, Dian

    2011-01-01

    Successful web portals help users stay informed, in touch, and up to speed. They are also a telling window into the efficiency of one's institution. To develop a cutting-edge portal takes planning, communication, and research. In this article, the author presents and discusses 10 keys to portal success: (1) make critical info visible; (2) make the…

  20. Portal hypertensive enteropathy

    PubMed Central

    Mekaroonkamol, Parit; Cohen, Robert; Chawla, Saurabh

    2015-01-01

    Portal hypertensive enteropathy (PHE) is a condition that describes the pathologic changes and mucosal abnormalities observed in the small intestine of patients with portal hypertension. This entity is being increasingly recognized and better understood over the past decade due to increased accessibility of the small intestine made possible by the introduction of video capsule endoscopy and deep enteroscopy. Though challenged by its diverse endoscopic appearance, multiple scoring systems have been proposed to classify the endoscopic presentation and grade its severity. Endoscopic findings can be broadly categorized into vascular and non-vascular lesions with many subtypes of both categories. Clinical manifestations of PHE can range from asymptomatic incidental findings to fatal gastrointestinal hemorrhage. Classic endoscopic findings in the setting of portal hypertension may lead to a prompt diagnosis. Occasionally histopathology and cross sectional imaging like computed tomography or magnetic resonance imaging may be helpful in establishing a diagnosis. Management of overt bleeding requires multidisciplinary approach involving hepatologists, endoscopists, surgeons, and interventional radiologists. Adequate resuscitation, reduction of portal pressure, and endoscopic therapeutic intervention remain the main principles of the initial treatment. This article reviews the existing evidence on PHE with emphasis on its classification, diagnosis, clinical manifestations, endoscopic appearance, pathological findings, and clinical management. A new schematic management of ectopic variceal bleed is also proposed. PMID:25729469

  1. 77 FR 33774 - Agency Information Collection Activities: Comment Request; Education and Human Resources Project...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-07

    ... Agency Information Collection Activities: Comment Request; Education and Human Resources Project... of Collection: Education and Human Resources Project Monitoring Clearance. OMB Approval Number: 3145... States and internationally. The Directorate for Education and Human Resources (EHR), a unit within...

  2. More Screen Time, Less Face time – Implications for EHR Design

    PubMed Central

    Asan, Onur; Smith, Paul; Montague, Enid

    2014-01-01

    Rationale, aims and objectives Understanding the impact of health information technology on doctor-patient interaction is vital to designing better electronic health records (EHRs). This article quantitatively examines and compares clinically experienced physicians’ interactions with patients using paper or electronic health records in ambulatory primary care settings. Methods Clinical encounters using paper or electronic health records were recorded with high-resolution video cameras to capture physicians’ interactions with the health records and patients. All videos were coded using quantified video coding methodology to understand how physicians interacted with EHRs and patients through measuring eye gaze durations. Statistical analysis was conducted to compare the results of the paper and electronic health record visits. Results Eight experienced family medicine physicians and eighty patients participated in the study. A total of 80 visits, 40 with paper and 40 with EHRs were recorded. The proportion of time physicians spent gazing at medical records during EHR visits was significantly more than in paper chart visits (35.2% VS 22.1%, P=0.001). A significantly smaller proportion of physician time was spent gazing at the patient when using an EHR compared to when using a paper chart (52.6% VS 45.6%, P= 0.041). Shared gaze by both physician and patient at the records was not significantly different between the two settings. Conclusions For this group of family medicine physicians, more time was spent looking at the EHR screen than paper records and a little less time looking at the patient. These findings may negatively affect the patient perception of the visit with the physician and have implications for the design of future EHRs. PMID:24835678

  3. Plug-and-play Integration of dual-model based Knowledge Artefacts into an Open Source Ehr System.

    PubMed

    Krexner, Rabea; Duftschmid, Georg

    2014-01-01

    In this paper we present our experiences with extending an existing approach for an archetype-compliant collection and export of data according to the openEHR specifications within the open source EHR system OpenMRS. It allows an automatic generation of forms from templates, which were introduced by openEHR as an extension of the dual-model approach. Data entered in these forms can be exported in form of standardized EHR extracts. The use of templates allowed us to solve problems reported for the original archetype-based version of the approach, which were caused by the high optionality within archetypes. PMID:25160154

  4. The Evaluation of SEPAS National Project Based on Electronic Health Record System (EHRS) Coordinates in Iran

    PubMed Central

    Asadi, Farkhondeh; Moghaddasi, Hamid; Rabiei, Reza; Rahimi, Forough; Mirshekarlou, Soheila Jahangiri

    2015-01-01

    Background: Electronic Health Records (EHRs) are secure private lifetime records that can be shared by using interoperability standards between different organizations and units. These records are created by the productive system that is called EHR system. Implementing EHR systems has a number of advantages such as facilitating access to medical records, supporting patient care, and improving the quality of care and health care decisions. The project of electronic health record system in Iran, which is the goal of this study, is called SEPAS. With respect to the importance of EHR and EHR systems the researchers investigated the project from two perspectives: determining the coordinates of the project and how it evolved, and incorporating the coordinates of EHR system in this project. Methods: In this study two evaluation tools, a checklist and a questionnaire, were developed based on texts and reliable documentation. The questionnaire and the checklist were validated using content validity by receiving the experts’ comments and the questionnaire’s reliability was estimated through Test-retest(r =87%). Data were collected through study, observation, and interviews with experts and specialists of SEPAS project. Results: This research showed that SEPAS project, like any other project, could be evaluated. It has some aims; steps, operational phases and certain start and end time, but all the resources and required facilities for the project have not been considered. Therefore it could not satisfy its specified objective and the useful and unique changes which are the other characteristics of any project have not been achieved. In addition, the findings of EHR system coordinates can be determined in 4 categories as Standards and rules, Telecommunication-Communication facilities, Computer equipment and facilities and Stakeholders. Conclusions: The findings indicated that SEPAS has the ability to use all standards of medical terminology and health classification

  5. EHR implementation in South Africa: how do we get it right?

    PubMed

    Yogeswaran, Parimalaranie; Wright, Graham

    2010-01-01

    In an environment of expanding demand on the health care system to provide equitable, accessible and safe health care, usage of information communication technology is one of the strategies identified to fulfil such expectations. Electronic Health Record (EHR) is an important tool towards achieving better health care using such technology, although, across the world EHR implementation has experienced a high failure rate. Nevertheless South Africa has made a strategic decision to implement EHR system in the public health sector. An evaluation toolkit was developed, to measure the state of readiness of health institutions in South Africa in implementing EHR based on Kaplan and Norton's work on Balanced Score Card (BSC), and the subsequent variant model developed by Protti. A Critical Success Factor (CSF) scorecard to assess the state of readiness and a Balanced Score Card matrix to be used as a strategic framework was developed. These tools were validated using critiques by a panel of experts. The toolkit developed has the potential to assist the organization towards a better EHR implementation path. PMID:20841716

  6. Using EHRs for Heart Failure Therapy Recommendation Using Multidimensional Patient Similarity Analytics.

    PubMed

    Panahiazar, Maryam; Taslimitehrani, Vahid; Pereira, Naveen L; Pathak, Jyotishman

    2015-01-01

    Electronic Health Records (EHRs) contain a wealth of information about an individual patient's diagnosis, treatment and health outcomes. This information can be leveraged effectively to identify patients who are similar to each for disease diagnosis and prognosis. In recent years, several machine learning methods have been proposed to assessing patient similarity, although the techniques have primarily focused on the use of patient diagnoses data from EHRs for the learning task. In this study, we develop a multidimensional patient similarity assessment technique that leverages multiple types of information from the EHR and predicts a medication plan for each new patient based on prior knowledge and data from similar patients. In our algorithm, patients have been clustered into different groups using a hierarchical clustering approach and subsequently have been assigned a medication plan based on the similarity index to the overall patient population. We evaluated the performance of our approach on a cohort of heart failure patients (N=1386) identified from EHR data at Mayo Clinic and achieved an AUC of 0.74. Our results suggest that it is feasible to harness population-based information from EHRs for an individual patient-specific assessment. PMID:25991168

  7. Educator Uses of Data-Enhanced Investigations for Climate Change Education (DICCE), An Online System for Accessing a Vast Portal of NASA Earth System Data Known As the Goddard Interactive Online Visualization and Analysis Infrastructure (GIOVANNI)

    NASA Astrophysics Data System (ADS)

    Zalles, D. R.; Acker, J. G.

    2015-12-01

    Data-enhanced Investigations for Climate Change Education (DICCE) has made it easier and more technologically feasible for secondary and post-secondary instructors and students to study climate change and related Earth system phenomena using data products from the Goddard Interactive Online Visualization and Analysis Infrastructure (GIOVANNI), a powerful portal of Earth observation data that provides access to numerous data products on Earth system phenomena representing the land biosphere, physical land, ocean biosphere, physical ocean, physical atmosphere, atmospheric gases, and energy and radiation system. These data products are derived from remote-sensing instruments on satellites, ground stations, and data assimilation models. Instructors and students can query the GIOVANNI data archive, then save the results as map images, time series plots, vertical profiles of the atmosphere, and data tables. Any part of the world can be selected for analysis. The project has also produced a tool for instructors to author and adapt standards-based lesson plans, student data investigation activities, and presentations around visualizations they make available to their students via DICCE-G. Supports are provided to students and teachers about how to interpret trends in data products of their choice at the regional level and a schema has been developed to help them understand how those data products fit into current scientific thinking about the certainties and uncertainties of climate change. The presentation will (1) describe the features of DICCE, (2) examples of curricula developed to make use of DICCE in classrooms, (3) how these curricula align to Next Generation Science Standards, and (4) how they align to science education research literature about how to make school science more engaging. Recently-analyzed teacher and student outcomes from DICCE use will also be reported.

  8. The Role of Ontologies for Sustainable, Semantically Interoperable and Trustworthy EHR Solutions

    PubMed Central

    BLOBEL, Bernd; KALRA, Dipak; KOEHN, Marc; LUNN, Ken; PHAROW, Peter; RUOTSALAINEN, Pekka; SCHULZ, Stefan; SMITH, Barry

    2016-01-01

    As health systems around the world turn towards highly distributed, specialized and cooperative structures to increase quality and safety of care as well as efficiency and efficacy of delivery processes, there is a growing need for supporting communication and collaboration of all parties involved with advanced ICT solutions. The Electronic Health Record (EHR) provides the information platform which is maturing towards the eHealth core application. To meet the requirements for sustainable, semantically interoperable, and trustworthy EHR solutions, different standards and different national strategies have been established. The workshop summarizes the requirements for such advanced EHR systems and their underlying architecture, presents different strategies and solutions advocated by corresponding protagonists, discusses pros and cons as well as harmonization and migration strategies for those approaches. It particularly highlights a turn towards ontology-driven architectures. The workshop is a joint activity of the EFMI Working Groups “Electronic Health Records” and “Security, Safety and Ethics”. PMID:19745454

  9. The role of ontologies for sustainable, semantically interoperable and trustworthy EHR solutions.

    PubMed

    Blobel, Bernd; Kalra, Dipak; Koehn, Marc; Lunn, Ken; Pharow, Peter; Ruotsalainen, Pekka; Schulz, Stefan; Smith, Barry

    2009-01-01

    As health systems around the world turn towards highly distributed, specialized and cooperative structures to increase quality and safety of care as well as efficiency and efficacy of delivery processes, there is a growing need for supporting communication and collaboration of all parties involved with advanced ICT solutions. The Electronic Health Record (EHR) provides the information platform which is maturing towards the eHealth core application. To meet the requirements for sustainable, semantically interoperable, and trustworthy EHR solutions, different standards and different national strategies have been established. The workshop summarizes the requirements for such advanced EHR systems and their underlying architecture, presents different strategies and solutions advocated by corresponding protagonists, discusses pros and cons as well as harmonization and migration strategies for those approaches. It particularly highlights a turn towards ontology-driven architectures. The workshop is a joint activity of the EFMI Working Groups "Electronic Health Records" and "Security, Safety and Ethics". PMID:19745454

  10. Concordance of Electronic Health Record (EHR) Data Describing Delirium at a VA Hospital

    PubMed Central

    Spuhl, Joshua; Doing-Harris, Kristina; Nelson, Scott; Estrada, Nicolette; Fiol, Guilherme Del; Weir, Charlene

    2014-01-01

    BACKGROUND Delirium is a common syndrome in elderly hospitalized patients that is correlated with poor outcomes and higher costs yet health care teams often overlook its diagnosis and treatment. Poor data quality in EHR systems can be contributing to this as a common tool teams use to communicate and record data about their patients. METHODS Data were gathered from 30 patients chosen randomly that spanned various data domains in the EHR. These were analyzed for concordance as an indicator of data quality. RESULTS Concordance was high between the physician and nursing narrative documentation. The other domains of data were drastically less concordant. DISCUSSION The low concordance between structured and narrative data domains suggests that clinicians are forgoing the features available in modern EHR systems and opting to work in narrative. For informatics, this can be troubling as narrative data are difficult to compute. PMID:25954416

  11. Using OpenEHR in SICTI an electronic health record system for critical medicine

    NASA Astrophysics Data System (ADS)

    Filgueira, R.; Odriazola, A.; Simini, F.

    2007-11-01

    SICTI is a software tool for registering health records in critical medicine environments. Version 1.0 has been in use since 2003. The Biomedical Engineering Group (Núcleo de Ingeniería Biomédica), with support from the Technological Development Programme (Programa de Desarrollo Tecnológico), decided to develop a new version, to provide an aid for more critical medicine processes, based on a framework which would make the application domain change oriented. The team analyzed three alternatives: to develop an original product based on new research, to base the development on OpenEHR framework, or to use HL7 RIM as the reference model for SICTI. The team opted for OpenEHR. This work describes the use of OpenEHR, its strong and weak points, and states future work perspectives.

  12. Building a Semantic Model to Enhance the User's Perceived Functionality of the EHR.

    PubMed

    Lasierra, Nelia; Schweitzer, Marco; Gorfer, Thilo; Toma, Ioan; Hoerbst, Alexander

    2016-01-01

    In order to facilitate and increase the usability of Electronic Health Records (EHRs) for healthcare professional's daily work, we have designed a system that enables functional and flexible EHR access, based on the execution of clinical workflows and the composition of Semantic Web Services (SWS). The backbone of this system is based on an ontology. In this paper we present the strategy that we have followed for its design, and an overview of the resulting model. The designed ontology enables to model patient-centred clinical EHR workflows, the involved sequence of tasks and its associated functionality and managed clinical data. This semantic model constitutes also the main pillar for enabling dynamic service selection in our system. PMID:27577358

  13. Portal Annular Pancreas

    PubMed Central

    Harnoss, Jonathan M.; Harnoss, Julian C.; Diener, Markus K.; Contin, Pietro; Ulrich, Alexis B.; Büchler, Markus W.; Schmitz-Winnenthal, Friedrich H.

    2014-01-01

    Abstract Portal annular pancreas (PAP) is an asymptomatic congenital pancreas anomaly, in which portal and/or mesenteric veins are encased by pancreas tissue. The aim of the study was to determine the role of PAP in pancreatic surgery as well as its management and potential complication, specifically, postoperative pancreatic fistula (POPF). On the basis of a case report, the MEDLINE and ISI Web of Science databases were systematically reviewed up to September 2012. All articles describing a case of PAP were considered. In summary, 21 studies with 59 cases were included. The overall prevalence of PAP was 2.4% and the patients' mean (SD) age was 55.9 (16.2) years. The POPF rate in patients with PAP (12 pancreaticoduodenectomies and 3 distal pancreatectomies) was 46.7% (in accordance with the definition of the International Study Group of Pancreatic Surgery). Portal annular pancreas is a quite unattended pancreatic variant with high prevalence and therefore still remains a clinical challenge to avoid postoperative complications. To decrease the risk for POPF, attentive preoperative diagnostics should also focus on PAP. In pancreaticoduodenectomy, a shift of the resection plane to the pancreas tail should be considered; in extensive pancreatectomy, coverage of the pancreatic remnant by the falciform ligament could be a treatment option. PMID:25207658

  14. Transjugular Portal Venous Stenting in Inflammatory Extrahepatic Portal Vein Stenosis

    SciTech Connect

    Schaible, Rolf; Textor, Jochen; Decker, Pan; Strunk, Holger; Schild, Hans

    2002-12-15

    We report the case of a 37-year-old man with necrotizing pancreatitis associated with inflammatory extrahepatic portal vein stenosis and progressive ascites. Four months after the acute onset, when no signs of infection were present, portal decompression was performed to treat refractory ascites. Transjugulartranshepatic venoplasty failed to dilate the stenosis in the extrahepatic portion of the portal vein sufficiently. Therefore a Wallstent was implanted, resulting in almost normal diameter of the vessel. In follow-up imaging studies the stent and the portal vein were still patent 12 months after the intervention and total resolution of the ascites was observed.

  15. Impact of a Prototype Visualization Tool for New Information in EHR Clinical Documents

    PubMed Central

    Farri, O.; Rahman, A.; Monsen, K.A.; Zhang, R.; Pakhomov, S.V.; Pieczkiewicz, D.S.; Speedie, S.M.; Melton, G.B.

    2012-01-01

    Background EHR clinical document synthesis by clinicians may be time-consuming and error-prone due to the complex organization of narratives, excessive redundancy within documents, and, at times, inadvertent proliferation of data inconsistencies. Development of EHR systems that are easily adaptable to the user’s work processes requires research into visualization techniques that can optimize information synthesis at the point of care. Objective To evaluate the effect of a prototype visualization tool for clinically relevant new information on clinicians’ synthesis of EHR clinical documents and to understand how the tool may support future designs of clinical document user interfaces. Methods A mixed methods approach to analyze the impact of the visualization tool was used with a sample of eight medical interns as they synthesized EHR clinical documents to accomplish a set of four pre-formed clinical scenarios using a think-aloud protocol. Results Differences in the missing (unretrieved) patient information (2.3±1.2 [with the visualization tool] vs. 6.8±1.2 [without the visualization tool], p = 0.08) and accurate inferences (1.3±0.3 vs 2.3±0.3, p = 0.09) were not statistically significant but suggest some improvement with the new information visualization tool. Despite the non-significant difference in total times to task completion (43±4 mins vs 36±4 mins, p = 0.35) we observed shorter times for two scenarios with the visualization tool, suggesting that the time-saving benefits may be more evident with certain clinical processes. Other observed effects of the tool include more intuitive navigation between patient details and increased efforts towards methodical synthesis of clinical documents. Conclusion Our study provides some evidence that new information visualization in clinical notes may positively influence synthesis of patient information from EHR clinical documents. Our findings provide groundwork towards a more effective display of EHR clinical

  16. IDL Grid Web Portal

    NASA Astrophysics Data System (ADS)

    Massimino, P.; Costa, A.

    2008-08-01

    Image Data Language is a software for data analysis, visualization and cross-platform application development. The potentiality of IDL is well-known in the academic scientific world, especially in the astronomical environment where thousands of procedures are developed by using IDL. The typical use of IDL is the interactive mode but it is also possible to run IDL programs that do not require any interaction with the user, submitting them in batch or background modality. Through the interactive mode the user immediately receives images or other data produced in the running phase of the program; in batch or background mode, the user will have to wait for the end of the program, sometime for many hours or days to obtain images or data that IDL produced as output: in fact in Grid environment it is possible to access to or retrieve data only after completion of the program. The work that we present gives flexibility to IDL procedures submitted to the Grid computer infrastructure. For this purpose we have developed an IDL Grid Web Portal to allow the user to access the Grid and to submit IDL programs granting a full job control and the access to images and data generated during the running phase, without waiting for their completion. We have used the PHP technology and we have given the same level of security that Grid normally offers to its users. In this way, when the user notices that the intermediate program results are not those expected, he can stop the job, change the parameters to better satisfy the computational algorithm and resubmit the program, without consuming the CPU time and other Grid resources. The IDL Grid Web Portal allows you to obtain IDL generated images, graphics and data tables by using a normal browser. All conversations from the user and the Grid resources occur via Web, as well as authentication phases. The IDL user has not to change the program source much because the Portal will automatically introduce the appropriate modification before

  17. A portal for the ocean biogeographic information system

    USGS Publications Warehouse

    Zhang, Yunqing; Grassle, J. F.

    2002-01-01

    Since its inception in 1999 the Ocean Biogeographic Information System (OBIS) has developed into an international science program as well as a globally distributed network of biogeographic databases. An OBIS portal at Rutgers University provides the links and functional interoperability among member database systems. Protocols and standards have been established to support effective communication between the portal and these functional units. The portal provides distributed data searching, a taxonomy name service, a GIS with access to relevant environmental data, biological modeling, and education modules for mariners, students, environmental managers, and scientists. The portal will integrate Census of Marine Life field projects, national data archives, and other functional modules, and provides for network-wide analyses and modeling tools.

  18. Knowledge portal: a tool to capture university requirements

    NASA Astrophysics Data System (ADS)

    Mansourvar, Marjan; Binti Mohd Yasin, Norizan

    2011-10-01

    New technologies, especially, the Internet have made a huge impact on knowledge management and information dissemination in education. The web portal as a knowledge management system is very popular topics in many organizations including universities. Generally, a web portal defines as a gateway to online network accessible resources through the intranet, extranet or Internet. This study develops a knowledge portal for the students in the Faculty of Computer Science and Information Technology (FCSIT), University of Malaya (UM). The goals of this portal are to provide information for the students to help them to choose the right courses and major that are relevant to their intended future jobs or career in IT. A quantitative approach used as the selected method for this research. Quantitative method provides an easy and useful way to collect data from a large sample population.

  19. 29 CFR 785.24 - Principles noted in Portal-to-Portal Bulletin.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Principles noted in Portal-to-Portal Bulletin. 785.24... of Principles Preparatory and Concluding Activities § 785.24 Principles noted in Portal-to-Portal Bulletin. In November, 1947, the Administrator issued the Portal-to-Portal Bulletin (part 790 of...

  20. 29 CFR 785.24 - Principles noted in Portal-to-Portal Bulletin.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Principles noted in Portal-to-Portal Bulletin. 785.24... of Principles Preparatory and Concluding Activities § 785.24 Principles noted in Portal-to-Portal Bulletin. In November, 1947, the Administrator issued the Portal-to-Portal Bulletin (part 790 of...

  1. 29 CFR 785.24 - Principles noted in Portal-to-Portal Bulletin.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Principles noted in Portal-to-Portal Bulletin. 785.24... of Principles Preparatory and Concluding Activities § 785.24 Principles noted in Portal-to-Portal Bulletin. In November, 1947, the Administrator issued the Portal-to-Portal Bulletin (part 790 of...

  2. 29 CFR 785.24 - Principles noted in Portal-to-Portal Bulletin.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Principles noted in Portal-to-Portal Bulletin. 785.24... of Principles Preparatory and Concluding Activities § 785.24 Principles noted in Portal-to-Portal Bulletin. In November, 1947, the Administrator issued the Portal-to-Portal Bulletin (part 790 of...

  3. Cognitive Analysis of a Highly Configurable Web 2.0 EHR Interface

    PubMed Central

    Senathirajah, Yalini; Kaufman, David; Bakken, Suzanne

    2010-01-01

    We summarize findings of one case from initial in-lab usability and cognitive tests of 13 clinicians using MedWISE, a widget-based electronic health record (EHR) interface, to familiarize themselves with real patient cases and verbalize their assessment and plan. Multiple methods were used to examine patterns of use, time taken, use of new functionality, user-created interfaces, and diagnostic and human-computer interaction processes. All clinicians learned MedWISE quickly, most used more than half the new functionalities and found MedWISE easy to use and useful. We discuss implications for the design of future EHRs. PMID:21347075

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

    PubMed Central

    2011-01-01

    Background 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. Methods 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. Results 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. Conclusions 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

  5. A Standards-based Semantic Metadata Repository to Support EHR-driven Phenotype Authoring and Execution

    PubMed Central

    Solbrig, Harold R.; Kiefer, Richard; Rasmussen, Luke V.; Mo, Huan; Speltz, Peter; Thompson, William K.; Denny, Joshua C.; Chute, Christopher G.; Pathak, Jyotishman

    2016-01-01

    This study describes our efforts in developing a standards-based semantic metadata repository for supporting electronic health record (EHR)-driven phenotype authoring and execution. Our system comprises three layers: 1) a semantic data element repository layer; 2) a semantic services layer; and 3) a phenotype application layer. In a prototype implementation, we developed the repository and services through integrating the data elements from both Quality Data Model (QDM) and HL7 Fast Healthcare Inteoroperability Resources (FHIR) models. We discuss the modeling challenges and the potential of our system to support EHR phenotype authoring and execution applications. PMID:26262397

  6. A Standards-based Semantic Metadata Repository to Support EHR-driven Phenotype Authoring and Execution.

    PubMed

    Jiang, Guoqian; Solbrig, Harold R; Kiefer, Richard; Rasmussen, Luke V; Mo, Huan; Speltz, Peter; Thompson, William K; Denny, Joshua C; Chute, Christopher G; Pathak, Jyotishman

    2015-01-01

    This study describes our efforts in developing a standards-based semantic metadata repository for supporting electronic health record (EHR)-driven phenotype authoring and execution. Our system comprises three layers: 1) a semantic data element repository layer; 2) a semantic services layer; and 3) a phenotype application layer. In a prototype implementation, we developed the repository and services through integrating the data elements from both Quality Data Model (QDM) and HL7 Fast Healthcare Inteoroperability Resources (FHIR) models. We discuss the modeling challenges and the potential of our system to support EHR phenotype authoring and execution applications. PMID:26262397

  7. Collateral Pathways in Portal Hypertension

    PubMed Central

    Sharma, Malay; Rameshbabu, Chittapuram S.

    2012-01-01

    Presence of portosystemic collateral veins (PSCV) is common in portal hypertension due to cirrhosis. Physiologically, normal portosystemic anastomoses exist which exhibit hepatofugal flow. With the development of portal hypertension, transmission of backpressure leads to increased flow in these patent normal portosystemic anastomoses. In extrahepatic portal vein obstruction collateral circulation develops in a hepatopetal direction and portoportal pathways are frequently found. The objective of this review is to illustrate the various PSCV and portoportal collateral vein pathways pertinent to portal hypertension in liver cirrhosis and EHPVO. PMID:25755456

  8. 8. Detail, skewed portal bracing at west portal, also showing ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. Detail, skewed portal bracing at west portal, also showing boxed endposts, latticed upper transverse and diagonal sway bracing, laced vertical members, view to northeast, 210mm lens. - Southern Pacific Railroad Shasta Route, Bridge No. 301.85, Milepost 301.85, Pollard Flat, Shasta County, CA

  9. Web portal on environmental sciences "ATMOS''

    NASA Astrophysics Data System (ADS)

    Gordov, E. P.; Lykosov, V. N.; Fazliev, A. Z.

    2006-06-01

    The developed under INTAS grant web portal ATMOS (http://atmos.iao.ru and http://atmos.scert.ru) makes available to the international research community, environmental managers, and the interested public, a bilingual information source for the domain of Atmospheric Physics and Chemistry, and the related application domain of air quality assessment and management. It offers access to integrated thematic information, experimental data, analytical tools and models, case studies, and related information and educational resources compiled, structured, and edited by the partners into a coherent and consistent thematic information resource. While offering the usual components of a thematic site such as link collections, user group registration, discussion forum, news section etc., the site is distinguished by its scientific information services and tools: on-line models and analytical tools, and data collections and case studies together with tutorial material. The portal is organized as a set of interrelated scientific sites, which addressed basic branches of Atmospheric Sciences and Climate Modeling as well as the applied domains of Air Quality Assessment and Management, Modeling, and Environmental Impact Assessment. Each scientific site is open for external access information-computational system realized by means of Internet technologies. The main basic science topics are devoted to Atmospheric Chemistry, Atmospheric Spectroscopy and Radiation, Atmospheric Aerosols, Atmospheric Dynamics and Atmospheric Models, including climate models. The portal ATMOS reflects current tendency of Environmental Sciences transformation into exact (quantitative) sciences and is quite effective example of modern Information Technologies and Environmental Sciences integration. It makes the portal both an auxiliary instrument to support interdisciplinary projects of regional environment and extensive educational resource in this important domain.

  10. Portal Vein Thrombosis in Cirrhosis

    PubMed Central

    Raja, Kaiser; Jacob, Mathew; Asthana, Sonal

    2013-01-01

    Portal vein thrombosis (PVT) is being increasingly recognized in patients with advanced cirrhosis and in those undergoing liver transplantation. Reduced flow in the portal vein is probably responsible for clotting in the spleno-porto-mesenteric venous system. There is also increasing evidence that hypercoagulability occurs in advanced liver disease and contributes to the risk of PVT. Ultrasound based studies have reported a prevalence of PVT in 10–25% of cirrhotic patients without hepatocellular carcinoma. Partial thrombosis of the portal vein is more common and may not have pathophysiological consequences. However, there is high risk of progression of partial PVT to complete PVT that may cause exacerbation of portal hypertension and progression of liver insufficiency. It is thus, essential to accurately diagnose and stage PVT in patients waiting for transplantation and consider anticoagulation therapy. Therapy with low molecular weight heparin and vitamin K antagonists has been shown to achieve complete and partial recanalization in 33–45% and 15–35% of cases respectively. There are however, no guidelines to help determine the dose and therapeutic efficacy of anticoagulation in patients with cirrhosis. Anticoagulation therapy related bleeding is the most feared complication but it appears that the risk of variceal bleeding is more likely to be dependent on portal pressure rather than solely related to coagulation status. TIPS has also been reported to restore patency of the portal vein. Patients with complete PVT currently do not form an absolute contraindication for liver transplantation. Thrombectomy or thromboendovenectomy is possible in more than 75% of patients followed by anatomical end-to-end portal anastomosis. When patency of the portal vein and/or superior mesenteric vein is not achieved, only non-anatomical techniques (reno-portal anastomosis or cavo-portal hemitransposition) can be performed. These techniques, which do not fully reverse portal

  11. A business case for HIT adoption: effects of "meaningful use" EHR financial incentives on clinic revenue.

    PubMed

    Behkami, Nima A; Dorr, David A; Morrice, Stuart

    2010-01-01

    The goal of this study is to describe a framework that allows decision makers to efficiently evaluate factors that affect Electronic Health Record (EHR) adoption and test suitable interventions; specifically financial incentives. The United States healthcare delivery system is experiencing a transformation to improve population health. There is strong agreement that "meaningful use" of Health Information Technology (HIT) is a major enabler in this effort. However it's also understood that the high cost of implementing an EHR is an obstacle for adoption. To help understand these complexities we developed a simulation model designed to capture the dynamic nature of policy interventions that affect the adoption of EHR. We found that "Effective" use of HIT approaches break-even-point and larger clinic revenue many times faster that "average" or "poor" use of HIT. This study uses a systems perspective to the evaluate EHR adoption process through the "meaningful use" redesign as proposed in the American Reinvestment and Recovery Act 2009 in the United States healthcare industry by utilizing the System Dynamics methodology and Scenario Analysis. PMID:20841792

  12. Validation of standardized and structured EHR data in the dual model approach.

    PubMed

    Rinner, Christoph; Duftschmid, Georg

    2009-01-01

    We present a W3C XML Schema-based method to validate standardized EHR data against semantic constraints that build the knowledge layer within the dual model approach. The approach was tested with three EN/ISO13606 archetypes and an HL7 CDA implementation guide for diabetes therapies. PMID:19745278

  13. A Correlational Analysis: Electronic Health Records (EHR) and Quality of Care in Critical Access Hospitals

    ERIC Educational Resources Information Center

    Khan, Arshia A.

    2012-01-01

    Driven by the compulsion to improve the evident paucity in quality of care, especially in critical access hospitals in the United States, policy makers, healthcare providers, and administrators have taken the advise of researchers suggesting the integration of technology in healthcare. The Electronic Health Record (EHR) System composed of multiple…

  14. User Satisfaction Evaluation of the EHR4CR Query Builder: A Multisite Patient Count Cohort System

    PubMed Central

    Soto-Rey, Iñaki; N'Dja, Aurèle; Cunningham, James; Newe, Axel; Trinczek, Benjamin; Lafitte, Caroline; Sedlmayr, Brita; Fritz, Fleur

    2015-01-01

    The Electronic Health Records for Clinical Research (EHR4CR) project aims to develop services and technology for the leverage reuse of Electronic Health Records with the purpose of improving the efficiency of clinical research processes. A pilot program was implemented to generate evidence of the value of using the EHR4CR platform. The user acceptance of the platform is a key success factor in driving the adoption of the EHR4CR platform; thus, it was decided to evaluate the user satisfaction. In this paper, we present the results of a user satisfaction evaluation for the EHR4CR multisite patient count cohort system. This study examined the ability of testers (n = 22 and n = 16 from 5 countries) to perform three main tasks (around 20 minutes per task), after a 30-minute period of self-training. The System Usability Scale score obtained was 55.83 (SD: 15.37), indicating a moderate user satisfaction. The responses to an additional satisfaction questionnaire were positive about the design of the interface and the required procedure to design a query. Nevertheless, the most complex of the three tasks proposed in this test was rated as difficult, indicating a need to improve the system regarding complicated queries. PMID:26539525

  15. 77 FR 8217 - Evaluating the Usability of Electronic Health Record (EHR) Systems

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE...) Systems AGENCY: National Institute of Standards and Technology, Commerce. ACTION: Notice. SUMMARY: NIST is... Letters of Understanding. Comparative information (e.g., testing results from unidentified EHR systems...

  16. EHR Documentation: The Hype and the Hope for Improving Nursing Satisfaction and Quality Outcomes.

    PubMed

    OʼBrien, Ann; Weaver, Charlotte; Settergren, Theresa Tess; Hook, Mary L; Ivory, Catherine H

    2015-01-01

    The phenomenon of "data rich, information poor" in today's electronic health records (EHRs) is too often the reality for nursing. This article proposes the redesign of nursing documentation to leverage EHR data and clinical intelligence tools to support evidence-based, personalized nursing care across the continuum. The principles consider the need to optimize nurses' documentation efficiency while contributing to knowledge generation. The nursing process must be supported by EHRs through integration of best care practices: seamless workflows that display the right tools, evidence-based content, and information at the right time for optimal clinical decision making. Design of EHR documentation must attain a balance that ensures the capture of nursing's impact on safety, quality, highly reliable care, patient engagement, and satisfaction, yet minimizes "death by data entry." In 2014, a group of diverse informatics leaders from practice, academia, and the vendor community formed to address how best to transform electronic documentation to provide knowledge at the point of care and to deliver value to front line nurses and nurse leaders. As our health care system moves toward reimbursement on the basis of quality outcomes and prevention, the value of nursing data in this business proposition will become a key differentiator for health care organizations' economic success. PMID:26340245

  17. Security challenges in integration of a PHR-S into a standards based national EHR.

    PubMed

    Mense, Alexander; Hoheiser Pförtner, Franz; Sauermann, Stefan

    2014-01-01

    Health related data provided by patients themselves is expected to play a major role in future healthcare. Data from personal health devices, vaccination records, health diaries or observations of daily living, for instance, is stored in personal health records (PHR) which are maintained by personal health record systems (PHR-S). Combining this information with medical records provided by healthcare providers in electronic health records (EHR) is one of the next steps towards "personal care". Austria currently sets up a nationwide EHR system that incorporates all healthcare providers and is technically based on international standards (IHE, HL7, OASIS, ...). Looking at the expected potential of merging PHR and EHR data it is worth to analyse integration approaches. Although knowing that an integration requires the coordination of processes, information models and technical architectures, this paper specifically focuses on security issues by evaluating general security requirements for a PHR-S (based on HL7 PHR-S FM), comparing them with the information security specifications for the Austrian's national EHR (based on ISO/IES 27000 series) and identifying the main challenges as well as possible approaches. PMID:25160182

  18. On the seamless, harmonized use of ISO/IEEE11073 and openEHR.

    PubMed

    Trigo, Jesús D; Kohl, Christian D; Eguzkiza, Aitor; Martínez-Espronceda, Miguel; Alesanco, Álvaro; Serrano, Luis; García, José; Knaup, Petra

    2014-05-01

    Standardized exchange of clinical information is a key factor in the provision of high quality health care systems. In this context, the openEHR specification facilitates the management of health data in electronic health records (EHRs), while the ISO/IEEE11073 (also referred to as X73PHD) family of standards provides a reference framework for medical device interoperability. Hospitals and health care providers using openEHR require flawless integration of data coming from external sources, such as X73PHD. Hence, a harmonization process is crucial for achieving a seamless, coherent use of those specifications in real scenarios. Such harmonization is the aim of this paper. Thus, the classes and attributes of a representative number of X73PHD specializations for medical devices--weight, temperature, blood pressure, pulse and heart rate, oximetry, and electrocardiograph--along with the X73PHD core document--ISO/IEEE11073-20601--have been analyzed and mapped to openEHR archetypes. The proposed methodology reuses the existing archetypes when possible and suggests new ones--or appropriate modifications--otherwise. As a result, this paper analyzes the inconsistencies found and the implications thereof in the coordinated use of these two standards. The procedure has also shown how existing standards are able to influence the archetype development process, enhancing the existing archetype corpus. PMID:24132031

  19. Of Portals, Policies, and Poets

    ERIC Educational Resources Information Center

    Bunt, Rick; Pennock, Lea

    2006-01-01

    Universities are drawn to portals as an effective way of organizing and delivering campus services and information. In a university environment, where the desire for local autonomy and the impetus for centralization are in constant tension, a portal seems especially appealing because it allows local solutions through a shared medium. But the fact…

  20. All Roads Lead to Portal

    ERIC Educational Resources Information Center

    Heid, Susan D.

    2007-01-01

    Portals are taking off on campuses nationwide. According to "Campus Computing 2006," the Campus Computing Project's survey of 540 two- and four-year public and private colleges and universities across the US, portal deployment for four-year public residential universities jumped from 28 to 74 percent of responding institutions between the…

  1. NSTA Portal to Science Safety

    ERIC Educational Resources Information Center

    Roy, Ken

    2010-01-01

    The National Science Teachers Association's (NSTA) Science Safety Advisory Board recently launched the Safety in the Science Classroom portal. This portal serves as a gateway to safety resources for teachers, supervisors, and administrators. It also contains an evolving list of safety resources for elementary, middle, and high schools. The list…

  2. CDAPubMed: a browser extension to retrieve EHR-based biomedical literature

    PubMed Central

    2012-01-01

    Background Over the last few decades, the ever-increasing output of scientific publications has led to new challenges to keep up to date with the literature. In the biomedical area, this growth has introduced new requirements for professionals, e.g., physicians, who have to locate the exact papers that they need for their clinical and research work amongst a huge number of publications. Against this backdrop, novel information retrieval methods are even more necessary. While web search engines are widespread in many areas, facilitating access to all kinds of information, additional tools are required to automatically link information retrieved from these engines to specific biomedical applications. In the case of clinical environments, this also means considering aspects such as patient data security and confidentiality or structured contents, e.g., electronic health records (EHRs). In this scenario, we have developed a new tool to facilitate query building to retrieve scientific literature related to EHRs. Results We have developed CDAPubMed, an open-source web browser extension to integrate EHR features in biomedical literature retrieval approaches. Clinical users can use CDAPubMed to: (i) load patient clinical documents, i.e., EHRs based on the Health Level 7-Clinical Document Architecture Standard (HL7-CDA), (ii) identify relevant terms for scientific literature search in these documents, i.e., Medical Subject Headings (MeSH), automatically driven by the CDAPubMed configuration, which advanced users can optimize to adapt to each specific situation, and (iii) generate and launch literature search queries to a major search engine, i.e., PubMed, to retrieve citations related to the EHR under examination. Conclusions CDAPubMed is a platform-independent tool designed to facilitate literature searching using keywords contained in specific EHRs. CDAPubMed is visually integrated, as an extension of a widespread web browser, within the standard PubMed interface. It has

  3. Health literacy and patient portals.

    PubMed

    Gu, Yulong; Orr, Martin; Warren, Jim

    2015-06-01

    Health literacy has been described as the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Improving health literacy may serve to promote concordance with therapy, engage patients in their own health care, and improve health outcomes. Patient portal technology aims at enabling patients and families to have easy access to key information in their own medical records and to communicate with their health care providers electronically. However, there is a gap in our understanding of how portals will improve patient outcome. The authors believe patient portal technology presents an opportunity to improve patient concordance with prescribed therapy, if adequate support is provided to equip patients (and family/carers) with the knowledge needed to utilise the health information available via the portals. Research is needed to understand what a health consumer will use patient portals for and how to support a user to realise the technology's potential. PMID:26125067

  4. The NSF IUSE-EHR Program: What's New (and Old) About It, and Resources for Geoscience Proposers

    NASA Astrophysics Data System (ADS)

    Singer, J.; Ryan, J. G.

    2015-12-01

    The NSF Division of Undergraduate Education recently released a new solicitation for the IUSE program -- the latest iteration in a succession of funding programs dating back over 30 years (including the Instrumentation and Laboratory Improvement Program (ILI), the Course and Curriculum Development Program (CCD), the Course Curriculum and Laboratory Improvement Program (CCLI), and the Transforming Undergraduate STEM Education Program (TUES). All of these programs sought/seek to support high quality STEM education for majors and non-majors in lower- and upper-division undergraduate courses. The current IUSE-EHR program is described in a 2-year solicitation that includes two tracks: Engaged Student Learning, and Institutional & Community Transformation. Each track has several options for funding level and project duration. A wide range of activities can be proposed for funding, and the program recognizes the varying needs across STEM disciplines. Geoscientists and other potential IUSE proposers are strongly encouraged to form collaborations with colleagues that conduct educational research and to propose projects that build upon the educational knowledge base in the discipline as well as contribute to it. Achieving this may not be immediately obvious to many geoscientists who have interests in improving student learning in their courses, but are not fluent in the scholarship of education in their field. To lower the barriers that have historically prevented larger numbers of geoscientists from developing their ideas into competitive education-related proposals, we have explored strategies for building and leveraging partnerships, sought to identify available resources for proposers, and explored a range of strategies for engaging and supporting larger numbers of potential geoscience proposers.

  5. Cost-Effectiveness Evaluation of EHR: Simulation of an Abdominal Aortic Aneurysm in the Emergency Department.

    PubMed

    Ben-Assuli, Ofir; Ziv, Amitai; Sagi, Doron; Ironi, Avinoah; Leshno, Moshe

    2016-06-01

    Health care organizations have installed electronic systems to increase efficiency in health care. Empirically assessing the cost-effectiveness of technologies to the health care system is a challenging and complex task. This study examined cost-effectiveness of additional clinical information supplied via an EHR system by simulating a case of abdominal aortic aneurysm devised and acted professionally by the Israel Center of Medical Simulation. We conducted a simulation-based study on physicians who were asked to treat a simulated patient for the prevalent medical scenario of hip and leg pain that actually corresponded to an abdominal aortic aneurysm. Half of the participating physicians from the Department of Emergency Medicine at Tel-Hashomer Hospital - Israel's largest - had access to an EHR system that integrates medical data from multiple health providers (community and hospitals) in addition to the local health record, and half did not. To model medical decision making, the results of the simulation were combined with a Markov Model within a decision tree. Cost-effectiveness was analyzed by comparing the effects of the admission/discharge decision in units of quality adjusted life years (QALYs) to the estimated costs. The results showed that using EHR in the ED increases the QALY of the patient and improves medical decision-making. The expenditure per patient for one QALY unit as a result of using the EHR was $1229, which is very cost-effective according to many accepted threshold values (less than all these values). Thus, using the EHR contributes to making a cost-effective decision in this specific but prevalent case. PMID:27114352

  6. The Portuguese Climate Portal

    NASA Astrophysics Data System (ADS)

    Gomes, Sandra; Deus, Ricardo; Nogueira, Miguel; Viterbo, Pedro; Miranda, Miguel; Antunes, Sílvia; Silva, Alvaro; Miranda, Pedro

    2016-04-01

    The Portuguese Local Warming Website (http://portaldoclima.pt) has been developed in order to support the society in Portugal in preparing for the adaptation to the ongoing and future effects of climate change. The climate portal provides systematic and easy access to authoritative scientific data ready to be used by a vast and diverse user community from different public and private sectors, key players and decision makers, but also to high school students, contributing to the increase in knowledge and awareness on climate change topics. A comprehensive set of regional climate variables and indicators are computed, explained and graphically presented. Variables and indicators were built in agreement with identified needs after consultation of the relevant social partners from different sectors, including agriculture, water resources, health, environment and energy and also in direct cooperation with the Portuguese National Strategy for Climate Change Adaptation (ENAAC) group. The visual interface allows the user to dynamically interact, explore, quickly analyze and compare, but also to download and import the data and graphics. The climate variables and indicators are computed from state-of-the-art regional climate model (RCM) simulations (e.g., CORDEX project), at high space-temporal detail, allowing to push the limits of the projections down to local administrative regions (NUTS3) and monthly or seasonal periods, promoting local adaptation strategies. The portal provides both historical data (observed and modelled for the 1971-2000 period) and future climate projections for different scenarios (modelled for the 2011-2100 period). A large effort was undertaken in order to quantify the impacts of the risk of extreme events, such as heavy rain and flooding, droughts, heat and cold waves, and fires. Furthermore the different climate scenarios and the ensemble of RCM models, with high temporal (daily) and spatial (~11km) detail, is taken advantage in order to

  7. Climate Outreach Using Regional Coastal Ocean Observing System Portals

    NASA Astrophysics Data System (ADS)

    Anderson, D. M.; Hernandez, D. L.; Wakely, A.; Bochenek, R. J.; Bickel, A.

    2015-12-01

    Coastal oceans are dynamic, changing environments affected by processes ranging from seconds to millennia. On the east and west coast of the U.S., regional observing systems have deployed and sustained a remarkable diverse array of observing tools and sensors. Data portals visualize and provide access to real-time sensor networks. Portals have emerged as an interactive tool for educators to help students explore and understand climate. Bringing data portals to outreach events, into classrooms, and onto tablets and smartphones enables educators to address topics and phenomena happening right now. For example at the 2015 Charleston Science Technology Engineering and Math (STEM) Festival, visitors navigated the SECOORA (Southeast Coastal Ocean Observing regional Association) data portal to view the real-time marine meteorological conditions off South Carolina. Map-based entry points provide an intuitive interface for most students, an array of time series and other visualizations depict many of the essential principles of climate science manifest in the coastal zone, and data down-load/ extract options provide access to the data and documentation for further inquiry by advanced users. Beyond the exposition of climate principles, the portal experience reveals remarkable technologies in action and shows how the observing system is enabled by the activity of many different partners.

  8. The parallel virtual file system for portals.

    SciTech Connect

    Schutt, James Alan

    2004-04-01

    This report presents the result of an effort to re-implement the Parallel Virtual File System (PVFS) using Portals as the transport. This report provides short overviews of PVFS and Portals, and describes the design and implementation of PVFS over Portals. Finally, the results of performance testing of both stock PVFS and PVFS over Portals are presented.

  9. 29 CFR 785.34 - Effect of section 4 of the Portal-to-Portal Act.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Effect of section 4 of the Portal-to-Portal Act. 785.34 Section 785.34 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR... of Principles Traveltime § 785.34 Effect of section 4 of the Portal-to-Portal Act. The Portal...

  10. 29 CFR 785.34 - Effect of section 4 of the Portal-to-Portal Act.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Effect of section 4 of the Portal-to-Portal Act. 785.34 Section 785.34 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR... of Principles Traveltime § 785.34 Effect of section 4 of the Portal-to-Portal Act. The Portal...

  11. 29 CFR 785.34 - Effect of section 4 of the Portal-to-Portal Act.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Effect of section 4 of the Portal-to-Portal Act. 785.34 Section 785.34 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR... of Principles Traveltime § 785.34 Effect of section 4 of the Portal-to-Portal Act. The Portal...

  12. Analysis of Clinical Record Data for Anticoagulation Management within an EHR System

    PubMed Central

    Austin, T; Kalra, D; Lea, N.C; Patterson, D.L.H; Ingram, D

    2009-01-01

    Objectives: This paper reports an evaluation of the properties of a generic electronic health record information model that were actually required and used when importing an existing clinical application into a generic EHR repository. Method: A generic EHR repository and system were developed as part of the EU Projects Synapses and SynEx. A Web application to support the management of anticoagulation therapy was developed to interface to the EHR system, and deployed within a north London hospital with five years of cumulative clinical data from the previous existing anticoagulation management application. This offered the opportunity to critique those parts of the generic EHR that were actually needed to represent the legacy data. Results: The anticoagulation records from 3,226 patients were imported and represented using over 900,000 Record Components (i.e. each patient’s record contained on average 289 nodes), of which around two thirds were Element Items (i.e. value-containing leaf nodes), the remainder being container nodes (i.e. headings and sub-headings). Each node is capable of incorporating a rich set of context properties, but in reality it was found that many properties were not used at all, and some infrequently (e.g. only around 0.5% of Record Components had ever been revised). Conclusions: The process of developing generic EHR information models, arising from research and embodied within new-generation interoperability standards and specifications, has been strongly driven by requirements. These requirements have been gathered primarily by collecting use cases and examples from clinical communities, and been added to successive generations of these models. A priority setting approach has not to date been pursued - all requirements have been received and almost invariably met. This work has shown how little of the resulting model is actually needed to represent useful and usable clinical data. A wider range of such evaluations, looking at different

  13. A socio-technical analytical framework on the EHR-organizational innovation interplay: Insights from a public hospital in Greece.

    PubMed

    Emmanouilidou, Maria

    2015-01-01

    The healthcare sector globally is confronted with increasing internal and external pressures that urge for a radical reform of health systems' status quo. The role of technological innovations such as Electronic Health Records (EHR) is recognized as instrumental in this transition process as it is expected to accelerate organizational innovations. This is why the widespread uptake of EHR systems is a top priority in the global healthcare agenda. The successful co-deployment though of EHR systems and organizational innovations within the context of secondary healthcare institutions is a complex and multifaceted issue. Existing research in the field has made little progress thus emphasizing the need for further research contribution that will incorporate a holistic perspective. This paper presents insights about the EHR-organizational innovation interplay from a public hospital in Greece into a socio-technical analytical framework providing a multilevel set of action points for the eHealth roadmap with worldwide relevance. PMID:25991259

  14. Restructuring an EHR system and the Medical Markup Language (MML) standard to improve interoperability by archetype technology.

    PubMed

    Kobayashi, Shinji; Kume, Naoto; Yoshihara, Hiroyuki

    2015-01-01

    In 2001, we developed an EHR system for regional healthcare information inter-exchange and to provide individual patient data to patients. This system was adopted in three regions in Japan. We also developed a Medical Markup Language (MML) standard for inter- and intra-hospital communications. The system was built on a legacy platform, however, and had not been appropriately maintained or updated to meet clinical requirements. To improve future maintenance costs, we reconstructed the EHR system using archetype technology on the Ruby on Rails platform, and generated MML equivalent forms from archetypes. The system was deployed as a cloud-based system for preliminary use as a regional EHR. The system now has the capability to catch up with new requirements, maintaining semantic interoperability with archetype technology. It is also more flexible than the legacy EHR system. PMID:26262183

  15. Hidden Magnetic Portals Around Earth

    NASA Video Gallery

    A NASA-sponsored researcher at the University of Iowa has developed a way for spacecraft to hunt down hidden magnetic portals in the vicinity of Earth. These gateways link the magnetic field of our...

  16. Building a robust, scalable and standards-driven infrastructure for secondary use of EHR data: The SHARPn project

    PubMed Central

    Rea, Susan; Pathak, Jyotishman; Savova, Guergana; Oniki, Thomas A.; Westberg, Les; Beebe, Calvin E.; Tao, Cui; Parker, Craig G.; Haug, Peter J.; Huff, Stanley M.; Chute, Christopher G.

    2016-01-01

    The Strategic Health IT Advanced Research Projects (SHARP) Program, established by the Office of the National Coordinator for Health Information Technology in 2010 supports research findings that remove barriers for increased adoption of health IT. The improvements envisioned by the SHARP Area 4 Consortium (SHARPn) will enable the use of the electronic health record (EHR) for secondary purposes, such as care process and outcomes improvement, biomedical research and epidemiologic monitoring of the nation’s health. One of the primary informatics problem areas in this endeavor is the standardization of disparate health data from the nation’s many health care organizations and providers. The SHARPn team is developing open source services and components to support the ubiquitous exchange, sharing and reuse or ‘liquidity’ of operational clinical data stored in electronic health records. One year into the design and development of the SHARPn framework, we demonstrated end to end data flow and a prototype SHARPn platform, using thousands of patient electronic records sourced from two large healthcare organizations: Mayo Clinic and Intermountain Healthcare. The platform was deployed to (1) receive source EHR data in several formats, (2) generate structured data from EHR narrative text, and (3) normalize the EHR data using common detailed clinical models and Consolidated Health Informatics standard terminologies, which were (4) accessed by a phenotyping service using normalized data specifications. The architecture of this prototype SHARPn platform is presented. The EHR data throughput demonstration showed success in normalizing native EHR data, both structured and narrative, from two independent organizations and EHR systems. Based on the demonstration, observed challenges for standardization of EHR data for interoperable secondary use are discussed. PMID:22326800

  17. Primary care practitioners’ views on test result management in EHR-enabled health systems: a national survey

    PubMed Central

    Singh, Hardeep; Spitzmueller, Christiane; Petersen, Nancy J; Sawhney, Mona K; Smith, Michael W; Murphy, Daniel R; Espadas, Donna; Laxmisan, Archana; Sittig, Dean F

    2013-01-01

    Context Failure to notify patients of test results is common even when electronic health records (EHRs) are used to report results to practitioners. We sought to understand the broad range of social and technical factors that affect test result management in an integrated EHR-based health system. Methods Between June and November 2010, we conducted a cross-sectional, web-based survey of all primary care practitioners (PCPs) within the Department of Veterans Affairs nationwide. Survey development was guided by a socio-technical model describing multiple inter-related dimensions of EHR use. Findings Of 5001 PCPs invited, 2590 (51.8%) responded. 55.5% believed that the EHRs did not have convenient features for notifying patients of test results. Over a third (37.9%) reported having staff support needed for notifying patients of test results. Many relied on the patient's next visit to notify them for normal (46.1%) and abnormal results (20.1%). Only 45.7% reported receiving adequate training on using the EHR notification system and 35.1% reported having an assigned contact for technical assistance with the EHR; most received help from colleagues (60.4%). A majority (85.6%) stayed after hours or came in on weekends to address notifications; less than a third reported receiving protected time (30.1%). PCPs strongly endorsed several new features to improve test result management, including better tracking and visualization of result notifications. Conclusions Despite an advanced EHR, both social and technical challenges exist in ensuring notification of test results to practitioners and patients. Current EHR technology requires significant improvement in order to avoid similar challenges elsewhere. PMID:23268489

  18. A cloud-based approach for interoperable electronic health records (EHRs).

    PubMed

    Bahga, Arshdeep; Madisetti, Vijay K

    2013-09-01

    We present a cloud-based approach for the design of interoperable electronic health record (EHR) systems. Cloud computing environments provide several benefits to all the stakeholders in the healthcare ecosystem (patients, providers, payers, etc.). Lack of data interoperability standards and solutions has been a major obstacle in the exchange of healthcare data between different stakeholders. We propose an EHR system - cloud health information systems technology architecture (CHISTAR) that achieves semantic interoperability through the use of a generic design methodology which uses a reference model that defines a general purpose set of data structures and an archetype model that defines the clinical data attributes. CHISTAR application components are designed using the cloud component model approach that comprises of loosely coupled components that communicate asynchronously. In this paper, we describe the high-level design of CHISTAR and the approaches for semantic interoperability, data integration, and security. PMID:25055368

  19. An Implementation of Clinical Data Repository with openEHR Approach: From Data Modeling to Architecture.

    PubMed

    Min, Lingtong; Liu, Juanjian; Lu, Xudong; Duan, Huilong; Qiao, Qingzhi

    2016-01-01

    Since electronic healthcare records are widely implemented in the hospitals, the explosion of the clinical data brings great opportunities to secondary use. Clinical data repository (CDR) plays an important role in clinical data using, including healthcare service, research and management. With evolving of clinical knowledge, it is a challenge for CDR to meet more and more requirements with adaptability and flexibility. In order to overcome this challenge, this paper proposed a solution that implemented a CDR with openEHR approach from data model to implementation. This study modelled archetypes according actual CDR requirements and implemented a CDR system in a tertiary hospital. Furthermore, this study developed data applications to facilitate healthcare service and research based on the CDR. The results of CDR system and data application demonstrate that openEHR approach could meet the continually evolving need of systems. PMID:27440296

  20. Standardized EHR interoperability - preliminary results of a German pilot project using the archetype methodology.

    PubMed

    Veseli, Hasan; Kopanitsa, Georgy; Demski, Hans

    2012-01-01

    The mobility of doctors and patients asks for multilingualism of electronic health record (EHR) systems: Doctors might face language problems using foreign medical information systems; people working abroad ask for continuous care which requires the treating physician to consult and understand the patient's health record. To address these linguistic and interoperability issues a solution is being developed that is based on widely acclaimed standards. Medical concepts that are derived from ASTM CCR define an interface model (based on ISO 13606). A server manages the data exchange between heterogeneous systems based on the interface model. It provides web services (automatic) and web forms (manual) and performs a transformation from the legacy scheme to the common structure. Furthermore, the server provides rich visualization capabilities (e.g. language-switch, custom charts etc.) which are useful for those EHR systems that don't provide these features. PMID:22874271

  1. A Data Quality Ontology for the Secondary Use of EHR Data

    PubMed Central

    Johnson, Steven G.; Speedie, Stuart; Simon, Gyorgy; Kumar, Vipin; Westra, Bonnie L.

    2015-01-01

    The secondary use of EHR data for research is expected to improve health outcomes for patients, but the benefits will only be realized if the data in the EHR is of sufficient quality to support these uses. A data quality (DQ) ontology was developed to rigorously define concepts and enable automated computation of data quality measures. The healthcare data quality literature was mined for the important terms used to describe data quality concepts and harmonized into an ontology. Four high-level data quality dimensions (“correctness”, “consistency”, “completeness” and “currency”) categorize 19 lower level measures. The ontology serves as an unambiguous vocabulary, which defines concepts more precisely than natural language; it provides a mechanism to automatically compute data quality measures; and is reusable across domains and use cases. A detailed example is presented to demonstrate its utility. The DQ ontology can make data validation more common and reproducible. PMID:26958293

  2. Validating free-text order entry for a note-centric EHR.

    PubMed

    Rule, Adam; Rick, Steven; Chiu, Michael; Rios, Phillip; Ashfaq, Shazia; Calvitti, Alan; Chan, Wesley; Weibel, Nadir; Agha, Zia

    2015-01-01

    Electronic Health Records (EHRs) have increased the utility and portability of health information by storing it in structured formats. However, EHRs separate this structured data from the rich, free-text descriptions of clinical notes. The ultimate objective of our research is to develop an interactive progress note that unifies entry, access, and retrieval of structured and unstructured health information. In this study we present the design and subsequent testing with eight clinicians of a core element of this envisioned note: free-text order entry. Clinicians saw this new order-entry paradigm as a way to save time and preserve data quality by reducing double-documentation. However, they wanted the prototype to recognize more diverse types of shorthand and apply default values to fields that remain fairly constant across orders, such as number of refills and pickup location. Future work will test more complex orders, such as cascading orders, with a broader range of clinicians. PMID:26958249

  3. Validating free-text order entry for a note-centric EHR

    PubMed Central

    Rule, Adam; Rick, Steven; Chiu, Michael; Rios, Phillip; Ashfaq, Shazia; Calvitti, Alan; Chan, Wesley; Weibel, Nadir; Agha, Zia

    2015-01-01

    Electronic Health Records (EHRs) have increased the utility and portability of health information by storing it in structured formats. However, EHRs separate this structured data from the rich, free-text descriptions of clinical notes. The ultimate objective of our research is to develop an interactive progress note that unifies entry, access, and retrieval of structured and unstructured health information. In this study we present the design and subsequent testing with eight clinicians of a core element of this envisioned note: free-text order entry. Clinicians saw this new order-entry paradigm as a way to save time and preserve data quality by reducing double-documentation. However, they wanted the prototype to recognize more diverse types of shorthand and apply default values to fields that remain fairly constant across orders, such as number of refills and pickup location. Future work will test more complex orders, such as cascading orders, with a broader range of clinicians. PMID:26958249

  4. Specialty Task Force: A Strategic Component to Electronic Health Record (EHR) Optimization.

    PubMed

    Romero, Mary Rachel; Staub, Allison

    2016-01-01

    Post-implementation stage comes after an electronic health record (EHR) deployment. Analyst and end users deal with the reality that some of the concepts and designs initially planned and created may not be complementary to the workflow; creating anxiety, dissatisfaction, and failure with early adoption of system. Problems encountered during deployment are numerous and can vary from simple to complex. Redundant ticket submission creates backlog for Information Technology personnel resulting in delays in resolving concerns with EHR system. The process of optimization allows for evaluation of system and reassessment of users' needs. A solid and well executed optimization infrastructure can help minimize unexpected end-user disruptions and help tailor the system to meet regulatory agency goals and practice standards. A well device plan to resolve problems during post implementation is necessary for cost containment and to streamline communication efforts. Creating a specialty specific collaborative task force is efficacious and expedites resolution of users' concerns through a more structured process. PMID:27332478

  5. Despite substantial progress In EHR adoption, health information exchange and patient engagement remain low in office settings.

    PubMed

    Furukawa, Michael F; King, Jennifer; Patel, Vaishali; Hsiao, Chun-Ju; Adler-Milstein, Julia; Jha, Ashish K

    2014-09-01

    The United States is making substantial investments to accelerate the adoption and use of interoperable electronic health record (EHR) systems. Using data from the 2009-13 Electronic Health Records Survey, we found that EHR adoption continues to grow: In 2013, 78 percent of office-based physicians had adopted some type of EHR, and 48 percent had the capabilities required for a basic EHR system. However, we also found persistent gaps in EHR adoption, with physicians in solo practices and non-primary care specialties lagging behind others. Physicians' electronic health information exchange with other providers was limited, with only 14 percent sharing data with providers outside their organization. Finally, we found that 30 percent of physicians routinely used capabilities for secure messaging with patients, and 24 percent routinely provided patients with the ability to view online, download, or transmit their health record. These findings suggest that although EHR adoption continues to grow, policies to support health information exchange and patient engagement will require ongoing attention. PMID:25104827

  6. Incorporating temporal EHR data in predictive models for risk stratification of renal function deterioration.

    PubMed

    Singh, Anima; Nadkarni, Girish; Gottesman, Omri; Ellis, Stephen B; Bottinger, Erwin P; Guttag, John V

    2015-02-01

    Predictive models built using temporal data in electronic health records (EHRs) can potentially play a major role in improving management of chronic diseases. However, these data present a multitude of technical challenges, including irregular sampling of data and varying length of available patient history. In this paper, we describe and evaluate three different approaches that use machine learning to build predictive models using temporal EHR data of a patient. The first approach is a commonly used non-temporal approach that aggregates values of the predictors in the patient's medical history. The other two approaches exploit the temporal dynamics of the data. The two temporal approaches vary in how they model temporal information and handle missing data. Using data from the EHR of Mount Sinai Medical Center, we learned and evaluated the models in the context of predicting loss of estimated glomerular filtration rate (eGFR), the most common assessment of kidney function. Our results show that incorporating temporal information in patient's medical history can lead to better prediction of loss of kidney function. They also demonstrate that exactly how this information is incorporated is important. In particular, our results demonstrate that the relative importance of different predictors varies over time, and that using multi-task learning to account for this is an appropriate way to robustly capture the temporal dynamics in EHR data. Using a case study, we also demonstrate how the multi-task learning based model can yield predictive models with better performance for identifying patients at high risk of short-term loss of kidney function. PMID:25460205

  7. Incorporating temporal EHR data in predictive models for risk stratification of renal function deterioration

    PubMed Central

    Singh, Anima; Nadkarni, Girish; Gottesman, Omri; Ellis, Stephen B.; Bottinger, Erwin P.; Guttag, John V.

    2015-01-01

    Predictive models built using temporal data in electronic health records (EHRs) can potentially play a major role in improving management of chronic diseases. However, these data present a multitude of technical challenges, including irregular sampling of data and varying length of available patient history. In this paper, we describe and evaluate three different approaches that use machine learning to build predictive models using temporal EHR data of a patient. The first approach is a commonly used non-temporal approach that aggregates values of the predictors in the patient’s medical history. The other two approaches exploit the temporal dynamics of the data. The two temporal approaches vary in how they model temporal information and handle missing data. Using data from the EHR of Mount Sinai Medical Center, we learned and evaluated the models in the context of predicting loss of estimated glomerular filtration rate (eGFR), the most common assessment of kidney function. Our results show that incorporating temporal information in patient’s medical history can lead to better prediction of loss of kidney function. They also demonstrate that exactly how this information is incorporated is important. In particular, our results demonstrate that the relative importance of different predictors varies over time, and that using multi-task learning to account for this is an appropriate way to robustly capture the temporal dynamics in EHR data. Using a case study, we also demonstrate how the multi-task learning based model can yield predictive models with better performance for identifying patients at high risk of short-term loss of kidney function. PMID:25460205

  8. EHR-based Visualization Tool: Adoption Rates, Satisfaction, and Patient Outcomes

    PubMed Central

    Foraker, Randi E.; Kite, Bobbie; Kelley, Marjorie M.; Lai, Albert M.; Roth, Caryn; Lopetegui, Marcelo A.; Shoben, Abigail B.; Langan, Michael; Rutledge, Nicole L.; Payne, Philip R. O.

    2015-01-01

    Background: Electronic health records (EHRs) have the potential to enhance patient-provider communication and improve patient outcomes. However, in order to impact patient care, clinical decision support (CDS) and communication tools targeting such needs must be integrated into clinical workflow and be flexible with regard to the changing health care landscape. Design: The Stroke Prevention in Healthcare Delivery Environments (SPHERE) team developed and implemented the SPHERE tool, an EHR-based CDS visualization, to enhance patient-provider communication around cardiovascular health (CVH) within an outpatient primary care setting of a large academic medical center. Implementation: We describe our successful CDS alert implementation strategy and report adoption rates. We also present results of a provider satisfaction survey showing that the SPHERE tool delivers appropriate content in a timely manner. Patient outcomes following implementation of the tool indicate one-year improvements in some CVH metrics, such as body mass index and diabetes. Discussion: Clinical decision-making and practices change rapidly and in parallel to simultaneous changes in the health care landscape and EHR usage. Based on these observations and our preliminary results, we have found that an integrated, extensible, and workflow-aware CDS tool is critical to enhancing patient-provider communications and influencing patient outcomes. PMID:26290891

  9. Too Much or Too Little? How Much Control Should Patients Have Over EHR Data?

    PubMed

    Bhuyan, Soumitra Sudip; Bailey-DeLeeuw, Sandra; Wyant, David K; Chang, Cyril F

    2016-07-01

    Electronic health records (EHRs) have been promoted as a mechanism to overcome the fragmented healthcare system in the United States. The challenge that is being discussed is the rights of the patient to control the access to their EHRs' data and the needs of healthcare professionals to know health data to make the best treatment decisions for their patients. The Federal Trade Commission has asked those who store consumer information to comply with the Fair Information Practice Principles. In the EHR context, these principles give the rights to the patient to control who can see their health data and what components of the data are restricted from view. Control is not limited to patients, as it also includes parents of adolescent children. We suggest that the ongoing policy discussion include consideration of the precise questions patients will be asked when a need for data sharing arises. Further, patients should understand the relative risks that they face, and the degree to which their decisions will (or will not) significantly reduce the risk of a data breach. As various approaches are considered, it is important to address the relative resource requirements and the associated costs of each option. PMID:27272134

  10. Architectural approach for semantic EHR systems development based on Detailed Clinical Models.

    PubMed

    Bernal, Juan G; Lopez, Diego M; Blobel, Bernd

    2012-01-01

    The integrative approach to health information in general and the development of pHealth systems in particular, require an integrated approach of formally modeled system architectures. Detailed Clinical Models (DCM) is one of the most promising modeling efforts for clinical concept representation in EHR system architectures. Although the feasibility of DCM modeling methodology has been demonstrated through examples, there is no formal, generic and automatic modeling transformation technique to ensure a semantic lossless transformation of clinical concepts expressed in DCM to either clinical concept representations based on ISO 13606/openEHR Archetypes or HL7 Templates. The objective of this paper is to propose a generic model transformation method and tooling for transforming DCM Clinical Concepts into ISO/EN 13606/openEHR Archetypes or HL7 Template models. The automation of the transformation process is supported by Model Driven-Development (MDD) transformation mechanisms and tools. The availability of processes, techniques and tooling for automatic DCM transformation would enable the development of intelligent, adaptive information systems as demanded for pHealth solutions. PMID:22942049

  11. Portal to the Future

    NASA Astrophysics Data System (ADS)

    Gates, Evalyn

    2011-04-01

    Museums are a portal connecting us to a deeper understanding of the world in which we live, from our own backyards to the most distant galaxies; an access point to the incredible discoveries we have made about the natural world and a flashpoint for inspiring the next generation of explorers. The Cleveland Museum of Natural History is poised to redefine what a natural history museum can be, offering visitors an opportunity to travel through space and time to explore the origins of our planet, follow the evolution of life on Earth and project into -- and plan for -- the future. The Museum will launch visitors into the future this summer via SmartHome Cleveland -- an extremely energy-efficient "passive house" that will demonstrate the future of green building technology. This unique exhibit is part of a special series of exhibits, programs and workshops on sustainability, including a major exhibit on Climate Change, which will be featured at the Museum this summer and fall.

  12. CzechGeo/EPOS - Building a national data portal

    NASA Astrophysics Data System (ADS)

    Zednik, J.; Hejda, P.

    2012-04-01

    CzechGeo/EPOS is the consortium of seven geoscience institutions in the Czech Republic (Institute of Geophysics AS CR Prague, Institute of Rock Structure and Mechanics AS CR Prague, Institute of Geonics AS CR Ostrava, Institute of Physics of the Earth, Masaryk University Brno, Faculty of Mathematics and Physics, Charles University Prague, Faculty of Science, Charles University Prague, and Research Institute of Geodesy, Cartography and Topography Zdiby). These institutions operate a distributed system of seismic, GPS, magnetic, gravimetric and geodynamic observatories. The operational and personal costs of CzechGeo/EPOS are mostly covered by the Ministry of education, sports and youth within the support of twelve large research infrastructures in the Czech Republic. Web pages of the project www.czechgeo.cz are being built as a data portal which should integrate all the data and services provided by the involved institutions and research infrastructures. Seismic portal offers selected portions of digital data from permanent, local and temporary seismic stations, locations of seismic events in the country and worldwide, daily seismograms from permanent observatories and local seismic network Webnet, seismic bulletins and catalogs, and macroseismic observations on the territory of the Czech Republic. Magnetic portal involves besides real-time magnetograms also recent state of geomagnetic activity and its forecast for the next day. GPS portal will provide preprocessed data from regional GPS stations. Building the national portal is closely related with the development of the Preparatory phase of the EPOS (European Plate Observing System) project.

  13. The Higgs portal above threshold

    NASA Astrophysics Data System (ADS)

    Craig, Nathaniel; Lou, Hou Keong; McCullough, Matthew; Thalapillil, Arun

    2016-02-01

    The discovery of the Higgs boson opens the door to new physics interacting via the Higgs Portal, including motivated scenarios relating to baryogenesis, dark matter, and electroweak naturalness. We systematically explore the collider signatures of singlet scalars produced via the Higgs Portal at the 14 TeV LHC and a prospective 100 TeV hadron collider. We focus on the challenging regime where the scalars are too heavy to be produced in the decays of an on-shell Higgs boson, and instead are produced primarily via an off-shell Higgs. Assuming these scalars escape the detector, promising channels include missing energy in association with vector boson fusion, monojets, and top pairs. We forecast the sensitivity of searches in these channels at √{s}=14 & 100 TeV and compare collider reach to the motivated parameter space of singlet-assisted electroweak baryogenesis, Higgs Portal dark matter, and neutral naturalness.

  14. The Cosmos Portal and the IYA2009 Project

    NASA Astrophysics Data System (ADS)

    Haisch, Bernard M.; Sims, M.; Lindblom, J.

    2009-05-01

    In 2007 the non-profit Digital Universe Foundation (DUF) launched the Earth Portal (earthportal.org) as a comprehensive resource for timely, objective, science-based information about the environment. There are currently over 1000 scholars from 60 countries engaged in this rapidly growing web-based collaboration. The Cosmos Portal is the second major DUF initiative (cosmosportal.org). In support of the IYA2009 effort, the Cosmos Portal is recruiting astronomy professionals to make use of easy online tools to publish articles, blogs, news items, image galleries, class notes, lectures, powerpoint presentations, links to other high quality websites or other educational material. A major difference between the Digital Universe and Wikipedia is that educational material is produced by identified experts, not anonymous contributors with unknown qualifications. The Digital Universe is a 501(c)(3) public charity whose goal is to evolve into a worldwide online community (a social network) whose centerpiece is an ever growing Asimov-Sagan Encyclopedia Galactica created by experts. We encourage you to write an encylopedia article or start a portal on your favorite topic or join an existing topic as an expert contributor.

  15. Web Portal for Multicast Delivery Management.

    ERIC Educational Resources Information Center

    Mannaert, H.; De Gruyter, B.; Adriaenssens, P.

    2003-01-01

    Presents a Web portal for multicast communication management, which provides fully automatic service management with integrated provisioning of hardware equipment. Describes the software architecture, the implementation, and the application usage of the Web portal for multicast delivery. (Author/AEF)

  16. 29 CFR 785.50 - Section 4 of the Portal-to-Portal Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Section 4 of the Portal-to-Portal Act. 785.50 Section 785.50 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR... Provisions § 785.50 Section 4 of the Portal-to-Portal Act. Section 4 of this Act provides that: (a) Except...

  17. 29 CFR 785.50 - Section 4 of the Portal-to-Portal Act.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Section 4 of the Portal-to-Portal Act. 785.50 Section 785.50 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR... Provisions § 785.50 Section 4 of the Portal-to-Portal Act. Section 4 of this Act provides that: (a) Except...

  18. 29 CFR 785.50 - Section 4 of the Portal-to-Portal Act.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Section 4 of the Portal-to-Portal Act. 785.50 Section 785.50 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR... Provisions § 785.50 Section 4 of the Portal-to-Portal Act. Section 4 of this Act provides that: (a) Except...

  19. 29 CFR 785.50 - Section 4 of the Portal-to-Portal Act.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Section 4 of the Portal-to-Portal Act. 785.50 Section 785.50 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR... Provisions § 785.50 Section 4 of the Portal-to-Portal Act. Section 4 of this Act provides that: (a) Except...

  20. 29 CFR 785.50 - Section 4 of the Portal-to-Portal Act.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Section 4 of the Portal-to-Portal Act. 785.50 Section 785.50 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR... Provisions § 785.50 Section 4 of the Portal-to-Portal Act. Section 4 of this Act provides that: (a) Except...

  1. Unusual Tumors Causing Extrahepatic Portal Venous Obstruction

    PubMed Central

    Sharma, B. C.; Dhiman, R. K.; Ghoshal, U. C.; Puri, A. S.; Sikora, S. S.

    1996-01-01

    Extrahepatic portal vein obstruction has been reported to be associated with tumors of liver, bile ducts and pancreas. We report two cases, one with gastric leiomyosarcoma and another with Non Hodgkin’s lymphoma, complicated by portal vein block and presenting with gastric variceal bleeding. Portal vein block in both cases was due to direct vascular infiltration. Development of portal hypertension posed difficulties in management. PMID:8725458

  2. From EGEE Operations Portal towards EGI Operations Portal

    NASA Astrophysics Data System (ADS)

    Cordier, Hélène; L'Orphelin, Cyril; Reynaud, Sylvain; Lequeux, Olivier; Loikkanen, Sinikka; Veyre, Pierre

    Grid operators in EGEE have been using a dedicated dashboard as their central operational tool, stable and scalable for the last 5 years despite continuous upgrade from specifications by users, monitoring tools or data providers. In EGEE-III, recent regionalisation of operations led the Operations Portal developers to conceive a standalone instance of this tool. We will see how the dashboard reorganization paved the way for the re-engineering of the portal itself. The outcome is an easily deployable package customized with relevant information sources and specific decentralized operational requirements. This package is composed of a generic and scalable data access mechanism, Lavoisier; a renowned php framework for configuration flexibility, Symfony and a MySQL database. VO life cycle and operational information, EGEE broadcast and Downtime notifications are next for the major reorganization until all other key features of the Operations Portal are migrated to the framework. Features specifications will be sketched at the same time to adapt to EGI requirements and to upgrade. Future work on feature regionalisation, on new advanced features or strategy planning will be tracked in EGI- Inspire through the Operations Tools Advisory Group, OTAG, where all users, customers and third parties of the Operations Portal are represented from January 2010.

  3. More than half of US hospitals have at least a basic EHR, but stage 2 criteria remain challenging for most.

    PubMed

    Adler-Milstein, Julia; DesRoches, Catherine M; Furukawa, Michael F; Worzala, Chantal; Charles, Dustin; Kralovec, Peter; Stalley, Samantha; Jha, Ashish K

    2014-09-01

    The national effort to promote the adoption and meaningful use of electronic health records (EHRs) is well under way. However, 2014 marks an important transition: For many hospitals, penalties will be assessed in fiscal year 2015 for failing to meet federal meaningful-use criteria by the end of fiscal year 2014. We used recent data from the American Hospital Association Annual Survey of Hospitals--IT Supplement to assess progress and challenges. EHR adoption among US hospitals continues to rise steeply: 59 percent now have at least a basic EHR. Small and rural hospitals continue to lag behind their better resourced counterparts. Most hospitals are able to meet many of the stage 2 meaningful-use criteria, but only 5.8 percent of hospitals are able to meet them all. Several criteria, including sharing care summaries with other providers and providing patients with online access to their data, will require attention from EHR vendors to ensure that the necessary functions are available and additional effort from many hospitals to make certain that these functionalities are used. Policy makers may want to consider new targeted strategies to ensure that all hospitals move toward meaningful use of EHRs. PMID:25104826

  4. OpenEHR-based representation of guideline compliance data through the example of stroke clinical practice guidelines.

    PubMed

    Anani, Nadim; Chen, Rong; Prazeres Moreira, Tiago; Koch, Sabine

    2012-01-01

    In light of the lack of integration between electronic health records and decision support, this research explores how semantic electronic health record technology, particularly openEHR, can be used to represent clinical practice guidelines (CPGs). We used the tool Visual Understanding Environment (VUE) to build a graphical representation of the European ischaemic stroke clinical management guidelines. We used openEHR archetypes to conceptually support this process and also to represent clinical concepts in stroke treatment compliance criteria. Our results show that, as an intermediate step in authoring computer-interpretable guidelines, an openEHR-based representation of CPGs and their compliance criteria supports the process of identifying the relevant knowledge and data elements in the care process to be modelled. It further eases the separation of the CPGs into data and logic components and is useful as a communication means for guideline verification by clinicians. Additionally, we retrieved existing and authored new openEHR archetypes for the acute stroke clinical management process. We conclude that openEHR-based guideline and compliance data representations may be a promising first step in building future decision support applications that are well connected to the electronic health record, can be useful in locating discrepancies between different sets of guidelines within the same care context and provide a helpful tool for driving the archetype authoring and review process. PMID:22874238

  5. Portal Monitor Future Development Work: Hardware Improvements

    SciTech Connect

    Browne, Michael C.

    2012-07-03

    LANL portal monitor was a modification of a previously installed (permanent) unattended monitoring system (UMS). Modifications to the UMS to make the portal were sometimes based on mistaken assumptions about exercise-specific installation and access. Philosophical approach to real-time portal differs in some areas from UMS.

  6. 29 CFR 790.5 - Effect of Portal-to-Portal Act on determination of hours worked.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Effect of Portal-to-Portal Act on determination of hours... GENERAL STATEMENT AS TO THE EFFECT OF THE PORTAL-TO-PORTAL ACT OF 1947 ON THE FAIR LABOR STANDARDS ACT OF... Effect of Portal-to-Portal Act on determination of hours worked. (a) In the application of the...

  7. 29 CFR 790.5 - Effect of Portal-to-Portal Act on determination of hours worked.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Effect of Portal-to-Portal Act on determination of hours... GENERAL STATEMENT AS TO THE EFFECT OF THE PORTAL-TO-PORTAL ACT OF 1947 ON THE FAIR LABOR STANDARDS ACT OF... Effect of Portal-to-Portal Act on determination of hours worked. (a) In the application of the...

  8. 29 CFR 790.5 - Effect of Portal-to-Portal Act on determination of hours worked.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Effect of Portal-to-Portal Act on determination of hours... GENERAL STATEMENT AS TO THE EFFECT OF THE PORTAL-TO-PORTAL ACT OF 1947 ON THE FAIR LABOR STANDARDS ACT OF... Effect of Portal-to-Portal Act on determination of hours worked. (a) In the application of the...

  9. 29 CFR 790.5 - Effect of Portal-to-Portal Act on determination of hours worked.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Effect of Portal-to-Portal Act on determination of hours... GENERAL STATEMENT AS TO THE EFFECT OF THE PORTAL-TO-PORTAL ACT OF 1947 ON THE FAIR LABOR STANDARDS ACT OF... Effect of Portal-to-Portal Act on determination of hours worked. (a) In the application of the...

  10. 29 CFR 785.34 - Effect of section 4 of the Portal-to-Portal Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Effect of section 4 of the Portal-to-Portal Act. 785.34... of Principles Traveltime § 785.34 Effect of section 4 of the Portal-to-Portal Act. The Portal Act... it. (See Tennessee Coal, Iron & RR. Co. v. Musecoda Local, 321 U.S. 590 (1946); Anderson v....

  11. 29 CFR 785.34 - Effect of section 4 of the Portal-to-Portal Act.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Effect of section 4 of the Portal-to-Portal Act. 785.34... of Principles Traveltime § 785.34 Effect of section 4 of the Portal-to-Portal Act. The Portal Act... even if the employer agrees to pay for it. (See Tennessee Coal, Iron & RR. Co. v. Musecoda Local, 321...

  12. Evaluation of a clinical simulation-based assessment method for EHR-platforms.

    PubMed

    Jensen, Sanne; Rasmussen, Stine Loft; Lyng, Karen Marie

    2014-01-01

    In a procurement process assessment of issues like human factors and interaction between technology and end-users can be challenging. In a large public procurement of an Electronic health record-platform (EHR-platform) in Denmark a clinical simulation-based method for assessing and comparing human factor issues was developed and evaluated. This paper describes the evaluation of the method, its advantages and disadvantages. Our findings showed that clinical simulation is beneficial for assessing user satisfaction, usefulness and patient safety, all though it is resource demanding. The method made it possible to assess qualitative topics during the procurement and it provides an excellent ground for user involvement. PMID:25160323

  13. A grid-based implementation of XDS-I as a part of a metropolitan EHR in Shanghai

    NASA Astrophysics Data System (ADS)

    Zhang, Jianguo; Zhang, Chenghao; Sun, Jianyong, Sr.; Yang, Yuanyuan; Jin, Jin; Yu, Fenghai; He, Zhenyu; Zheng, Xichuang; Qin, Huanrong; Feng, Jie; Zhang, Guozheng

    2007-03-01

    A number of hospitals in Shanghai are piloting the development of an EHR solution based on a grid concept with a service-oriented architecture (SOA). The first phase of the project targets the Diagnostic Imaging domain and allows seamless sharing of images and reports across the multiple hospitals. The EHR solution is fully aligned with the IHE XDS-I integration profile and consists of the components of the XDS-I Registry, Repository, Source and Consumer actors. By using SOA, the solution uses ebXML over secured http for all transactions with in the grid. However, communication with the PACS and RIS is DICOM and HL7 v3.x. The solution was installed in three hospitals and one date center in Shanghai and tested for performance of data publication, user query and image retrieval. The results are extremely positive and demonstrate that the EHR solution based on SOA with grid concept can scale effectively to server a regional implementation.

  14. Modelling of Operative Report Documents for Data Integration into an openEHR-Based Enterprise Data Warehouse.

    PubMed

    Haarbrandt, Birger; Wilschko, Andreas; Marschollek, Michael

    2016-01-01

    In order to integrate operative report documents from two operating room management systems into a data warehouse, we investigated the application of the two-level modelling approach of openEHR to create a shared data model. Based on the systems' analyses, a template consisting of 13 archetypes has been developed. Of these 13 archetypes, 3 have been obtained from the international archetype repository of the openEHR foundation. The remaining 10 archetypes have been newly created. The template was evaluated by an application system expert and through conducting a first test mapping of real-world data from one of the systems. The evaluation showed that by using the two-level modelling approach of openEHR, we succeeded to represent an integrated and shared information model for operative report documents. More research is needed to learn about the limitations of this approach in other data integration scenarios. PMID:27577414

  15. Searching for document contents in an IHE-XDS EHR architecture via archetype-based indexing of document types.

    PubMed

    Rinner, Christoph; Kohler, Michael; Saboor, Samrend; Huebner-Bloder, Gudrun; Ammenwerth, Elske; Duftschmid, Georg

    2013-01-01

    The shared EHR (electronic health record) system architecture IHE XDS is widely adopted internationally. It ensures a high level of data privacy via distributed storage of EHR documents. Its standard search capabilities, however, are limited; it only allows a retrieval of complete documents by querying a restricted set of document metadata. Existing approaches that aim to extend XDS queries to document contents typically employ a central index of document contents. Hereby they undermine XDS' basic characteristic of distributed data storage. To avoid data privacy concerns, we propose querying EHR contents in XDS by indexing document types based on Archetypes instead. We successfully tested our approach within the ISO/EN 13606 standard. PMID:23920866

  16. The new IAGOS Database Portal

    NASA Astrophysics Data System (ADS)

    Boulanger, Damien; Gautron, Benoit; Thouret, Valérie; Fontaine, Alain

    2016-04-01

    IAGOS (In-service Aircraft for a Global Observing System) is a European Research Infrastructure which aims at the provision of long-term, regular and spatially resolved in situ observations of the atmospheric composition. IAGOS observation systems are deployed on a fleet of commercial aircraft. The IAGOS database is an essential part of the global atmospheric monitoring network. It contains IAGOS-core data and IAGOS-CARIBIC (Civil Aircraft for the Regular Investigation of the Atmosphere Based on an Instrument Container) data. The IAGOS Database Portal (http://www.iagos.fr, damien.boulanger@obs-mip.fr) is part of the French atmospheric chemistry data center AERIS (http://www.aeris-data.fr). The new IAGOS Database Portal has been released in December 2015. The main improvement is the interoperability implementation with international portals or other databases in order to improve IAGOS data discovery. In the frame of the IGAS project (IAGOS for the Copernicus Atmospheric Service), a data network has been setup. It is composed of three data centers: the IAGOS database in Toulouse; the HALO research aircraft database at DLR (https://halo-db.pa.op.dlr.de); and the CAMS data center in Jülich (http://join.iek.fz-juelich.de). The CAMS (Copernicus Atmospheric Monitoring Service) project is a prominent user of the IGAS data network. The new portal provides improved and new services such as the download in NetCDF or NASA Ames formats, plotting tools (maps, time series, vertical profiles, etc.) and user management. Added value products are available on the portal: back trajectories, origin of air masses, co-location with satellite data, etc. The link with the CAMS data center, through JOIN (Jülich OWS Interface), allows to combine model outputs with IAGOS data for inter-comparison. Finally IAGOS metadata has been standardized (ISO 19115) and now provides complete information about data traceability and quality.

  17. Developing Interoperable Air Quality Community Portals

    NASA Astrophysics Data System (ADS)

    Falke, S. R.; Husar, R. B.; Yang, C. P.; Robinson, E. M.; Fialkowski, W. E.

    2009-04-01

    Web portals are intended to provide consolidated discovery, filtering and aggregation of content from multiple, distributed web sources targeted at particular user communities. This paper presents a standards-based information architectural approach to developing portals aimed at air quality community collaboration in data access and analysis. An important characteristic of the approach is to advance beyond the present stand-alone design of most portals to achieve interoperability with other portals and information sources. We show how using metadata standards, web services, RSS feeds and other Web 2.0 technologies, such as Yahoo! Pipes and del.icio.us, helps increase interoperability among portals. The approach is illustrated within the context of the GEOSS Architecture Implementation Pilot where an air quality community portal is being developed to provide a user interface between the portals and clearinghouse of the GEOSS Common Infrastructure and the air quality community catalog of metadata and data services.

  18. Portal biliopathy treated with endoscopic biliary stenting

    PubMed Central

    Jeon, Sung Jin; Min, Jae Ki; Kwon, So Young; Kim, Jun Hyun; Moon, Sun Young; Lee, Kang Hoon; Kim, Jeong Han; Choe, Won Hyeok; Cheon, Young Koog; Kim, Tae Hyung; Park, Hee Sun

    2016-01-01

    Portal biliopathy is defined as abnormalities in the extra- and intrahepatic ducts and gallbladder of patients with portal hypertension. This condition is associated with extrahepatic venous obstruction and dilatation of the venous plexus of the common bile duct, resulting in mural irregularities and compression of the biliary tree. Most patients with portal biliopathy remain asymptomatic, but approximately 10% of them advance to symptomatic abdominal pain, jaundice, and fever. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography are currently used as diagnostic tools because they are noninvasive and can be used to assess the regularity, length, and degree of bile duct narrowing. Management of portal biliopathy is aimed at biliary decompression and reducing the portal pressure. Portal biliopathy has rarely been reported in Korea. We present a symptomatic case of portal biliopathy that was complicated by cholangitis and successfully treated with biliary endoscopic procedures. PMID:27044769

  19. Role of OpenEHR as an open source solution for the regional modelling of patient data in obstetrics.

    PubMed

    Pahl, Christina; Zare, Mojtaba; Nilashi, Mehrbakhsh; de Faria Borges, Marco Aurélio; Weingaertner, Daniel; Detschew, Vesselin; Supriyanto, Eko; Ibrahim, Othman

    2015-06-01

    This work investigates, whether openEHR with its reference model, archetypes and templates is suitable for the digital representation of demographic as well as clinical data. Moreover, it elaborates openEHR as a tool for modelling Hospital Information Systems on a regional level based on a national logical infrastructure. OpenEHR is a dual model approach developed for the modelling of Hospital Information Systems enabling semantic interoperability. A holistic solution to this represents the use of dual model based Electronic Healthcare Record systems. Modelling data in the field of obstetrics is a challenge, since different regions demand locally specific information for the process of treatment. Smaller health units in developing countries like Brazil or Malaysia, which until recently handled automatable processes like the storage of sensitive patient data in paper form, start organizational reconstruction processes. This archetype proof-of-concept investigation has tried out some elements of the openEHR methodology in cooperation with a health unit in Colombo, Brazil. Two legal forms provided by the Brazilian Ministry of Health have been analyzed and classified into demographic and clinical data. LinkEHR-Ed editor was used to read, edit and create archetypes. Results show that 33 clinical and demographic concepts, which are necessary to cover data demanded by the Unified National Health System, were identified. Out of the concepts 61% were reused and 39% modified to cover domain requirements. The detailed process of reuse, modification and creation of archetypes is shown. We conclude that, although a major part of demographic and clinical patient data were already represented by existing archetypes, a significant part required major modifications. In this study openEHR proved to be a highly suitable tool in the modelling of complex health data. In combination with LinkEHR-Ed software it offers user-friendly and highly applicable tools, although the complexity

  20. Automatically Detecting Acute Myocardial Infarction Events from EHR Text: A Preliminary Study.

    PubMed

    Zheng, Jiaping; Yarzebski, Jorge; Ramesh, Balaji Polepalli; Goldberg, Robert J; Yu, Hong

    2014-01-01

    The Worcester Heart Attack Study (WHAS) is a population-based surveillance project examining trends in the incidence, in-hospital, and long-term survival rates of acute myocardial infarction (AMI) among residents of central Massachusetts. It provides insights into various aspects of AMI. Much of the data has been assessed manually. We are developing supervised machine learning approaches to automate this process. Since the existing WHAS data cannot be used directly for an automated system, we first annotated the AMI information in electronic health records (EHR). With strict inter-annotator agreement over 0.74 and un-strict agreement over 0.9 of Cohen's κ, we annotated 105 EHR discharge summaries (135k tokens). Subsequently, we applied the state-of-the-art supervised machine-learning model, Conditional Random Fields (CRFs) for AMI detection. We explored different approaches to overcome the data sparseness challenge and our results showed that cluster-based word features achieved the highest performance. PMID:25954440

  1. Anomaly and Signature Filtering Improve Classifier Performance For Detection Of Suspicious Access To EHRs

    PubMed Central

    Kim, Jihoon; Grillo, Janice M; Boxwala, Aziz A; Jiang, Xiaoqian; Mandelbaum, Rose B; Patel, Bhakti A; Mikels, Debra; Vinterbo, Staal A; Ohno-Machado, Lucila

    2011-01-01

    Our objective is to facilitate semi-automated detection of suspicious access to EHRs. Previously we have shown that a machine learning method can play a role in identifying potentially inappropriate access to EHRs. However, the problem of sampling informative instances to build a classifier still remained. We developed an integrated filtering method leveraging both anomaly detection based on symbolic clustering and signature detection, a rule-based technique. We applied the integrated filtering to 25.5 million access records in an intervention arm, and compared this with 8.6 million access records in a control arm where no filtering was applied. On the training set with cross-validation, the AUC was 0.960 in the control arm and 0.998 in the intervention arm. The difference in false negative rates on the independent test set was significant, P=1.6×10−6. Our study suggests that utilization of integrated filtering strategies to facilitate the construction of classifiers can be helpful. PMID:22195129

  2. Developing a National-Level Concept Dictionary for EHR Implementations in Kenya.

    PubMed

    Keny, Aggrey; Wanyee, Steven; Kwaro, Daniel; Mulwa, Edwin; Were, Martin C

    2015-01-01

    The increasing adoption of Electronic Health Records (EHR) by developing countries comes with the need to develop common terminology standards to assure semantic interoperability. In Kenya, where the Ministry of Health has rolled out an EHR at 646 sites, several challenges have emerged including variable dictionaries across implementations, inability to easily share data across systems, lack of expertise in dictionary management, lack of central coordination and custody of a terminology service, inadequately defined policies and processes, insufficient infrastructure, among others. A Concept Working Group was constituted to address these challenges. The country settled on a common Kenya data dictionary, initially derived as a subset of the Columbia International eHealth Laboratory (CIEL)/Millennium Villages Project (MVP) dictionary. The initial dictionary scope largely focuses on clinical needs. Processes and policies around dictionary management are being guided by the framework developed by Bakhshi-Raiez et al. Technical and infrastructure-based approaches are also underway to streamline workflow for dictionary management and distribution across implementations. Kenya's approach on comprehensive common dictionary can serve as a model for other countries in similar settings. PMID:26262158

  3. Analysis of cloud-based solutions on EHRs systems in different scenarios.

    PubMed

    Fernández-Cardeñosa, Gonzalo; de la Torre-Díez, Isabel; López-Coronado, Miguel; Rodrigues, Joel J P C

    2012-12-01

    Nowadays with the growing of the wireless connections people can access all the resources hosted in the Cloud almost everywhere. In this context, organisms can take advantage of this fact, in terms of e-Health, deploying Cloud-based solutions on e-Health services. In this paper two Cloud-based solutions for different scenarios of Electronic Health Records (EHRs) management system are proposed. We have researched articles published between the years 2005 and 2011 about the implementation of e-Health services based on the Cloud in Medline. In order to analyze the best scenario for the deployment of Cloud Computing two solutions for a large Hospital and a network of Primary Care Health centers have been studied. Economic estimation of the cost of the implementation for both scenarios has been done via the Amazon calculator tool. As a result of this analysis two solutions are suggested depending on the scenario: To deploy a Cloud solution for a large Hospital a typical Cloud solution in which are hired just the needed services has been assumed. On the other hand to work with several Primary Care Centers it's suggested the implementation of a network, which interconnects these centers with just one Cloud environment. Finally it's considered the fact of deploying a hybrid solution: in which EHRs with images will be hosted in the Hospital or Primary Care Centers and the rest of them will be migrated to the Cloud. PMID:22492177

  4. Determining the reasons for medication prescriptions in the EHR using knowledge and natural language processing.

    PubMed

    Li, Ying; Salmasian, Hojjat; Harpaz, Rave; Chase, Herbert; Friedman, Carol

    2011-01-01

    Knowledge of medication indications is significant for automatic applications aimed at improving patient safety, such as computerized physician order entry and clinical decision support systems. The Electronic Health Record (EHR) contains pertinent information related to patient safety such as information related to appropriate prescribing. However, the reasons for medication prescriptions are usually not explicitly documented in the patient record. This paper describes a method that determines the reasons for medication uses based on information occurring in outpatient notes. The method utilizes drug-indication knowledge that we acquired, and natural language processing. Evaluation showed the method obtained a sensitivity of 62.8%, specificity of 93.9%, precision of 90% and F-measure of 73.9%. This pilot study demonstrated that linking external drug indication knowledge to the EHR for determining the reasons for medication use was promising, but also revealed some challenges. Future work will focus on increasing the accuracy and coverage of the indication knowledge and evaluating its performance using a much larger set of drugs frequently used in the outpatient population. PMID:22195134

  5. Comparison of response times of a mobile-web EHRs system using PHP and JSP languages.

    PubMed

    De la Torre-Díez, Isabel; Antón-Rodríguez, Míriam; Díaz-Pernas, Francisco Javier; Perozo-Rondón, Freddy José

    2012-12-01

    Performance evaluation is highly important in the Electronic Health Records (EHRs) system implementation. Response time's measurement can be considered as one manner to make that evaluation. In the e-health field, after the creation of EHRs available through different platforms such as Web and/or mobile, a performance evaluation is necessary. The operation of the system in the right way is essential. In this paper, a comparison of the response times for the MEHRmobile system is presented. The first version uses PHP language with a MySQL database and the second one employs JSP with an eXist database. Both versions have got the same functionalities. In addition to the technological aspects, a significant difference is the way the information is stored. The main goal of this paper is choosing the version which offers better response times. We have created a new benchmark to calculate the response times. Better results have been obtained for the PHP version. Nowadays, this version is being used for specialists from Fundación Intras, Spain. PMID:22706897

  6. Determining the Reasons for Medication Prescriptions in the EHR using Knowledge and Natural Language Processing

    PubMed Central

    Li, Ying; Salmasian, Hojjat; Harpaz, Rave; Chase, Herbert; Friedman, Carol

    2011-01-01

    Knowledge of medication indications is significant for automatic applications aimed at improving patient safety, such as computerized physician order entry and clinical decision support systems. The Electronic Health Record (EHR) contains pertinent information related to patient safety such as information related to appropriate prescribing. However, the reasons for medication prescriptions are usually not explicitly documented in the patient record. This paper describes a method that determines the reasons for medication uses based on information occurring in outpatient notes. The method utilizes drug-indication knowledge that we acquired, and natural language processing. Evaluation showed the method obtained a sensitivity of 62.8%, specificity of 93.9%, precision of 90% and F-measure of 73.9%. This pilot study demonstrated that linking external drug indication knowledge to the EHR for determining the reasons for medication use was promising, but also revealed some challenges. Future work will focus on increasing the accuracy and coverage of the indication knowledge and evaluating its performance using a much larger set of drugs frequently used in the outpatient population. PMID:22195134

  7. Developing a data element repository to support EHR-driven phenotype algorithm authoring and execution.

    PubMed

    Jiang, Guoqian; Kiefer, Richard C; Rasmussen, Luke V; Solbrig, Harold R; Mo, Huan; Pacheco, Jennifer A; Xu, Jie; Montague, Enid; Thompson, William K; Denny, Joshua C; Chute, Christopher G; Pathak, Jyotishman

    2016-08-01

    The Quality Data Model (QDM) is an information model developed by the National Quality Forum for representing electronic health record (EHR)-based electronic clinical quality measures (eCQMs). In conjunction with the HL7 Health Quality Measures Format (HQMF), QDM contains core elements that make it a promising model for representing EHR-driven phenotype algorithms for clinical research. However, the current QDM specification is available only as descriptive documents suitable for human readability and interpretation, but not for machine consumption. The objective of the present study is to develop and evaluate a data element repository (DER) for providing machine-readable QDM data element service APIs to support phenotype algorithm authoring and execution. We used the ISO/IEC 11179 metadata standard to capture the structure for each data element, and leverage Semantic Web technologies to facilitate semantic representation of these metadata. We observed there are a number of underspecified areas in the QDM, including the lack of model constraints and pre-defined value sets. We propose a harmonization with the models developed in HL7 Fast Healthcare Interoperability Resources (FHIR) and Clinical Information Modeling Initiatives (CIMI) to enhance the QDM specification and enable the extensibility and better coverage of the DER. We also compared the DER with the existing QDM implementation utilized within the Measure Authoring Tool (MAT) to demonstrate the scalability and extensibility of our DER-based approach. PMID:27392645

  8. 1. West portal of the mudshed abutting the west portal ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. West portal of the mudshed abutting the west portal of Tunnel 5, view to the northwest, 135mm lens. The flat-roofed reinforced concrete mudsheds, rocksheds, and snowsheds are a common feature of the Natron Cutoff over the summit of the Cascades. With the railroad located on a sidehill bench cut into the precipitous slopes, the sheds protect the track from rock and mud slides, as well as from avalanches. With a solid wall on the uphill side and a series of columns on the downhill side, they form a gallery-like effect from within. This mudshed was built concurrent with the tunnel, in 1927. Though none of the mudsheds on the line are scheduled to be modified, this shed was documented as an integral element of Tunnel 5. - Southern Pacific Railroad Natron Cutoff, Tunnel 5, Milepost 545.2, McCredie Springs, Lane County, OR

  9. The ADRICOSM STAR GeoPortal

    NASA Astrophysics Data System (ADS)

    Giorgetti, Alessandra; Cesarini, Claudia; Gambetta, Marco; Reseghetti, Franco; Vinci, Matteo

    2010-05-01

    From Stockholm (1972) to Rio de Janeiro (1992) and to Johannesburg (2002), environmental protection objectives are related to the principles of sustainable development. This includes the following important components: participation, information, communication, training (capacity building) and education. Better information ensure more participation from individuals, and allows citizens to take part in many different actions that can influence the policy process. Participation to political decisions need access to reliable and quality controlled information. The ADRICOSM Portal was developed in order to manage data diversity, provide access to any kind of product, provide metadata completeness and accuracy. The product, as defined in ADRICOSM, is anything that can be offered to a client and that might satisfy a want or need. This implied the implementation of services that was taking into consideration the diversity of the objects to be provided to users: observations, model outputs, maps, etc. The implementation of the portal was based on two metadata levels: 1. Directory level - consisting of broad descriptions of the contents of data sets; used to locate data sets of potential interest and 2. Data level - consisting of the actual data objects. The portal was developed as a simplified front end for the partners data management systems, giving emphasis on federated access points focused on thematic aspects. This was based on the idea that specialized customer-related access points can be better carried out by delegated teams of experts who know the needs of different customers, define the user software which is most suited to them. The data management systems provide facilities for two data tracks, one in real-time (or near-realtime) and one in delayed mode. Both tracks are based on the same data sources and transmission systems, but the data follow different routes and are processed differently depending on user requirements. The real-time data and model products

  10. Vertical flow chemical detection portal

    DOEpatents

    Linker, Kevin L.; Hannum, David W.; Conrad, Frank James

    1999-01-01

    A portal apparatus for screening objects or persons for the presence of trace amounts of chemical substances such as illicit drugs or explosives. The apparatus has a test space, in which a person may stand, defined by two generally upright sides spanned by a horizontal transom. One or more fans in the transom generate a downward air flow (uni-directional) within the test space. The air flows downwardly from a high pressure upper zone, past the object or person to be screened. Air moving past the object dislodges from the surface thereof both volatile and nonvolatile particles of the target substance. The particles are entrained into the air flow which continues flowing downward to a lower zone of reduced pressure, where the particle-bearing air stream is directed out of the test space and toward preconcentrator and detection components. The sides of the portal are specially configured to partially contain and maintain the air flow.

  11. Vertical flow chemical detection portal

    DOEpatents

    Linker, K.L.; Hannum, D.W.; Conrad, F.J.

    1999-06-22

    A portal apparatus is described for screening objects or persons for the presence of trace amounts of chemical substances such as illicit drugs or explosives. The apparatus has a test space, in which a person may stand, defined by two generally upright sides spanned by a horizontal transom. One or more fans in the transom generate a downward air flow (uni-directional) within the test space. The air flows downwardly from a high pressure upper zone, past the object or person to be screened. Air moving past the object dislodges from the surface thereof both volatile and nonvolatile particles of the target substance. The particles are entrained into the air flow which continues flowing downward to a lower zone of reduced pressure, where the particle-bearing air stream is directed out of the test space and toward preconcentrator and detection components. The sides of the portal are specially configured to partially contain and maintain the air flow. 3 figs.

  12. Endoscopic Management of Portal Hypertension

    PubMed Central

    Al-Busafi, Said A.; Ghali, Peter; Wong, Philip; Deschenes, Marc

    2012-01-01

    Cirrhosis is the leading cause of portal hypertension worldwide, with the development of bleeding gastroesophageal varices being one of the most life-threatening consequences. Endoscopy plays an indispensible role in the diagnosis, staging, and prophylactic or active management of varices. With the expected future refinements in endoscopic technology, capsule endoscopy may one day replace traditional gastroscopy as a diagnostic modality, whereas endoscopic ultrasound may more precisely guide interventional therapy for gastric varices. PMID:22830037

  13. Provider documentation of patient education: a lean investigation*

    PubMed Central

    Shipman, Jean P.; Lake, Erica W.; Van Der Volgen, Jessica; Doman, Darrin

    2016-01-01

    Purpose The study evaluates how providers give patient education materials and identifies improvements to comply with Meaningful Use (MU) requirements. Methods Thirty-eight patient-provider interactions in two health care outpatient clinics were observed. Results Providers do not uniformly know MU patient education requirements. Providers have individual preferences and find gaps in what is available. Accessing and documenting patient education varies among providers. Embedded electronic health record (EHR) materials, while available, have technical access barriers. Conclusions Providers' EHR skills and knowledge levels contribute to non-standardized patient education delivery. PMID:27076805

  14. Two-portal dark matter

    NASA Astrophysics Data System (ADS)

    Ghorbani, Karim; Ghorbani, Hossein

    2015-06-01

    We propose a renormalizable dark matter model in which a fermionic dark matter (DM) candidate communicates with the standard model particles through two distinct portals: Higgs and vector portals. The dark sector is charged under a U (1 )' gauge symmetry while the standard model has a leptophobic interaction with the dark vector boson. The leading contribution of the DM-nucleon elastic scattering cross section begins at one-loop level. The model meets all the constraints imposed by direct detection experiments provided by LUX and XENON100, observed relic abundance according to WMAP and Planck, and the invisible Higgs decay width measured at the LHC. It turns out that the dark matter mass in the viable parameter space can take values from a few GeV up to 1 TeV. This is a new feature which is absent in the models with only one portal. In addition, we can find in the constrained regions of the parameter space a DM mass of ˜34 GeV annihilating into b quark pair, which explains the Fermi-LAT gamma-ray excess.

  15. Z-portal dark matter

    SciTech Connect

    Arcadi, Giorgio; Mambrini, Yann; Richard, Francois

    2015-03-11

    We propose to generalize the extensions of the Standard Model where the Z boson serves as a mediator between the Standard Model sector and the dark sector χ. We show that, like in the Higgs portal case, the combined constraints from the recent direct searches restrict severely the nature of the coupling of the dark matter to the Z boson and set a limit m{sub χ}≳200 GeV (except in a very narrow region around the Z-pole region). Using complementarity between spin dependent, spin independent and FERMI limits, we predict the nature of this coupling, more specifically the axial/vectorial ratio that respects a thermal dark matter coupled through a Z-portal while not being excluded by the current observations. We also show that the next generation of experiments of the type LZ or XENON1T will test Z-portal scenario for dark matter mass up to 2 TeV. The condition of a thermal dark matter naturally predicts the spin-dependent scattering cross section on the neutron to be σ{sub χn}{sup SD}≃10{sup −40} cm{sup 2}, which then becomes a clear prediction of the model and a signature testable in the near future experiments.

  16. [Mexican consensus on portal hypertension].

    PubMed

    Narváez-Rivera, R M; Cortez-Hernández, C A; González-González, J A; Tamayo-de la Cuesta, J L; Zamarripa-Dorsey, F; Torre-Delgadillo, A; Rivera-Ramos, J F J; Vinageras-Barroso, J I; Muneta-Kishigami, J E; Blancas-Valencia, J M; Antonio-Manrique, M; Valdovinos-Andraca, F; Brito-Lugo, P; Hernández-Guerrero, A; Bernal-Reyes, R; Sobrino-Cossío, S; Aceves-Tavares, G R; Huerta-Guerrero, H M; Moreno-Gómez, N; Bosques-Padilla, F J

    2013-01-01

    The aim of the Mexican Consensus on Portal Hypertension was to develop documented guidelines to facilitate clinical practice when dealing with key events of the patient presenting with portal hypertension and variceal bleeding. The panel of experts was made up of Mexican gastroenterologists, hepatologists, and endoscopists, all distinguished professionals. The document analyzes themes of interest in the following modules: preprimary and primary prophylaxis, acute variceal hemorrhage, and secondary prophylaxis. The management of variceal bleeding has improved considerably in recent years. Current information indicates that the general management of the cirrhotic patient presenting with variceal bleeding should be carried out by a multidisciplinary team, with such an approach playing a major role in the final outcome. The combination of drug and endoscopic therapies is recommended for initial management; vasoactive drugs should be started as soon as variceal bleeding is suspected and maintained for 5 days. After the patient is stabilized, urgent diagnostic endoscopy should be carried out by a qualified endoscopist, who then performs the corresponding endoscopic variceal treatment. Antibiotic prophylaxis should be regarded as an integral part of treatment, started upon hospital admittance and continued for 5 days. If there is treatment failure, rescue therapies should be carried out immediately, taking into account that interventional radiology therapies are very effective in controlling refractory variceal bleeding. These guidelines have been developed for the purpose of achieving greater clinical efficacy and are based on the best evidence of portal hypertension that is presently available. PMID:23664429

  17. Uzbekistan Radiation Portal Monnitoring System

    SciTech Connect

    Richardson, J; Knapp, R; Loshak, A; Yuldashev, B; Petrenko, V

    2005-06-10

    The work proposed in this presentation builds on the foundation set by the DTRA funded demonstration project begun in 2000 and completed in December of 2003. This previous work consisted of two phases whose overall objective was to install portal radiation monitors at four select ports-of-entry in Uzbekistan (Tashkent International Airport, Gisht-Kuprik (Kazakhstan border), Alat (Turkmenistan border), and Termez (Afghanistan border)) in order to demonstrate their effectiveness in preventing the illicit trafficking of nuclear materials. The objectives also included developing and demonstrating capabilities in the design, installation, operation, training, and maintenance of a radiation portal monitoring system. The system and demonstration project has proved successful in many ways. An effective working relationship among the Uzbekistan Customs Services, Uzbekistan Border Guards, and Uzbekistan Institute of Nuclear Physics has been developed. There has been unprecedented openness with the sharing of portal monitor data with Lawrence Livermore National Laboratory. The system has proved to be effective, with detection of illicit trafficking, and, at Alat, an arrest of three persons illegally transporting radioactive materials into Turkmenistan. The demonstration project has made Uzbekistan a model nonproliferation state in Central Asia and, with an expanded program, places them in a position to seal a likely transit route for illicit nuclear materials. These results will be described. In addition, this work is currently being expanded to include additional ports-of-entry in Uzbekistan. The process for deciding on which additional ports-of-entry to equip will also be described.

  18. Rapid EHR development and implementation using web and cloud-based architecture in a large home health and hospice organization.

    PubMed

    Weaver, Charlotte A; Teenier, Pamela

    2014-01-01

    Health care organizations have long been limited to a small number of major vendors in their selection of an electronic health record (EHR) system in the national and international marketplace. These major EHR vendors have in common base systems that are decades old, are built in antiquated programming languages, use outdated server architecture, and are based on inflexible data models [1,2]. The option to upgrade their technology to keep pace with the power of new web-based architecture, programming tools and cloud servers is not easily undertaken due to large client bases, development costs and risk [3]. This paper presents the decade-long efforts of a large national provider of home health and hospice care to select an EHR product, failing that to build their own and failing that initiative to go back into the market in 2012. The decade time delay had allowed new technologies and more nimble vendors to enter the market. Partnering with a new start-up company doing web and cloud based architecture for the home health and hospice market, made it possible to build, test and implement an operational and point of care system in 264 home health locations across 40 states and three time zones in the United States. This option of "starting over" with the new web and cloud technologies may be posing a next generation of new EHR vendors that retells the Blackberry replacement by iPhone story in healthcare. PMID:24943570

  19. Modeling shared care plans using CONTsys and openEHR to support shared homecare of the elderly

    PubMed Central

    Chen, Rong; Koch, Sabine

    2010-01-01

    This case report describes how two complementary standards, CONTsys (European Standard EN 13940-1 for continuity of care) and the reference model of openEHR, were applied in modeling a shared care plan for shared homecare based on requirements from the OLD@HOME project. Our study shows that these requirements are matched by CONTsys on a general level. However, certain attributes are not explicit in CONTsys, for example agents responsible for performing planned interventions, and support for monitoring outcome of interventions. We further studied how the care plan conceptual model can be implemented using the openEHR reference model. The study demonstrates the feasibility of developing shared care plans combining a standard concept model, for example CONTsys with an electronic health records (EHR) interoperability specification, that is the openEHR, while highlighting areas that need further exploration. It also explores the reusability of existing clinical archetypes as building blocks of care plans and the modeling of new shared care plan archetypes. PMID:21106993

  20. Portal hypertension complicating myelofibrosis: reversal following splenectomy.

    PubMed Central

    Lukie, B. E.; Card, R. T.

    1977-01-01

    Portal hypertension occurs in approximately 10% of patients with myelofibrosis. Increased portal blood flow secondary to splenomegaly has been proposed to explain its development. In a 60-year-old woman with proven myelofibrosis of 10 years' duration and gross splenomegaly, portal hypertension developed with esophageal varices and ascites. There was no demonstrable obstruction to portal blood flow. Following splenectomy the ascites and esophageal varices disappeared. Despite the presence of splenic myeloid metaplasia, splenectomy did not impair the patient's hematologic status. Portal hypertension complicating myelofibrosis has a poor prognosis, so careful attention should be given to its detection. Splenectomy may be preferable to portal-systemic shunting in the management of this complication. Images FIG. 1 FIG. 2 PMID:907949

  1. Noncirrhotic portal fibrosis after Wilms' tumor therapy

    SciTech Connect

    Barnard, J.A.; Marshall, G.S.; Neblett, W.W.; Gray, G.; Ghishan, F.K.

    1986-04-01

    A 9-yr-old girl developed massive hemorrhage from esophageal varices 2 yr after combined modality therapy for Wilms' tumor. Evaluation showed a patent extrahepatic portal venous system and an elevated splenic pulp pressure. In contrast to previous reports of hepatopathy after irradiation injury, histologic sections of the liver did not demonstrate occlusion of the central veins, but rather a diffuse obliteration of intrahepatic portal venous radicles. This pattern of noncirrhotic portal fibrosis has not been described following antitumor therapy.

  2. Preduodenal portal vein: its surgical significance.

    PubMed

    Makey, D A; Bowen, J C

    1978-11-01

    Preduodenal portal vein is a rare anatomical variant which may be one of many anomalies in the neonate with duodenal "atresia." Preduodenal portal vein also may be an occasional finding in an adult undergoing biliary, gastric, or pancreatic surgery. Awareness and recognition of the anomaly are essential for the avoidance of injury during such operations. We report here a symptomless patient whose preduodenal portal vein was discovered at cholecystectomy. PMID:715684

  3. Portal hypertension: pathophysiology, diagnosis, and treatment.

    PubMed

    Buob, S; Johnston, A N; Webster, C R L

    2011-01-01

    Portal hypertension (PH) is the result of increased vascular resistance in the portal circulation, increased portal venous blood flow, or both. In veterinary medicine, where portal pressure is seldom measured directly, the diagnosis of PH often is inferred from identification of associated complications including multiple acquired portosystemic shunts, ascites, and hepatic encephalopathy. Likewise, treatment of PH primarily is aimed at controlling these complications. The goal of this review is to provide an update on the pathophysiology, diagnosis, and treatment of PH. The review draws from information in the veterinary hepatology literature, reviews, and consensus statements in human hepatology and the literature on experimental models of PH. PMID:21382073

  4. Web-based Service Portal in Healthcare

    NASA Astrophysics Data System (ADS)

    Silhavy, Petr; Silhavy, Radek; Prokopova, Zdenka

    Information delivery is one the most important task in healthcare. The growing sector of electronic healthcare has an important impact on the information delivery. There are two basic approaches towards information delivering. The first is web portal and second is touch-screen terminal. The aim of this paper is to investigate the web-based service portal. The most important advantage of web-based portal in the field of healthcare is an independent access for patients. This paper deals with the conditions and frameworks for healthcare portals

  5. Automatic acquisition of synonyms from French UMLS for enhanced search of EHRs.

    PubMed

    Grabar, Natalia; Varoutas, Paul-Christophe; Rizand, Philippe; Livartowski, Alain; Hamon, Thierry

    2008-01-01

    Currently, the use of Natural Language Processing (NLP) approaches in order to improve search and exploration of electronic health records (EHRs) within healthcare information systems is not a common practice. One reason for this is the lack of suitable lexical resources: various types of such resources need to be collected or acquired. In this work, we propose a novel method for the acquisition of synonymous resources. This method is language-independent and relies on existence of structured terminologies. It enables to decipher hidden synonymous relations between simple words and terms on the basis of their syntactic analysis and exploitation of their compositionality. Applied to series of synonym terms from the French subset of the UMLS, the method shows 99% precision. The overlap between thus inferred terms and the existing sparse resources of synonyms is very low. PMID:18487831

  6. A Process for the Representation of openEHR ADL Archetypes in OWL Ontologies.

    PubMed

    Porn, Alex Mateus; Peres, Leticia Mara; Didonet Del Fabro, Marcos

    2015-01-01

    ADL is a formal language to express archetypes, independent of standards or domain. However, its specification is not precise enough in relation to the specialization and semantic of archetypes, presenting difficulties in implementation and a few available tools. Archetypes may be implemented using other languages such as XML or OWL, increasing integration with Semantic Web tools. Exchanging and transforming data can be better implemented with semantics oriented models, for example using OWL which is a language to define and instantiate Web ontologies defined by W3C. OWL permits defining significant, detailed, precise and consistent distinctions among classes, properties and relations by the user, ensuring the consistency of knowledge than using ADL techniques. This paper presents a process of an openEHR ADL archetypes representation in OWL ontologies. This process consists of ADL archetypes conversion in OWL ontologies and validation of OWL resultant ontologies using the mutation test. PMID:26262167

  7. Surveying Recent Themes in Translational Bioinformatics: Big Data in EHRs, Omics for Drugs, and Personal Genomics

    PubMed Central

    2014-01-01

    Summary Objective To provide a survey of recent progress in the use of large-scale biologic data to impact clinical care, and the impact the reuse of electronic health record data has made in genomic discovery. Method Survey of key themes in translational bioinformatics, primarily from 2012 and 2013. Result This survey focuses on four major themes: the growing use of Electronic Health Records (EHRs) as a source for genomic discovery, adoption of genomics and pharmacogenomics in clinical practice, the possible use of genomic technologies for drug repurposing, and the use of personal genomics to guide care. Conclusion Reuse of abundant clinical data for research is speeding discovery, and implementation of genomic data into clinical medicine is impacting care with new classes of data rarely used previously in medicine. PMID:25123743

  8. Development and Psychometric Qualities of the SEIPS Survey to Evaluate CPOE/EHR Implementation in ICUs

    PubMed Central

    Hoonakker, Peter L.T.; Cartmill, Randi S.; Carayon, Pascale; Walker, James M.

    2011-01-01

    Health Information Technology (IT) implementation can fail or meet high levels of user resistance for a variety of reasons, including lack of attention to users’ needs and the significant workflow changes induced and required by the technology. End-user satisfaction is a critical factor in health IT implementation. In this paper we describe the process of developing and testing a questionnaire to evaluate health IT implementation, in particular Computerized Provider Order Entry (CPOE) and Electronic Health Record (EHR) technologies. Results showed evidence for the validity and reliability of the questionnaire. The Systems Engineering Initiative for Patient Safety (SEIPS) questionnaire is relatively easy to administer and allows researchers to evaluate different aspects of health IT implementation. Results of this research can be used for benchmarking results of future studies evaluating health IT implementation. PMID:21475612

  9. Morphological observation of Epithemia ocellata (Ehr.) Kütz. (Bacillariophyceae) from China

    NASA Astrophysics Data System (ADS)

    Fan, Yawen; Hu, Zhengyu

    2007-10-01

    The species of Epithemia ocellata (Ehr.) Kütz. from Northeastern China were observed by scanning electron microscopy (SEM). The studies on silica valve formation in different stages were made. At the early stage, a Y-shaped raphe sternum was found. Areolae were made from virgae and vimines. In immature valves, the canal formation before the raphe fissure is visible. The raphe system, virgae and vimines (areolae) might be the early siliceous elements of the valve during morphogenesis. The formations of virgae and vimines are similar to that of Gephyria media W. Arnott. Rows of silica papillae formed gradually on the face of the valve. After the areolae were covered with silica and form rows of papillae, the outer valve surface could become mature. Details of the internal costae were observed in mature valves.

  10. Development and Psychometric Qualities of the SEIPS Survey to Evaluate CPOE/EHR Implementation in ICUs.

    PubMed

    Hoonakker, Peter L T; Cartmill, Randi S; Carayon, Pascale; Walker, James M

    2011-01-01

    Health Information Technology (IT) implementation can fail or meet high levels of user resistance for a variety of reasons, including lack of attention to users' needs and the significant workflow changes induced and required by the technology. End-user satisfaction is a critical factor in health IT implementation. In this paper we describe the process of developing and testing a questionnaire to evaluate health IT implementation, in particular Computerized Provider Order Entry (CPOE) and Electronic Health Record (EHR) technologies. Results showed evidence for the validity and reliability of the questionnaire. The Systems Engineering Initiative for Patient Safety (SEIPS) questionnaire is relatively easy to administer and allows researchers to evaluate different aspects of health IT implementation. Results of this research can be used for benchmarking results of future studies evaluating health IT implementation. PMID:21475612

  11. Access High Quality Imagery from the NOAA View Portal

    NASA Astrophysics Data System (ADS)

    Pisut, D.; Powell, A. M.; Loomis, T.; Goel, V.; Mills, B.; Cowan, D.

    2013-12-01

    NOAA curates a vast treasure trove of environmental data, but one that is sometimes not easily accessed, especially for education, outreach, and media purposes. Traditional data portals in NOAA require extensive knowledge of the specific names of observation platforms, models, and analyses, along with nomenclature for variable outputs. A new website and web mapping service (WMS) from NOAA attempts to remedy such issues. The NOAA View data imagery portal provides a seamless entry point into data from across the agency: satellite, models, in-situ analysis, etc. The system provides the user with ability to browse, animate, and download high resolution (e.g., 4,000 x 2,000 pixel) imagery, Google Earth, and even proxy data files. The WMS architecture also allows the resources to be ingested into other software systems or applications.

  12. How is the electronic health record being used? Use of EHR data to assess physician-level variability in technology use

    PubMed Central

    Ancker, Jessica S; Kern, Lisa M; Edwards, Alison; Nosal, Sarah; Stein, Daniel M; Hauser, Diane; Kaushal, Rainu

    2014-01-01

    Background Studies of the effects of electronic health records (EHRs) have had mixed findings, which may be attributable to unmeasured confounders such as individual variability in use of EHR features. Objective To capture physician-level variations in use of EHR features, associations with other predictors, and usage intensity over time. Methods Retrospective cohort study of primary care providers eligible for meaningful use at a network of federally qualified health centers, using commercial EHR data from January 2010 through June 2013, a period during which the organization was preparing for and in the early stages of meaningful use. Results Data were analyzed for 112 physicians and nurse practitioners, consisting of 430 803 encounters with 99 649 patients. EHR usage metrics were developed to capture how providers accessed and added to patient data (eg, problem list updates), used clinical decision support (eg, responses to alerts), communicated (eg, printing after-visit summaries), and used panel management options (eg, viewed panel reports). Provider-level variability was high: for example, the annual average proportion of encounters with problem lists updated ranged from 5% to 60% per provider. Some metrics were associated with provider, patient, or encounter characteristics. For example, problem list updates were more likely for new patients than established ones, and alert acceptance was negatively correlated with alert frequency. Conclusions Providers using the same EHR developed personalized patterns of use of EHR features. We conclude that physician-level usage of EHR features may be a valuable additional predictor in research on the effects of EHRs on healthcare quality and costs. PMID:24914013

  13. Analysis of multi-dimensional contemporaneous EHR data to refine delirium assessments.

    PubMed

    Corradi, John P; Chhabra, Jyoti; Mather, Jeffrey F; Waszynski, Christine M; Dicks, Robert S

    2016-08-01

    Delirium is a potentially lethal condition of altered mental status, attention, and level of consciousness with an acute onset and fluctuating course. Its causes are multi-factorial, and its pathophysiology is not well understood; therefore clinical focus has been on prevention strategies and early detection. One patient evaluation technique in routine use is the Confusion Assessment Method (CAM): a relatively simple test resulting in 'positive', 'negative' or 'unable-to-assess' (UTA) ratings. Hartford Hospital nursing staff use the CAM regularly on all non-critical care units, and a high frequency of UTA was observed after reviewing several years of records. In addition, patients with UTA ratings displayed poor outcomes such as in-hospital mortality, longer lengths of stay, and discharge to acute and long term care facilities. We sought to better understand the use of UTA, especially outside of critical care environments, in order to improve delirium detection throughout the hospital. An unsupervised clustering approach was used with additional, concurrent assessment data available in the EHR to categorize patient visits with UTA CAMs. The results yielded insights into the most common situations in which the UTA rating was used (e.g. impaired verbal communication, dementia), suggesting potentially inappropriate ratings that could be refined with further evaluation and remedied with updated clinical training. Analysis of the patient clusters also suggested that unrecognized delirium may contribute to the poor outcomes associated with the use of UTA. This method of using temporally related high dimensional EHR data to illuminate a dynamic medical condition could have wider applicability. PMID:27340924

  14. Patient portals - An online tool for your health

    MedlinePlus

    A patient portal is a website for your personal health care. The online tool helps you to keep track of ... questions through the portal. Many providers now offer patient portals. For access, you will need to set up ...

  15. Issue of data acquisition and processing using short range photogrammetry and terrestrial laser scanning for educational portals and virtual museums based on Wawel cathedral. (Polish Title: Problematyka pozyskiwania i przetwarzania danych fotogrametrycznych i z naziemnego skaningu laserowego na potrzeby tworzenia portali edukacyjnych i wirtualnych muzeów na przykładzie Katedry Wawelskiej)

    NASA Astrophysics Data System (ADS)

    Mitka, B.; Szelest, P.

    2013-12-01

    This paper presents the issues related to the acquisition and processing of terrestrial photogrammetry and laser scanning for building educational portals and virtual museums. Discusses the specific requirements of measurement technology and data processing for all kinds of objects, ranging from architecture through sculpture and architectural detail on the fabric and individual museum exhibits. Educational portals and virtual museums require a modern, high-quality visuals (3D models, virtual tours, animations, etc.) supplemented by descriptive content or audio commentary. Source for obtaining such materials are mostly terrestrial laser scanning and photogrammetry as technologies that provide complete information about the presented geometric objects. However, the performance requirements of web services impose severe restrictions on the presented content. It is necessary to use optimalization geometry process to streamline the way of its presentation. Equally important problem concerns the selection of appropriate technology and process measurement data processing presented for each type of objects. Only skillful selection of measuring equipment and data processing tools effectively ensure the achievement of a satisfactory end result. Both terrestrial laser scanning technology and digital close range photogrammetry has its strengths which should be used but also the limitations that must be taken into account in this kind of work. The key is choosing the right scanner for both the measured object and terrain such as pixel size in the performance of his photos.

  16. NEWT, a new taxonomy portal.

    PubMed

    Phan, I Q H; Pilbout, S F; Fleischmann, W; Bairoch, A

    2003-07-01

    NEWT is a new taxonomy portal to the SWISS-PROT protein sequence knowledgebase. It contains taxonomy data, which is updated daily, for the complete set of species represented in SWISS-PROT, as well as those stored at the NCBI. Users can navigate through the taxonomy tree and access corresponding SWISS-PROT protein entries. In addition, a manually curated selection of external links allows access to specific information on selected species. NEWT is available at http://www.ebi.ac.uk/newt/. PMID:12824428

  17. NEWT, a new taxonomy portal

    PubMed Central

    Phan, I. Q. H.; Pilbout, S. F.; Fleischmann, W.; Bairoch, A.

    2003-01-01

    NEWT is a new taxonomy portal to the SWISS-PROT protein sequence knowledgebase. It contains taxonomy data, which is updated daily, for the complete set of species represented in SWISS-PROT, as well as those stored at the NCBI. Users can navigate through the taxonomy tree and access corresponding SWISS-PROT protein entries. In addition, a manually curated selection of external links allows access to specific information on selected species. NEWT is available at http://www.ebi.ac.uk/newt/. PMID:12824428

  18. Portal hypertensive polyps, a new entity?

    PubMed

    Martín Domínguez, Verónica; Díaz Méndez, Ariel; Santander, Cecilio; García-Buey, Luisa

    2016-05-01

    We present a case of a 62 year old woman with history of liver cirrhosis secondary to autoimmune hepatitis, with portal hypertension and coagulopathy. Gastroscopy findings were a polypoid and polylobed lesions in the gastric antrum. These were removed and the pathological study described hyperplastic polyps with edema, vascular congestion and hyperplasia of smooth muscle, corresponding to "portal hypertensive polyps" (PHP). PMID:27188590

  19. Factors Affecting Faculty Web Portal Usability

    ERIC Educational Resources Information Center

    Bringula, Rex P.; Basa, Roselle S.

    2011-01-01

    The study investigated the factors that might significantly affect web portal usability. Results of the study were intended to serve as inputs for faculty web portal development of the University of the East-Manila. Descriptive statistics utilized questionnaire data from 82 faculty members. The data showed that most of the respondents were…

  20. Pancreatic pseudocyst rupture into the portal vein.

    PubMed

    Dawson, Brian C; Kasa, David; Mazer, Mark A

    2009-07-01

    A patient with a pancreatic pseudocyst rupture into the portal vein with a resultant noninfectious systemic inflammatory response syndrome and subsequent portal vein thrombosis diagnosed by computed tomography and ultrasonography is reported. A review of the existing English literature on this rare complication is also provided. PMID:19561436

  1. Idiopathic noncirrhotic portal hypertension: current perspectives.

    PubMed

    Riggio, Oliviero; Gioia, Stefania; Pentassuglio, Ilaria; Nicoletti, Valeria; Valente, Michele; d'Amati, Giulia

    2016-01-01

    The term idiopathic noncirrhotic portal hypertension (INCPH) has been recently proposed to replace terms, such as hepatoportal sclerosis, idiopathic portal hypertension, incomplete septal cirrhosis, and nodular regenerative hyperplasia, used to describe patients with a hepatic presinusoidal cause of portal hypertension of unknown etiology, characterized by features of portal hypertension (esophageal varices, nonmalignant ascites, porto-venous collaterals), splenomegaly, patent portal, and hepatic veins and no clinical and histological signs of cirrhosis. Physicians should learn to look for this condition in a number of clinical settings, including cryptogenic cirrhosis, a disease known to be associated with INCPH, drug administration, and even chronic alterations in liver function tests. Once INCPH is clinically suspected, liver histology becomes mandatory for the correct diagnosis. However, pathologists should be familiar with the histological features of INCPH, especially in cases in which histology is not only requested to exclude liver cirrhosis. PMID:27555800

  2. Idiopathic noncirrhotic portal hypertension: current perspectives

    PubMed Central

    Riggio, Oliviero; Gioia, Stefania; Pentassuglio, Ilaria; Nicoletti, Valeria; Valente, Michele; d’Amati, Giulia

    2016-01-01

    The term idiopathic noncirrhotic portal hypertension (INCPH) has been recently proposed to replace terms, such as hepatoportal sclerosis, idiopathic portal hypertension, incomplete septal cirrhosis, and nodular regenerative hyperplasia, used to describe patients with a hepatic presinusoidal cause of portal hypertension of unknown etiology, characterized by features of portal hypertension (esophageal varices, nonmalignant ascites, porto-venous collaterals), splenomegaly, patent portal, and hepatic veins and no clinical and histological signs of cirrhosis. Physicians should learn to look for this condition in a number of clinical settings, including cryptogenic cirrhosis, a disease known to be associated with INCPH, drug administration, and even chronic alterations in liver function tests. Once INCPH is clinically suspected, liver histology becomes mandatory for the correct diagnosis. However, pathologists should be familiar with the histological features of INCPH, especially in cases in which histology is not only requested to exclude liver cirrhosis. PMID:27555800

  3. Isocurvature constraints on portal couplings

    NASA Astrophysics Data System (ADS)

    Kainulainen, Kimmo; Nurmi, Sami; Tenkanen, Tommi; Tuominen, Kimmo; Vaskonen, Ville

    2016-06-01

    We consider portal models which are ultraweakly coupled with the Standard Model, and confront them with observational constraints on dark matter abundance and isocurvature perturbations. We assume the hidden sector to contain a real singlet scalar s and a sterile neutrino ψ coupled to s via a pseudoscalar Yukawa term. During inflation, a primordial condensate consisting of the singlet scalar s is generated, and its contribution to the isocurvature perturbations is imprinted onto the dark matter abundance. We compute the total dark matter abundance including the contributions from condensate decay and nonthermal production from the Standard Model sector. We then use the Planck limit on isocurvature perturbations to derive a novel constraint connecting dark matter mass and the singlet self coupling with the scale of inflation: mDM/GeV lesssim 0.2λs3/8 (H*/1011 GeV)‑3/2. This constraint is relevant in most portal models ultraweakly coupled with the Standard Model and containing light singlet scalar fields.

  4. Straddle carrier radiation portal monitoring

    NASA Astrophysics Data System (ADS)

    Andersen, Eric S.; Samuel, Todd J.; Mullen, O. Dennis

    2005-05-01

    U.S. Customs and Border Protection (CBP) is the primary enforcement agency protecting the nation"s ports of entry. CBP is enhancing its capability to interdict the illicit import of nuclear and radiological materials and devices that may be used by terrorists. Pacific Northwest National Laboratory (PNNL) is providing scientific and technical support to CBP in their goal to enable rapid deployment of nuclear and radiation detection systems at U. S. ports of entry to monitor 100% of the incoming international traffic and cargo while not adversely impacting the operations or throughput of the ports. The U.S. ports of entry include the following vectors: land border crossings, seaports, airports, rail crossings, and mail and express consignment courier facilities. U.S. Customs and Border Protection (CBP) determined that a screening solution was needed for Seaport cargo containers being transported by Straddle Carriers (straddle carriers). A stationary Radiation Portal Monitor (RPM) for Straddle Carriers (SCRPM) is needed so that cargo containers can be scanned while in transit under a Straddle Carrier. The Straddle Carrier Portal operational impacts were minimized by conducting a time-motion study at the Port, and adaptation of a Remotely Operated RPM (RO-RPM) booth concept that uses logical lighting schemes for traffic control, cameras, Optical Character Recognition, and wireless technology.

  5. Araport: the Arabidopsis information portal.

    PubMed

    Krishnakumar, Vivek; Hanlon, Matthew R; Contrino, Sergio; Ferlanti, Erik S; Karamycheva, Svetlana; Kim, Maria; Rosen, Benjamin D; Cheng, Chia-Yi; Moreira, Walter; Mock, Stephen A; Stubbs, Joseph; Sullivan, Julie M; Krampis, Konstantinos; Miller, Jason R; Micklem, Gos; Vaughn, Matthew; Town, Christopher D

    2015-01-01

    The Arabidopsis Information Portal (https://www.araport.org) is a new online resource for plant biology research. It houses the Arabidopsis thaliana genome sequence and associated annotation. It was conceived as a framework that allows the research community to develop and release 'modules' that integrate, analyze and visualize Arabidopsis data that may reside at remote sites. The current implementation provides an indexed database of core genomic information. These data are made available through feature-rich web applications that provide search, data mining, and genome browser functionality, and also by bulk download and web services. Araport uses software from the InterMine and JBrowse projects to expose curated data from TAIR, GO, BAR, EBI, UniProt, PubMed and EPIC CoGe. The site also hosts 'science apps,' developed as prototypes for community modules that use dynamic web pages to present data obtained on-demand from third-party servers via RESTful web services. Designed for sustainability, the Arabidopsis Information Portal strategy exploits existing scientific computing infrastructure, adopts a practical mixture of data integration technologies and encourages collaborative enhancement of the resource by its user community. PMID:25414324

  6. Straddle Carrier Radiation Portal Monitoring

    SciTech Connect

    Andersen, Eric S.; Samuel, Todd J.; Mullen, O Dennis

    2005-08-01

    U.S. Customs and Border Protection (CBP) is the primary enforcement agency protecting the nation’s ports of entry. CBP is enhancing its capability to interdict the illicit import of nuclear and radiological materials and devices that may be used by terrorists. Pacific Northwest National Laboratory (PNNL) is providing scientific and technical support to CBP in their goal to enable rapid deployment of nuclear and radiation detection systems at U. S. ports of entry to monitor 100% of the incoming international traffic and cargo while not adversely impacting the operations or throughput of the ports. The U.S. ports of entry include the following vectors: land border crossings, seaports, airports, rail crossings, and mail and express consignment courier facilities. U.S. Customs and Border Protection (CBP) determined that a screening solution was needed for Seaport cargo containers being transported by Straddle Carriers (straddle carriers). A stationary Radiation Portal Monitor (RPM) for Straddle Carriers (SCRPM) is needed so that cargo containers can be scanned while in transit under a Straddle Carrier. The Straddle Carrier Portal operational impacts were minimized by conducting a time-motion study at the Port, and adaptation of a Remotely Operated RPM (RO-RPM) booth concept that uses logical lighting schemes for traffic control, cameras, Optical Character Recognition, and wireless technology.

  7. Araport: the Arabidopsis Information Portal

    PubMed Central

    Krishnakumar, Vivek; Hanlon, Matthew R.; Contrino, Sergio; Ferlanti, Erik S.; Karamycheva, Svetlana; Kim, Maria; Rosen, Benjamin D.; Cheng, Chia-Yi; Moreira, Walter; Mock, Stephen A.; Stubbs, Joseph; Sullivan, Julie M.; Krampis, Konstantinos; Miller, Jason R.; Micklem, Gos; Vaughn, Matthew; Town, Christopher D.

    2015-01-01

    The Arabidopsis Information Portal (https://www.araport.org) is a new online resource for plant biology research. It houses the Arabidopsis thaliana genome sequence and associated annotation. It was conceived as a framework that allows the research community to develop and release ‘modules’ that integrate, analyze and visualize Arabidopsis data that may reside at remote sites. The current implementation provides an indexed database of core genomic information. These data are made available through feature-rich web applications that provide search, data mining, and genome browser functionality, and also by bulk download and web services. Araport uses software from the InterMine and JBrowse projects to expose curated data from TAIR, GO, BAR, EBI, UniProt, PubMed and EPIC CoGe. The site also hosts ‘science apps,’ developed as prototypes for community modules that use dynamic web pages to present data obtained on-demand from third-party servers via RESTful web services. Designed for sustainability, the Arabidopsis Information Portal strategy exploits existing scientific computing infrastructure, adopts a practical mixture of data integration technologies and encourages collaborative enhancement of the resource by its user community. PMID:25414324

  8. Regional Ocean Data Portal: Transforming Information to Knowledge

    NASA Astrophysics Data System (ADS)

    Howard, M. K.; Gayanilo, F. C.; Jochens, A. E.

    2009-12-01

    producers, recreational boaters, etc.) workshops were held to elicit user needs and requirements for observing system products for each group. The GCOOS-RA’s Products and Services Committee and Education and Outreach Council have gone through similar activities aimed at determining what products various users groups want. We have been sensitive to the private sector when deciding which products to produce. While science users want numbers, users of all types mainly want maps. We have tried to develop flexible capabilities within the portal that helps users to create their own fused products, ad hoc, for a variety of output devices, from desktop screens to the smart phones. We will discuss how our data management system has evolved within the backdrop of rapidly changing technologies and diverse community requirements.

  9. The LCOGT Observation Portal, Data Pipeline and Science Archive

    NASA Astrophysics Data System (ADS)

    Lister, Tim; LCOGT Science Archive Team

    2014-01-01

    Las Cumbres Observatory Global Telescope (LCOGT) is building and deploying a world-wide network of optical telescopes dedicated to time-domain astronomy. During 2012-2013, we successfully deployed and commissioned nine new 1m telescopes at McDonald Observatory (Texas), CTIO (Chile), SAAO (South Africa) and Siding Spring Observatory (Australia). New, improved cameras and additional telescopes will be deployed during 2014. To enable the diverse LCOGT user community of scientific and educational users to request observations on the LCOGT Network and to see their progress and get access to their data, we have developed an Observation Portal system. This Observation Portal integrates proposal submission and observation requests with seamless access to the data products from the data pipelines in near-realtime and long-term products from the Science Archive. We describe the LCOGT Observation Portal and the data pipeline, currently in operation, which makes use of the ORAC-DR automated recipe-based data reduction pipeline and illustrate some of the new data products. We also present the LCOGT Science Archive, which is being developed in partnership with the Infrared Processing and Analysis Center (IPAC) and show some of the new features the Science Archive provides.

  10. The Portal to the Universe an IYA2009 Cornerstone Project

    NASA Astrophysics Data System (ADS)

    Lindberg Christensen, Lars; Gay, P.; IYA2009 TPTTU Cornerstone Task Group

    2008-05-01

    The science of astronomy is extremely fast moving, and delivers new results on a daily basis, often in the form of spectacular news, images of forms and shapes not seen anywhere else, enhanced by illustrations and animations. Public astronomy communication has to develop apace with the other players in the mass market for electronic information such as the gaming and entertainment industries. The problem today is not so much the availability of excellent astronomy multimedia resources for use in education, outreach and the like, but rather finding and accessing these materials. The Portal to the Universe (TPTTU) seeks to fix this problem. The Portal to the Universe (TPTTU) is an IYA2009 Cornerstone project that will feature a comprehensive directory of observatories, facilities, astronomical societies, amateur astronomy societies, space artists, science communication universities, as well as news-, image-, event- and video- aggregators and Web 2.0 collaborative tools for astronomy multimedia community interaction. The Portal will enable innovative access to, and vastly multiply the use of, astronomy multimedia resources - including news, images, videos, events, podcasts, vodcasts etc. as a selective aggregator with a non-painful editorial mechanism in place. This talk will discuss the plans for the TPTTU content as well as the technology and editorial choices behind the scenes.

  11. MedlinePlus Connect in Use

    MedlinePlus

    ... R System e-MDs ehrTHOMAS EnableDoc EHR Enablemyhealth Patient Portal enki EHR Epic MyChart ezAccess Falcon EHR Find- ... EHR iChartsMD EHR iChartsMD Hospital Information System InteliChart Patient Portal Intivia InSync EMR and Practice Management System MCHART ...

  12. PTXT Finder - an application for finding appropriate EHR data elements for data analysis using cross referencing information sources.

    PubMed

    Lin, Jau-Huei; Haug, Peter J

    2007-01-01

    PTXT Finder was developed to reduce the manual efforts necessary to map from clinical variables in a decision support system to data elements in an EHR. The descriptions in a data dictionary may be inadequate for pinpointing data elements that represent a clinical variable. Semantics implied in taxonomy and real usage of the element are two important supporting information sources. PTXT Finder provides description, hierarchy, and statistics displays so users can cross-reference among these views. PMID:18694132

  13. Are Meaningful Use Stage 2 certified EHRs ready for interoperability? Findings from the SMART C-CDA Collaborative

    PubMed Central

    D'Amore, John D; Mandel, Joshua C; Kreda, David A; Swain, Ashley; Koromia, George A; Sundareswaran, Sumesh; Alschuler, Liora; Dolin, Robert H; Mandl, Kenneth D; Kohane, Isaac S; Ramoni, Rachel B

    2014-01-01

    Background and objective Upgrades to electronic health record (EHR) systems scheduled to be introduced in the USA in 2014 will advance document interoperability between care providers. Specifically, the second stage of the federal incentive program for EHR adoption, known as Meaningful Use, requires use of the Consolidated Clinical Document Architecture (C-CDA) for document exchange. In an effort to examine and improve C-CDA based exchange, the SMART (Substitutable Medical Applications and Reusable Technology) C-CDA Collaborative brought together a group of certified EHR and other health information technology vendors. Materials and methods We examined the machine-readable content of collected samples for semantic correctness and consistency. This included parsing with the open-source BlueButton.js tool, testing with a validator used in EHR certification, scoring with an automated open-source tool, and manual inspection. We also conducted group and individual review sessions with participating vendors to understand their interpretation of C-CDA specifications and requirements. Results We contacted 107 health information technology organizations and collected 91 C-CDA sample documents from 21 distinct technologies. Manual and automated document inspection led to 615 observations of errors and data expression variation across represented technologies. Based upon our analysis and vendor discussions, we identified 11 specific areas that represent relevant barriers to the interoperability of C-CDA documents. Conclusions We identified errors and permissible heterogeneity in C-CDA documents that will limit semantic interoperability. Our findings also point to several practical opportunities to improve C-CDA document quality and exchange in the coming years. PMID:24970839

  14. The Feasibility of using Electronic Health Records (EHRs) to describe demographic and clinical indicators of Migrant and Seasonal Farmworkers

    PubMed Central

    Socias, Christina; Liang, Yuanyuan; Delclos, George; Graves, Julie; Hendrikson, Ed; Cooper, Sharon

    2016-01-01

    Few extensive, national clinical databases exist on the health of migrant and seasonal farmworkers (MSFWs). Electronic health records (EHRs) are increasingly utilized by Federally Qualified Health Centers (FQHCs) and have the potential to improve clinical care and complement current surveillance and epidemiologic studies of underserved working populations, such as MSFWs. The aim of this feasibility study was to describe the demographics and baseline clinical indicators of patients at an FQHC by MSFW status. We described 2012 patient demographics, social history, medical indicators, and diagnoses by MSFW status from the de-identified EHR database of a large, multi-site Colorado Migrant Health Center (MHC). Included in the study were 41,817 patients from 2012: 553(1.3%) MSFWs; 20,665(49.4%) non-MSFWs; and 20,599 (49.3%) who had no information in the MSFW field. MSFWs were more often male, married, employed, Hispanic, and Spanish-speaking compared to non-MSFWs. The most frequent diagnoses for all patients were hypertension, overweight/obesity, lipid disorder, type 2 diabetes, or a back disorder. Although there were significant missing values, this feasibility study was able to analyze medical data in a timely manner and show that Meaningful Use requirements can improve the usability of EHR data for epidemiologic research of MSFWs and other patients at FQHCs. The results of this study were consistent with current literature available for MSFWs. By reaching this vulnerable working population, EHRs may be a key data source for occupational injury and illness surveillance and research. PMID:26479964

  15. Developing EHR-driven heart failure risk prediction models using CPXR(Log) with the probabilistic loss function.

    PubMed

    Taslimitehrani, Vahid; Dong, Guozhu; Pereira, Naveen L; Panahiazar, Maryam; Pathak, Jyotishman

    2016-04-01

    Computerized survival prediction in healthcare identifying the risk of disease mortality, helps healthcare providers to effectively manage their patients by providing appropriate treatment options. In this study, we propose to apply a classification algorithm, Contrast Pattern Aided Logistic Regression (CPXR(Log)) with the probabilistic loss function, to develop and validate prognostic risk models to predict 1, 2, and 5year survival in heart failure (HF) using data from electronic health records (EHRs) at Mayo Clinic. The CPXR(Log) constructs a pattern aided logistic regression model defined by several patterns and corresponding local logistic regression models. One of the models generated by CPXR(Log) achieved an AUC and accuracy of 0.94 and 0.91, respectively, and significantly outperformed prognostic models reported in prior studies. Data extracted from EHRs allowed incorporation of patient co-morbidities into our models which helped improve the performance of the CPXR(Log) models (15.9% AUC improvement), although did not improve the accuracy of the models built by other classifiers. We also propose a probabilistic loss function to determine the large error and small error instances. The new loss function used in the algorithm outperforms other functions used in the previous studies by 1% improvement in the AUC. This study revealed that using EHR data to build prediction models can be very challenging using existing classification methods due to the high dimensionality and complexity of EHR data. The risk models developed by CPXR(Log) also reveal that HF is a highly heterogeneous disease, i.e., different subgroups of HF patients require different types of considerations with their diagnosis and treatment. Our risk models provided two valuable insights for application of predictive modeling techniques in biomedicine: Logistic risk models often make systematic prediction errors, and it is prudent to use subgroup based prediction models such as those given by CPXR

  16. Becoming a Learning Organization: New Directions in Science Education Research at the National Science Foundation

    NASA Astrophysics Data System (ADS)

    Ramaley, Judith A.; Olds, Barbara M.; Earle, Janice

    2005-06-01

    The Education and Human Resources (EHR) Directorate at the National Science Foundation has been examining its role in supporting the development of new approaches to science, technology, engineering and mathematics (STEM) education. This article explores what it means to be scientifically literate, what it takes to become a learning organization, how the EHR Directorate is working towards becoming such an organization through rigorous self-study, and how EHR can best manage its large portfolio of awards that support investigations in STEM education to enhance their collective value to researchers, policymakers and educators. Several elements of the self-study process are described, and the implications for the Directorate as well as for the field of researchers in science education are explored.

  17. BSD Portals for LINUX 2.0

    NASA Technical Reports Server (NTRS)

    McNab, A. David; woo, Alex (Technical Monitor)

    1999-01-01

    Portals, an experimental feature of 4.4BSD, extend the file system name space by exporting certain open () requests to a user-space daemon. A portal daemon is mounted into the file name space as if it were a standard file system. When the kernel resolves a pathname and encounters a portal mount point, the remainder of the path is passed to the portal daemon. Depending on the portal "pathname" and the daemon's configuration, some type of open (2) is performed. The resulting file descriptor is passed back to the kernel which eventually returns it to the user, to whom it appears that a "normal" open has occurred. A proxy portalfs file system is responsible for kernel interaction with the daemon. The overall effect is that the portal daemon performs an open (2) on behalf of the kernel, possibly hiding substantial complexity from the calling process. One particularly useful application is implementing a connection service that allows simple scripts to open network sockets. This paper describes the implementation of portals for LINUX 2.0.

  18. Evaluation of a Framework to Implement Electronic Health Record Systems Based on the openEHR Standard

    NASA Astrophysics Data System (ADS)

    Orellana, Diego A.; Salas, Alberto A.; Solarz, Pablo F.; Medina Ruiz, Luis; Rotger, Viviana I.

    2016-04-01

    The production of clinical information about each patient is constantly increasing, and it is noteworthy that the information is created in different formats and at diverse points of care, resulting in fragmented, incomplete, inaccurate and isolated, health information. The use of health information technology has been promoted as having a decisive impact to improve the efficiency, cost-effectiveness, quality and safety of medical care delivery. However in developing countries the utilization of health information technology is insufficient and lacking of standards among other situations. In the present work we evaluate the framework EHRGen, based on the openEHR standard, as mean to reach generation and availability of patient centered information. The framework has been evaluated through the provided tools for final users, that is, without intervention of computer experts. It makes easier to adopt the openEHR ideas and provides an open source basis with a set of services, although some limitations in its current state conspire against interoperability and usability. However, despite the described limitations respect to usability and semantic interoperability, EHRGen is, at least regionally, a considerable step toward EHR adoption and interoperability, so that it should be supported from academic and administrative institutions.

  19. EHR systems in the Spanish Public Health National System: the lack of interoperability between primary and specialty care.

    PubMed

    de la Torre-Díez, Isabel; González, Sandra; López-Coronado, Miguel

    2013-02-01

    One of the problems of the Spanish Public Health National System is the lack of interoperability in the implemented Electronic Health Records (EHRs) systems in primary and specialty care. There is a deficiency in the electronic health systems that store the data of primary care patients, so one of the basic problems that prevent that every hospital and health center working on the same method is that deficiency. In this paper we research on this problem and to give expression to a series of solutions to it. Bibliographic material in this work has been obtained mainly from MEDLINE source. Additionally, due to the lack of information and privacy about the different EHRs systems, we have resorted to making direct contact with the organizations that have implemented those systems and technological providers. Two solutions have been propounded given several aspects for a feasibility study. The first solution is based upon in the execution of backups in different EHRs databases, which implies a huge economical and infrastructure development. The second of these solutions so that due to the creation of protocols by means of Cloud Computing Technologies. It is crucial the need to reach a homogeneity concerning to the storage of patients clinical data. On the results achieved we can emphasize that maybe the main problems are not the economical handicaps or the large technological development needed, but, as for Health each Region manages its own competences, each one governs with independent policies and decisions. PMID:23321962

  20. Using Electronic Health Records to Support Clinical Trials: A Report on Stakeholder Engagement for EHR4CR

    PubMed Central

    McCowan, Colin; Thomson, Elizabeth; Szmigielski, Cezary A.; Kalra, Dipak; Sullivan, Frank M.; Prokosch, Hans-Ulrich; Dugas, Martin; Ford, Ian

    2015-01-01

    Background. The conduct of clinical trials is increasingly challenging due to greater complexity and governance requirements as well as difficulties with recruitment and retention. Electronic Health Records for Clinical Research (EHR4CR) aims at improving the conduct of trials by using existing routinely collected data, but little is known about stakeholder views on data availability, information governance, and acceptable working practices. Methods. Senior figures in healthcare organisations across Europe were provided with a description of the project and structured interviews were subsequently conducted to elicit their views. Results. 37 structured interviewees in Germany, UK, Switzerland, and France indicated strong support for the proposed EHR4CR platform. All interviewees reported that using the platform for assessing feasibility would enhance the conduct of clinical trials and the majority also felt it would reduce workloads. Interviewees felt the platform could enhance trial recruitment and adverse event reporting but also felt it could raise either ethical or information governance concerns in their country. Conclusions. There was clear support for EHR4CR and a belief that it could reduce workloads and improve the conduct and quality of trials. However data security, privacy, and information governance issues would need to be carefully managed in the development of the platform. PMID:26539523

  1. Evaluation of matched control algorithms in EHR-based phenotyping studies: a case study of inflammatory bowel disease comorbidities.

    PubMed

    Castro, Victor M; Apperson, W Kay; Gainer, Vivian S; Ananthakrishnan, Ashwin N; Goodson, Alyssa P; Wang, Taowei D; Herrick, Christopher D; Murphy, Shawn N

    2014-12-01

    The success of many population studies is determined by proper matching of cases to controls. Some of the confounding and bias that afflict electronic health record (EHR)-based observational studies may be reduced by creating effective methods for finding adequate controls. We implemented a method to match case and control populations to compensate for sparse and unequal data collection practices common in EHR data. We did this by matching the healthcare utilization of patients after observing that more complete data was collected on high healthcare utilization patients vs. low healthcare utilization patients. In our results, we show that many of the anomalous differences in population comparisons are mitigated using this matching method compared to other traditional age and gender-based matching. As an example, the comparison of the disease associations of ulcerative colitis and Crohn's disease show differences that are not present when the controls are chosen in a random or even a matched age/gender/race algorithm. In conclusion, the use of healthcare utilization-based matching algorithms to find adequate controls greatly enhanced the accuracy of results in EHR studies. Full source code and documentation of the control matching methods is available at https://community.i2b2.org/wiki/display/conmat/. PMID:25196084

  2. Higgs portals to pulsar collapse

    NASA Astrophysics Data System (ADS)

    Bramante, Joseph; Elahi, Fatemeh

    2015-06-01

    Pulsars apparently missing from the Galactic center could have been destroyed by asymmetric fermionic dark matter (mX=1 - 100 GeV ) coupled to a light scalar (mϕ=5 - 20 MeV ), which mixes with the Higgs boson. We point out that this pulsar-collapsing dark sector can resolve the core-cusp problem and will either be excluded or discovered by upcoming direct detection experiments. Another implication is a maximum pulsar age curve that increases with distance from the Galactic center, with a normalization that depends on the couplings and masses of dark sector particles. In addition, we use old pulsars outside the Galactic center to place bounds on asymmetric Higgs portal models.

  3. Freeze-in through portals

    SciTech Connect

    Blennow, Mattias; Fernandez-Martínez, Enrique; Zaldívar, Bryan E-mail: enrique.fernandez-martinez@uam.es

    2014-01-01

    The popular freeze-out paradigm for Dark Matter (DM) production, relies on DM-baryon couplings of the order of the weak interactions. However, different search strategies for DM have failed to provide a conclusive evidence of such (non-gravitational) interactions, while greatly reducing the parameter space of many representative models. This motivates the study of alternative mechanisms for DM genesis. In the freeze-in framework, the DM is slowly populated from the thermal bath while never reaching equilibrium. In this work, we analyse in detail the possibility of producing a frozen-in DM via a mediator particle which acts as a portal. We give analytical estimates of different freeze-in regimes and support them with full numerical analyses, taking into account the proper distribution functions of bath particles. Finally, we constrain the parameter space of generic models by requiring agreement with DM relic abundance observations.

  4. The Astrostatistics and Astroinformatics Portal

    NASA Astrophysics Data System (ADS)

    Feigelson, Eric; Hilbe, J. M.

    2014-01-01

    The Astrostatistics and Astroinformatics Portal (ASAIP, http://asaip.psu.edu) is a Web resource started in 2012 to foster research into advanced methodologies for astronomical research, and to promulgate such methods into the broader astronomy community. It provides searchable abstracts to Recent Papers in the field, several discussion Forums, various resources for researchers, brief Articles by experts, lists of Meetings, and access to various Web resources such as on-line courses, books and blogs. The material can be electronically searched. The site will be used for public outreach by organizations associated with the AAS, IAU, ISI (International Statistical Institute), and LSST. ASAIP has nearly 700 members who can contribute material, and its resources are readable by the general Web public. This presentation gives examples of recent ASAIP entries and encourages AAS members to use its resources.

  5. Infusing informatics into interprofessional education: the iTEAM (Interprofessional Technology Enhanced Advanced practice Model) project.

    PubMed

    Skiba, Diane J; Barton, Amy J; Knapfel, Sarah; Moore, Gina; Trinkley, Katy

    2014-01-01

    The iTEAM goal is to prepare advanced practice nurses, physicians and pharmacists with the interprofessional (IP) core competencies (informatics, patient centric, quality-focused, evidence based care) to provide technology enhanced collaborative care by: offering technology enhanced learning opportunities through a required informatics course, advanced practice courses (team based experiences with both standardized and virtual patients) and team based clinical experiences including e-health experiences. The innovative features of iTEAM project will be achieved through use of social media strategies, a web accessible Electronic Health Records (EHRs) system, a Virtual Clinic/Hospital in Second Life, various e-health applications including traditional telehealth tools and consumer oriented tools such as patient portals, social media consumer groups and mobile health (m-health) applications for health and wellness functions. It builds upon the schools' rich history of IP education and includes clinical partners, such as the VA and other clinical sites focused on care for underserved patient populations. PMID:24943525

  6. Electronic health record training in undergraduate medical education: bridging theory to practice with curricula for empowering patient- and relationship-centered care in the computerized setting.

    PubMed

    Wald, Hedy S; George, Paul; Reis, Shmuel P; Taylor, Julie Scott

    2014-03-01

    While electronic health record (EHR) use is becoming state-of-the-art, deliberate teaching of health care information technology (HCIT) competencies is not keeping pace with burgeoning use. Medical students require training to become skilled users of HCIT, but formal pedagogy within undergraduate medical education (UME) is sparse. How can medical educators best meet the needs of learners while integrating EHRs into medical education and practice? How can they help learners preserve and foster effective communication skills within the computerized setting? In general, how can UME curricula be devised for skilled use of EHRs to enhance rather than hinder provision of effective, humanistic health care?Within this Perspective, the authors build on recent publications that "set the stage" for next steps: EHR curricula innovation and implementation as concrete embodiments of theoretical underpinnings. They elaborate on previous calls for maximizing benefits and minimizing risks of EHR use with sufficient focus on physician-patient communication skills and for developing core competencies within medical education. The authors describe bridging theory into practice with systematic longitudinal curriculum development for EHR training in UME at their institution, informed by Kern and colleagues' curriculum development framework, narrative medicine, and reflective practice. They consider this innovation within a broader perspective-the overarching goal of empowering undergraduate medical students' patient- and relationship-centered skills while effectively demonstrating HCIT-related skills. PMID:24448045

  7. Zolmitriptan: A Novel Portal Hypotensive Agent Which Synergizes with Propranolol in Lowering Portal Pressure

    PubMed Central

    Reboredo, Mercedes; Chang, Haisul C. Y.; Barbero, Roberto; Rodríguez-Ortigosa, Carlos M.; Pérez-Vizcaíno, Francisco; Morán, Asunción; García, Mónica; Banales, Jesús M.; Carreño, Norberto; Alegre, Félix; Herrero, Ignacio; Quiroga, Jorge

    2013-01-01

    Objective Only a limited proportion of patients needing pharmacological control of portal hypertension are hemodynamic responders to propranolol. Here we analyzed the effects of zolmitriptan on portal pressure and its potential interaction with propranolol. Methods Zolmitriptan, propranolol or both were tested in two rat models of portal hypertension: common bile duct ligation (CBDL) and CCl4-induced cirrhosis. In these animals we measured different hemodynamic parameters including portal venous pressure, arterial renal flow, portal blood flow and cardiac output. We also studied the changes in superior mesenteric artery perfusion pressure and in arterial wall cAMP levels induced by zolmitriptan, propranolol or both. Moreover, we determined the effect of splanchnic sympathectomy on the response of PVP to zolmitriptan. Results In both models of portal hypertension zolmitriptan induced a dose-dependent transient descent of portal pressure accompanied by reduction of portal flow with only slight decrease in renal flow. In cirrhotic rats, splanchnic sympathectomy intensified and prolonged zolmitriptan-induced portal pressure descent. Also, propranolol caused more intense and durable portal pressure fall when combined with zolmitriptan. Mesenteric artery perfusion pressure peaked for about 1 min upon zolmitriptan administration but showed no change with propranolol. However propranolol enhanced and prolonged the elevation in mesenteric artery perfusion pressure induced by zolmitriptan. In vitro studies showed that propranolol prevented the inhibitory effects of β2-agonists on zolmitriptan-induced vasoconstriction and the combination of propranolol and zolmitriptan significantly reduced the elevation of cAMP caused by β2-agonists. Conclusion Zolmitriptan reduces portal hypertension and non-selective beta-blockers can improve this effect. Combination therapy deserves consideration for patients with portal hypertension failing to respond to non-selective beta

  8. The Effect of E-Portal System on Corporate Image of Universities

    ERIC Educational Resources Information Center

    Tunji, Oyedepo; Nelson, Okorie

    2011-01-01

    Internet connectivity in tertiary institutions in Africa has been summarized in three characteristics-- too little, too expensive and poorly managed (African Tertiary Institutions Connectivity Survey (ATICS), 2006 report). The Internet portal system offers educational organizations the ability to track students needs and promote their programs and…

  9. Use of Cannulated Instruments to Localize the Portals in Anterior Ankle Arthroscopy: A Technique Tip.

    PubMed

    Needleman, Richard L

    2016-01-01

    The use of cannulated instruments under fluoroscopy can improve the localization of the anteromedial and posterolateral portals for use in ankle arthroscopy. This technique is valuable for the less-experienced ankle arthroscopist, in resident education, and for the experienced arthroscopist when surface anatomy palpation and visualization is less than ideal due to soft tissue edema and obesity. PMID:26947000

  10. [Idiopathic non-cirrhotic portal hypertension: An update].

    PubMed

    Bissonnette, Julien; Rautou, Pierre-Emmanuel; Valla, Dominique-Charles

    2015-10-01

    Idiopathic non-cirrhotic portal hypertension is an under-estimated cause of portal hypertension. The diagnosis requires the exclusion of cirrhosis, common causes of chronic liver disease and venous obstruction of the portal and hepatic veins. It has been associated with various extra-hepatic conditions that are most frequently immunologic, prothrombotic, hematologic and toxic. The most frequent clinical complications are variceal hemorrhage and portal vein thrombosis. Complications of portal hypertension should be managed as in patients with cirrhosis. PMID:26362514

  11. [Association of biliary calculosis and portal cavernomatosis].

    PubMed

    Crespi, C; De Giorgio, A M

    1992-08-01

    This paper reports the case of a woman, who underwent surgery because of cholelithiasis, with intraoperative finding of prehepatic portal hypertension from portal vein thrombosis ("portal cavernoma") with healthy liver, later confirmed by angiographic studies. This rare pathologic association carries a higher risk of major operative complications; therefore the Authors agree with the general belief that, for these cases, biliary tract surgery should be as simple and safe as possible. In the case of preoperative diagnosis of biliary disease associated with portal cavernoma, should a surgical approach on the biliary tract be required, we agree on the advisability of performing a shunting procedure before any kind of biliary surgery. In case of variceal bleeding endoscopic sclerotherapy will be the first choice; surgical procedures (shunting) should be seen as a second choice in case of rebleeding after sclerotherapy. PMID:1407632

  12. 23. INCLINED END POST / VERTICAL / DIAGONAL / PORTAL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    23. INCLINED END POST / VERTICAL / DIAGONAL / PORTAL BRACING DETAIL. VIEW TO SOUTHEAST. - Abraham Lincoln Memorial Bridge, Spanning Missouri River on Highway 30 between Nebraska & Iowa, Blair, Washington County, NE

  13. The Fukushima Daiichi Accident Study Information Portal

    SciTech Connect

    Shawn St. Germain; Curtis Smith; David Schwieder; Cherie Phelan

    2012-11-01

    This paper presents a description of The Fukushima Daiichi Accident Study Information Portal. The Information Portal was created by the Idaho National Laboratory as part of joint NRC and DOE project to assess the severe accident modeling capability of the MELCOR analysis code. The Fukushima Daiichi Accident Study Information Portal was created to collect, store, retrieve and validate information and data for use in reconstructing the Fukushima Daiichi accident. In addition to supporting the MELCOR simulations, the Portal will be the main DOE repository for all data, studies and reports related to the accident at the Fukushima Daiichi nuclear power station. The data is stored in a secured (password protected and encrypted) repository that is searchable and accessible to researchers at diverse locations.

  14. Modeling and analysis of web portals performance

    NASA Astrophysics Data System (ADS)

    Abdul Rahim, Rahela; Ibrahim, Haslinda; Syed Yahaya, Sharipah Soaad; Khalid, Khairini

    2011-10-01

    The main objective of this study is to develop a model based on queuing theory at a system level of web portals performance for a university. A system level performance model views the system being modeled as a 'black box' which considers the arrival rate of packets to the portals server and service rate of the portals server. These two parameters are important elements to measure Web portals performance metrics such as server utilization, average server throughput, average number of packet in the server and mean response time. This study refers to infinite population and finite queue. The proposed analytical model is simple in such a way that it is easy to define and fast to interpret the results but still represents the real situation.

  15. Patient Portals and Patient Engagement: A State of the Science Review

    PubMed Central

    DeVito Dabbs, Annette; Curran, Christine R

    2015-01-01

    Background Patient portals (ie, electronic personal health records tethered to institutional electronic health records) are recognized as a promising mechanism to support greater patient engagement, yet questions remain about how health care leaders, policy makers, and designers can encourage adoption of patient portals and what factors might contribute to sustained utilization. Objective The purposes of this state of the science review are to (1) present the definition, background, and how current literature addresses the encouragement and support of patient engagement through the patient portal, and (2) provide a summary of future directions for patient portal research and development to meaningfully impact patient engagement. Methods We reviewed literature from 2006 through 2014 in PubMed, Ovid Medline, and PsycInfo using the search terms “patient portal” OR “personal health record” OR “electronic personal health record”. Final inclusion criterion dictated that studies report on the patient experience and/or ways that patients may be supported to make competent health care decisions and act on those decisions using patient portal functionality. Results We found 120 studies that met the inclusion criteria. Based on the research questions, explicit and implicit aims of the studies, and related measures addressed, the studies were grouped into five major topics (patient adoption, provider endorsement, health literacy, usability, and utility). We discuss the findings and conclusions of studies that address the five topical areas. Conclusions Current research has demonstrated that patients’ interest and ability to use patient portals is strongly influenced by personal factors such age, ethnicity, education level, health literacy, health status, and role as a caregiver. Health care delivery factors, mainly provider endorsement and patient portal usability also contribute to patient’s ability to engage through and with the patient portal. Future

  16. The EHR-ARCHE project: Satisfying clinical information needs in a Shared Electronic Health Record System based on IHE XDS and Archetypes☆

    PubMed Central

    Duftschmid, Georg; Rinner, Christoph; Kohler, Michael; Huebner-Bloder, Gudrun; Saboor, Samrend; Ammenwerth, Elske

    2013-01-01

    Purpose While contributing to an improved continuity of care, Shared Electronic Health Record (EHR) systems may also lead to information overload of healthcare providers. Document-oriented architectures, such as the commonly employed IHE XDS profile, which only support information retrieval at the level of documents, are particularly susceptible for this problem. The objective of the EHR-ARCHE project was to develop a methodology and a prototype to efficiently satisfy healthcare providers’ information needs when accessing a patient's Shared EHR during a treatment situation. We especially aimed to investigate whether this objective can be reached by integrating EHR Archetypes into an IHE XDS environment. Methods Using methodical triangulation, we first analysed the information needs of healthcare providers, focusing on the treatment of diabetes patients as an exemplary application domain. We then designed ISO/EN 13606 Archetypes covering the identified information needs. To support a content-based search for fine-grained information items within EHR documents, we extended the IHE XDS environment with two additional actors. Finally, we conducted a formative and summative evaluation of our approach within a controlled study. Results We identified 446 frequently needed diabetes-specific information items, representing typical information needs of healthcare providers. We then created 128 Archetypes and 120 EHR documents for two fictive patients. All seven diabetes experts, who evaluated our approach, preferred the content-based search to a conventional XDS search. Success rates of finding relevant information was higher for the content-based search (100% versus 80%) and the latter was also more time-efficient (8–14 min versus 20 min or more). Conclusions Our results show that for an efficient satisfaction of health care providers’ information needs, a content-based search that rests upon the integration of Archetypes into an IHE XDS-based Shared EHR system is

  17. Idiopathic Noncirrhotic Portal Hypertension: An Appraisal

    PubMed Central

    Lee, Hwajeong; Rehman, Aseeb Ur; Fiel, M. Isabel

    2016-01-01

    Idiopathic noncirrhotic portal hypertension is a poorly defined clinical condition of unknown etiology. Patients present with signs and symptoms of portal hypertension without evidence of cirrhosis. The disease course appears to be indolent and benign with an overall better outcome than cirrhosis, as long as the complications of portal hypertension are properly managed. This condition has been recognized in different parts of the world in diverse ethnic groups with variable risk factors, resulting in numerous terminologies and lack of standardized diagnostic criteria. Therefore, although the diagnosis of idiopathic noncirrhotic portal hypertension requires clinical exclusion of other conditions that can cause portal hypertension and histopathologic confirmation, this entity is under-recognized clinically as well as pathologically. Recent studies have demonstrated that variable histopathologic entities with different terms likely represent a histologic spectrum of a single entity of which obliterative portal venopathy might be an underlying pathogenesis. This perception calls for standardization of the nomenclature and formulation of widely accepted diagnostic criteria, which will facilitate easier recognition of this disorder and will highlight awareness of this entity. PMID:26563701

  18. Interest in the Use of Computerized Patient Portals: Role of the Provider–Patient Relationship

    PubMed Central

    Hess, Rachel; Bryce, Cindy L.; McTigue, Kathleen; Olshansky, Ellen; Fitzgerald, Katharine; Fischer, Gary S.

    2007-01-01

    Background Bioinformatics experts are developing interactive patient portals to help those living with diabetes and other chronic diseases to better manage their conditions. However, little is known about what influences patients’ desires to use this technology. Objective To discern the impact of the provider–patient relationship on interest in using a web-based patient portal. Design Qualitative analysis of focus groups. Participants Ten focus groups involving 39 patients (range 2–7) recruited from four primary care practices. Approach A qualitative approach was used, which involved reading transcribed texts until a consensus was reached on data interpretation. An intercoder reliability kappa score (0.89) was determined by comparing the provider–patient relationship talk selected by the two coders. A conceptual framework was developed, which involved the development and refinement of a codebook and the application of it to the transcripts. Results Interest in the portal was linked to dissatisfaction with the provider–patient relationship, including dissatisfaction with provider communication/responsiveness, the inability to obtain medical information, and logistical problems with the office. Disinterest in the portal was linked to satisfaction with the provider–patient relationship, including provider communication/responsiveness, difficulty in using the portal, and fear of losing relationships and e-mail contact with the provider. No patient identified encrypted e-mail communication through the portal as an advantage. Conclusions Promoting the use of computerized portals requires patient-based adaptations. These should include ease of use, direct provider e-mail, and reassurances that access and interpersonal relationships will not be lost. Education is needed about privacy concerns regarding traditional e-mail communication. PMID:18095039

  19. A new ICPP portal monitor

    NASA Astrophysics Data System (ADS)

    Georgeson, M. A.; Nichols, C. E.

    1981-04-01

    Low levels of beta and/or gamma contamination as well as gram quantities of special nuclear materials can be detected by a portal-mounted monitor even though the monitor is located in the presence of varying background levels of radiation. The detector consists of 14 area-wide gas proportional detectors, an occupancy monitor, an electronic system for signal and alarm logic, and support hardware. Each of the 14-15.3 and 35.6 cm propane purged detectors has a two to five mg/sq cm mylar cover and each detector has a total sensitive area of 450 sq cm. Six separate signal alarm and logic channels detect the presence of radioactivity and indicate whether the radiation is coming from the head, top right body, top left body, lower right body, lower left body, or the feet area, making it easier to locate the source and minimize personnel delay. The swinging door design of the monitor is such that anyone passing through must come into close proximity of the detectors and is slowed enough to allow for a meaningful scan without causing inordinate delays.

  20. The ENSEMBLES Statistical Downscaling Portal

    NASA Astrophysics Data System (ADS)

    Cofino, Antonio S.; San-Martín, Daniel; Gutiérrez, Jose M.

    2010-05-01

    The demand for high-resolution seasonal and ACC predictions is continuously increasing due to the multiple end-user applications in a variety of sectors (hydrology, agronomy, energy, etc.) which require regional meteorological inputs. To fill the gap between the coarse-resolution grids used by global weather models and the regional needs of applications, a number of statistical downscaling techniques have been proposed. Statistical downscaling is a complex multi-disciplinary problem which requires a cascade of different scientific tools to access and process different sources of data, from GCM outputs to local observations and to run complex statistical algorithms. Thus, an end-to-end approach is needed in order to link the outputs of the ensemble prediction systems to a range of impact applications. To accomplish this task in an interactive and user-friendly form, a Web portal has been developed within the European ENSEMBLES project, integrating the necessary tools and providing the appropriate technology for distributed data access and computing. In this form, users can obtain their downscaled data testing and validating different statistical methods (from the categories weather typing, regression or weather generators) in a transparent form, not worrying about the details of the downscaling techniques and the data formats and access.

  1. Photonic dark matter portal revisited

    NASA Astrophysics Data System (ADS)

    Alavi, S. A.; Kazemian, F. S.

    2016-05-01

    In our previous paper, we studied a model of dark matter (DM) in which the hidden sector interacts with standard model particles via a hidden photonic portal (HP). We investigated the effects of this new interaction on the hydrogen atom and obtained an upper bound for the coupling of the model as f ≤ 10-12. In this work, we study the effects of HP on two interesting exotic atoms namely muonium and positronium. We obtain a tighter upper limit on the coupling as f ≤ 10-13. We also calculate the change (shift) in the Aharonov-Bohm phase due to HP and find that the phase shift is negligibly small (for DM particles mass in the GeV range). Recently a 3.5 keV X-ray line signal observed in the spectrum of 73 galaxy clusters, reported by the XXM-Newton X-ray observatory. Since in HP model the DM particles can decay directly into photons, so we finally calculate the value of the coupling constant f using the condition ΔEDM = 3.5 keV.

  2. Evaluation of a flowchart-based EHR query system: a case study of RetroGuide

    PubMed Central

    Huser, Vojtech; Narus, Scott P.; Rocha, Roberto A.

    2010-01-01

    Provision of query systems which are intuitive for non-experts has been recognized as an important informatics challenge. We developed a prototype of a flowchart-based analytical framework called RetroGuide that enables non-experts to formulate query tasks using a step-based, patient-centered paradigm inspired by workflow technology. We present results of the evaluation of RetroGuide in comparison to Structured Query Language (SQL) in laboratory settings using a mixed method design. We asked 18 human subjects with limited database experience to solve query tasks in RetroGuide and SQL, and quantitatively compared their test scores. A follow-up questionnaire was designed to compare both technologies qualitatively and investigate RetroGuide technology acceptance. The quantitative comparison of test scores showed that the study subjects achieved significantly higher scores using the RetroGuide technology. Qualitative study results indicated that 94% of subjects preferred RetroGuide to SQL because RetroGuide was easier to learn, it better supported temporal tasks, and it seemed to be a more logical modeling paradigm. Additional qualitative evaluation results, based on a technology acceptance model, suggested that a fully developed RetroGuide-like technology would be well accepted by users. Our study is an example of a structure validation study of a prototype query system, results of which provided significant guidance in further development of a novel query paradigm for EHR data. We discuss the strengths and weakness of our study design and results, and their implication for future evaluations of query systems in general. PMID:19560553

  3. Anterolateral Portal Is Less Painful than Superolateral Portal in Knee Intra-Articular Injection

    PubMed Central

    Lee, Sung Yup; GN, Kiran Kumar; Chung, Byung June; Lee, Sang Wook

    2015-01-01

    Purpose Intra-articular knee injections are commonly performed in clinical practice for treating various knee joint disorders such as osteoarthritis and rheumatoid arthritis. When selecting the portal for injection, not only intra-articular needle accuracy but also procedural pain should be taken into consideration. The purpose of this study was to determine whether injection through anterolateral portal provokes less pain and provides better pain relief compared to superolateral portal. Materials and Methods A total of 60 patients with primary osteoarthritis of the knee receiving intra-articular injections were randomized into 2 groups according to the type of portal approach; anterolateral or superolateral. All patients received hyaluronic acid (20 mg) and triamcinolone (40 mg) as the first injection followed by second and third injections of hyaluronic acid on a weekly basis. Underlying knee pain, procedural pain, and knee pain at 4 weeks were evaluated using visual analogue scale (VAS). Results Injection through anterolateral portal provoked less pain (VAS, 1.5±1.3) than the superolateral portal (VAS, 1.5 vs. 2.7; p=0.004). No differences were found in the degree of pain relief at weeks between the two groups (p=0.517). Conclusions We recommend the use of anterolateral portal for intra-articular knee injection as it provokes less pain and comparably short-term pain relief than the superolateral portal. PMID:26676089

  4. Portal of medical data models: information infrastructure for medical research and healthcare

    PubMed Central

    Dugas, Martin; Neuhaus, Philipp; Meidt, Alexandra; Doods, Justin; Storck, Michael; Bruland, Philipp; Varghese, Julian

    2016-01-01

    with semantic annotation and better information exchange between information systems, in particular Electronic Data Capture (EDC) and Electronic Health Records (EHR) systems. Contents of the MDM portal need to be further expanded to reach broad coverage of all relevant medical domains. Database URL: https://medical-data-models.org PMID:26868052

  5. Using the NASA Giovanni DICCE Portal to Investigate Land-Ocean Linkages with Satellite and Model Data

    NASA Technical Reports Server (NTRS)

    Acker, James G.; Zalles, Daniel; Krumhansl, Ruth

    2012-01-01

    Data-enhanced Investigations for Climate Change Education (DICCE), a NASA climate change education project, employs the NASA Giovanni data system to enable teachers to create climate-related classroom projects using selected satellite and assimilated model data. The easy-to-use DICCE Giovanni portal (DICCE-G) provides data parameters relevant to oceanic, terrestrial, and atmospheric processes. Participants will explore land-ocean linkages using the available data in the DICCE-G portal, in particular focusing on temperature, ocean biology, and precipitation variability related to El Ni?o and La Ni?a events. The demonstration includes the enhanced information for educators developed for the DICCE-G portal. The prototype DICCE Learning Environment (DICCE-LE) for classroom project development will also be demonstrated.

  6. The MISTRALS programme data portal

    NASA Astrophysics Data System (ADS)

    Fleury, Laurence; Brissebrat, Guillaume; Belmahfoud, Nizar; Boichard, Jean-Luc; Brosolo, Laetitia; Cloché, Sophie; Descloitres, Jacques; Ferré, Hélène; Focsa, Loredana; Henriot, Nicolas; Labatut, Laurent; Mière, Arnaud; Petit de la Villéon, Loïc; Ramage, Karim; Schmechtig, Catherine; Vermeulen, Anne; André, François

    2015-04-01

    different file formats and data processing tools. The MISTRALS data portal - http://mistrals.sedoo.fr/ - has been designed and developed as a unified tool for sharing scientific data in spite of many sources of heterogeneity, and for fostering collaboration between research communities. The metadata (data description) are standardized and comply with international standards (ISO 19115-19139; INSPIRE European Directive; Global Change Master Directory Thesaurus). A search tool allows to browse the catalog by keyword or multicriteria selection (area, period, physical property...) and to access data. Data sets managed by different data centres (ICARE, IPSL, SEDOO, CORIOLIS) are available through interoperability protocols (OPeNDAP, xml requests...) or archive synchronisation. Every in situ data set is available in the native format, but the most commonly used data sets have been homogenized (property names, units, quality flags...) and inserted in a relational database, in order to enable accurate data selection, and download of different data sets in a shared format. At present the MISTRALS data portal enables to access about 550 datasets. It counts more than 600 registered users and about 100 data requests every month. The number of available datasets is increasing daily, due to the provision of campaign datasets (2012, 2013, 2014) by several projects. Every scientist is invited to browse the catalog, complete the online registration form and use MISTRALS data. Feel free to contact mistrals-contact@sedoo.fr for any question.

  7. The MISTRALS programme data portal

    NASA Astrophysics Data System (ADS)

    Brissebrat, Guillaume; Albert-Aguilar, Alexandre; Belmahfoud, Nizar; Cloché, Sophie; Darras, Sabine; Descloitres, Jacques; Ferré, Hélène; Fleury, Laurence; Focsa, Loredana; Henriot, Nicolas; Labatut, Laurent; Petit de la Villéon, Loïc; Ramage, Karim; Schmechtig, Catherine; Vermeulen, Anne

    2016-04-01

    different file formats and data processing tools. The MISTRALS data portal - http://mistrals.sedoo.fr/ - has been designed and developed as a unified tool for sharing scientific data in spite of many sources of heterogeneity, and for fostering collaboration between research communities. The metadata (data description) are standardized and comply with international standards (ISO 19115-19139; INSPIRE European Directive; Global Change Master Directory Thesaurus). A search tool allows to browse the catalog by keyword or multicriteria selection (area, period, physical property...) and to access data. Data sets managed by different data centres (ICARE, IPSL, SEDOO, CORIOLIS) are available through interoperability protocols (OPeNDAP, xml requests...) or archive synchronisation. Every in situ data set is available in the native format, but the most commonly used data sets have been homogenized (property names, units, quality flags...) and inserted in a relational database, in order to enable accurate data selection, and download of different data sets in a shared format. At present the MISTRALS data portal enables to access about 600 datasets. It counts more than 675 registered users and about 100 data requests every month. The number of available datasets is increasing daily, due to the provision of campaign datasets by several projects. Every scientist is invited to browse the catalog, complete the online registration form and use MISTRALS data. Feel free to contact mistrals-contact@sedoo.fr for any question.

  8. The MISTRALS programme data portal

    NASA Astrophysics Data System (ADS)

    Fleury, Laurence; Brissebrat, Guillaume; Belmahfoud, Nizar; Boichard, Jean-Luc; Brosolo, Laetitia; Cloché, Sophie; Descloitres, Jacques; Ferré, Hélène; Focsa, Loredana; Labatut, Laurent; Mastrorillo, Laurence; Mière, Arnaud; Petit de la Villéon, Loïc; Ramage, Karim; Schmechtig, Catherine

    2014-05-01

    different file formats and data processing tools. The MISTRALS data portal - http://mistrals.sedoo.fr/ - has been designed and developed as a unified tool to share scientific data in spite of many sources of heterogeneity, and to foster collaboration between research communities. The metadata (data description) are standardized and comply with international standards (ISO 19115-19139; INSPIRE European Directive; Global Change Master Directory Thesaurus). A search tool allows to browse the catalogue by keyword or by multicriteria selection (location, period, physical property...) and to access data. Data sets managed by different data centres (ICARE, IPSL, SEDOO, CORIOLIS) are available through interoperability protocols (OPeNDAP, xml requests...) or archive synchronisation. At present the MISTRALS data portal allows to access more than 400 datasets and counts more than 500 registered users. The number of available datasets is increasing daily, due to the provision of campaign datasets (2012, 2013) by several projects. Every in situ data set is available in the native format, but the favorite data sets have been homogenized (property names, units, quality flags...) and inserted in a relational database, in order to enable more accurate data selection, and download of different datasets in a shared format. Every scientist is invited to make use of the different MISTRALS tools and data. Do not hesitate to browse the catalogue and fill the online registration form. Feel free to contact mistrals-contact@sedoo.fr for any question.

  9. The GB/3D Type Fossils Online Web Portal

    NASA Astrophysics Data System (ADS)

    McCormick, T.; Howe, M. P.

    2013-12-01

    Fossils are the remains of once-living organisms that existed and played out their lives in 3-dimensional environments. The information content provided by a 3d representation of a fossil is much greater than that provided by a traditional photograph, and can grab the attention and imagination of the younger and older general public alike. The British Geological Survey has been leading a consortium of UK natural history museums including the Oxford University Museum of Natural History, the Sedgwick Museum Cambridge, the National Museum of Wales Cardiff, and a number of smaller regional British museums to construct a web portal giving access to metadata, high resolution images and interactive 3d models of type fossils from the UK. The web portal at www.3d-fossils.ac.uk was officially launched in August 2013. It can be used to discover metadata describing the provenance, taxonomy, and stratigraphy of the specimens. Zoom-able high resolution digital photographs are available, including for many specimens ';anaglyph' stereo images that can be viewed in 3d using red-cyan stereo spectacles. For many of the specimens interactive 3d models were generated by scanning with portable ';NextEngine 3D HD' 3d scanners. These models can be downloaded in zipped .OBJ and .PLY format from the web portal, or may be viewed and manipulated directly in certain web browsers. The images and scans may be freely downloaded subject to a Creative Commons Attribution ShareAlike Non-Commercial license. There is a simple application programming interface (API) allowing metadata to be downloaded, with links to the images and models, in a standardised format for use in data mash-ups and third party applications. The web portal also hosts ';open educational resources' explaining the process of fossilization and the importance of type specimens in taxonomy, as well as providing introductions to the most important fossil groups. We have experimented with using a 3d printer to create replicas of the

  10. Design and Testing of an EHR-Integrated, Busulfan Pharmacokinetic Decision Support Tool for the Point-of-Care Clinician

    PubMed Central

    Abdel-Rahman, Susan M.; Breitkreutz, Matthew L.; Bi, Charlie; Matzuka, Brett J.; Dalal, Jignesh; Casey, K. Leigh; Garg, Uttam; Winkle, Sara; Leeder, J. Steven; Breedlove, JeanAnn; Rivera, Brian

    2016-01-01

    Background: Busulfan demonstrates a narrow therapeutic index for which clinicians routinely employ therapeutic drug monitoring (TDM). However, operationalizing TDM can be fraught with inefficiency. We developed and tested software encoding a clinical decision support tool (DST) that is embedded into our electronic health record (EHR) and designed to streamline the TDM process for our oncology partners. Methods: Our development strategy was modeled based on the features associated with successful DSTs. An initial Requirements Analysis was performed to characterize tasks, information flow, user needs, and system requirements to enable push/pull from the EHR. Back-end development was coded based on the algorithm used when manually performing busulfan TDM. The code was independently validated in MATLAB using 10,000 simulated patient profiles. A 296-item heuristic checklist was used to guide design of the front-end user interface. Content experts and end-users (n = 28) were recruited to participate in traditional usability testing under an IRB approved protocol. Results: Decision support software was developed to systematically walk the point-of-care clinician through the TDM process. The system is accessed through the EHR which transparently imports all of the requisite patient data. Data are visually inspected and then curve fit using a model-dependent approach. Quantitative goodness-of-fit are converted to single tachometer where “green” alerts the user that the model is strong, “yellow” signals caution and “red” indicates that there may be a problem with the fitting. Override features are embedded to permit application of a model-independent approach where appropriate. Simulations are performed to target a desired exposure or dose as entered by the clinician and the DST pushes the user approved recommendation back into the EHR. Usability testers were highly satisfied with our DST and quickly became proficient with the software. Conclusions: With early

  11. 2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications. Final rule.

    PubMed

    2015-10-16

    This final rule finalizes a new edition of certification criteria (the 2015 Edition health IT certification criteria or "2015 Edition'') and a new 2015 Edition Base Electronic Health Record (EHR) definition, while also modifying the ONC Health IT Certification Program to make it open and accessible to more types of health IT and health IT that supports various care and practice settings. The 2015 Edition establishes the capabilities and specifies the related standards and implementation specifications that Certified Electronic Health Record Technology (CEHRT) would need to include to, at a minimum, support the achievement of meaningful use by eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) under the Medicare and Medicaid EHR Incentive Programs (EHR Incentive Programs) when such edition is required for use under these programs. PMID:26477063

  12. Factors influencing nursing students' acceptance of electronic health records for nursing education (EHRNE) software program.

    PubMed

    Kowitlawakul, Yanika; Chan, Sally Wai Chi; Pulcini, Joyce; Wang, Wenru

    2015-01-01

    The Institute of Medicine (IOM) and the Health Information Technology Act (2009) in America had recommended that electronic health records (EHRs) should be fully adopted by 2014. This has urged educational institutions to prepare healthcare professionals to be competent in using electronic health records (EHRs) while they are in schools. To equip nursing students with competency in using EHRs, an electronic health record for nursing education (EHRNE) has been developed and integrated it into nursing curricula. The purposes of the study were to investigate the factors influencing nursing students' acceptance of the EHRs in nursing education using the extended Technology Acceptance Model with self-efficacy as a conceptual framework. The study is a descriptive study design using self-reported questionnaires with 212 student participants. The IBM SPSS and AMOS 22.0 were used to analyze the data. The results showed that attitude toward using the EHRNE was the most influential factor on students' acceptance. The preliminary findings suggested that to enhance the students' acceptance of the EHRNE, cultivation of a positive attitude toward using this EHR as well as increasing the perceived usefulness is very important. Also, the study's framework could be used in guiding learning health informatics and be applied to nursing students. PMID:24947068

  13. Disparities in registration and use of an online patient portal among older adults: findings from the LitCog cohort

    PubMed Central

    Smith, Samuel G; O’Conor, Rachel; Aitken, William; Curtis, Laura M; Goel, Mita Sanghavi

    2015-01-01

    Objective To document disparities in registration and use of an online patient portal among older adults. Materials and methods Data from 534 older adults were linked with information from the Northwestern Medicine Electronic Data Warehouse on patient portal registration and use of functions (secure messaging, prescription reauthorizations, checking test results, and monitoring vital statistics). Age, gender, race, education, self-reported chronic conditions, and the Newest Vital Sign health literacy measure were available from cohort data. Results Most patients (93.4%) had a patient portal access code generated for them, and among these 57.5% registered their accounts. In multivariable analyses, White patients (P < .001) and college graduates were more likely to have registered their patient portal (P = .015). Patients with marginal (P = .034) or adequate (P < .001) health literacy were also more likely to have registered their patient portal. Among those registering their accounts, most had messaged their physician (90%), checked a test result (96%), and ordered a reauthorization (55%), but few monitored their vital statistics (11%). Adequate health literacy patients were more likely to have used the messaging function (P = .003) and White patients were more likely to have accessed test results (P = .004). Higher education was consistently associated with prescription reauthorization requests (all P < .05). Discussion Among older American adults, there are stark health literacy, educational, and racial disparities in the registration, and subsequent use of an online patient portal. These population sub-group differences may exacerbate existing health disparities. Conclusions If patient portals are implemented, intervention strategies are needed to monitor and reduce disparities in their use. PMID:25914099

  14. Pancreatic Adenocarcinoma Complicated by Sinistral Portal Hypertension

    PubMed Central

    Kaley, Kristin; Lamb, Lynne

    2016-01-01

    Pancreatic cancer is known for vague symptoms that lead to a delay in diagnosis, and hence most cases are found at an advanced stage. Many complications can happen secondary to pancreatic cancer including diabetes, malabsorption, and deep venous thrombosis. Sinistral (segmental or left-sided) portal hypertension (SPH) refers to portal hypertension confined to the left-sided segment of the portal venous system namely the splenic side, and the most common etiology is splenic vein thrombosis (SVT). We present here a case of a 66-year-old male with advanced pancreatic cancer who died due to bleeding secondary to SVT. We advise physicians caring for these patients to be aware of this complication, which may also be the manifestation of an undiagnosed pancreatic cancer. PMID:27555987

  15. Spontaneous Resolution of Portal Vein Thrombosis

    PubMed Central

    Banumukala, Vishnu; Babu, Adarsh

    2008-01-01

    A 56-year-old male was admitted with symptoms of belching, abdominal pain and weight loss of 2 weeks duration. Examination revealed hepatosplenomegaly which was confirmed by computed tomography (CT). CT images also revealed filling defects in the portal vein and intrahepatic branches consistent with thrombosis and hepatosplenic infarcts. Alkaline phosphatase was elevated at 688 units, all other investigations, including full blood count, coagulation screen and tumour markers, were normal. Magnetic resonance cholangiopancreatography did not reveal any mass in the porta hepatis. Upper gastrointestinal endoscopy and colonoscopy were normal. Liver biopsy was normal and did not reveal any evidence of lymphoma. The raised alkaline phosphatase settled to reference range over a period of 3 weeks. Thrombophilia screen was negative. Contrast CT of the abdomen performed after 4 weeks displayed revascularisation of the previously thrombosed portal vein and intrahepatic branches. The patient has remained asymptomatic since and we note spontaneous recanalisation of the previously occluded portal vein. PMID:21490872

  16. Spontaneous resolution of portal vein thrombosis.

    PubMed

    Banumukala, Vishnu; Babu, Adarsh

    2008-01-01

    A 56-year-old male was admitted with symptoms of belching, abdominal pain and weight loss of 2 weeks duration. Examination revealed hepatosplenomegaly which was confirmed by computed tomography (CT). CT images also revealed filling defects in the portal vein and intrahepatic branches consistent with thrombosis and hepatosplenic infarcts. Alkaline phosphatase was elevated at 688 units, all other investigations, including full blood count, coagulation screen and tumour markers, were normal. Magnetic resonance cholangiopancreatography did not reveal any mass in the porta hepatis. Upper gastrointestinal endoscopy and colonoscopy were normal. Liver biopsy was normal and did not reveal any evidence of lymphoma. The raised alkaline phosphatase settled to reference range over a period of 3 weeks. Thrombophilia screen was negative. Contrast CT of the abdomen performed after 4 weeks displayed revascularisation of the previously thrombosed portal vein and intrahepatic branches. The patient has remained asymptomatic since and we note spontaneous recanalisation of the previously occluded portal vein. PMID:21490872

  17. Unifying access to services: ESO's user portal

    NASA Astrophysics Data System (ADS)

    Chavan, A. M.; Tacconi-Garman, L. E.; Peron, M.; Sogni, F.; Canavan, T.; Nass, P.

    2006-06-01

    The European Southern Observatory (ESO) is in the process of creating a central access point for all services offered to its user community via the Web. That gateway, called the User Portal, will provide registered users with a personalized set of service access points, the actual set depending on each user's privileges. Correspondence between users and ESO will take place by way of "profiles", that is, contact information. Each user may have several active profiles, so that an investigator may choose, for instance, whether their data should be delivered to their own address or to a collaborator. To application developers, the portal will offer authentication and authorization services, either via database queries or an LDAP server. The User Portal is being developed as a Web application using Java-based technology, including servlets and JSPs.

  18. Portal hypertension and ascites in extramedullary hematopoiesis.

    PubMed

    Amarapurkar, Pooja; Parekh, Sunil; Amarapurkar, Anjali; Amarapurkar, Deepak

    2012-06-01

    Myeloproliferative diseases (MPD) are clonal stem cell disorders which mainly include polycythemia vera (PV), essential thrombocythemia (ET), and idiopathic myelofibrosis (IMF). They are characterized by leucocytosis, thrombocytosis, erythrocytosis, splenomegaly, and bone marrow hypercellularity. This might also result in extramedullary hematopoiesis. Abdominal manifestation has been recognized as a feature of these disorders. Splenomegaly and hepatomegaly are fairly common as opposed to ascites which is rare. The MPDs mainly affect the hepatic circulatory systems. The common hepatic manifestations are Budd-Chiari syndrome (BCS), portal vein thrombosis (PVT), and nodular regenerative hyperplasia. A few other features seen in MPDs are caused by extramedullary hematopoiesis, increased hepatic blood flow, and secondary hemosiderosis from multiple blood transfusions. Portal hypertension is found in up to 7% of patients. We report a case of portal hypertension with ascites in a patient with extramedullary hematopoiesis treated with transjugular intrahepatic portocaval shunt (TIPS). PMID:25755427

  19. Best Practices for Building Web Data Portals

    NASA Astrophysics Data System (ADS)

    Anderson, R. A.; Drew, L.

    2013-12-01

    With a data archive of more than 1.5 petabytes and a key role as the NASA Distributed Active Archive Center (DAAC) for synthetic aperture radar (SAR) data, the Alaska Satellite Facility (ASF) has an imperative to develop effective Web data portals. As part of continuous enhancement and expansion of its website, ASF recently created two data portals for distribution of SAR data: one for the archiving and distribution of NASA's MEaSUREs Wetlands project and one for newly digitally processed data from NASA's 1978 Seasat satellite. These case studies informed ASF's development of the following set of best practices for developing Web data portals. 1) Maintain well-organized, quality data. This is fundamental. If data are poorly organized or contain errors, credibility is lost and the data will not be used. 2) Match data to likely data uses. 3) Identify audiences in as much detail as possible. ASF DAAC's Seasat and Wetlands portals target three groups of users: a) scientists already familiar with ASF DAAC's SAR archive and our data download tool, Vertex; b) scientists not familiar with SAR or ASF, but who can use the data for their research of oceans, sea ice, volcanoes, land deformation and other Earth sciences; c) audiences wishing to learn more about SAR and its use in Earth sciences. 4) Identify the heaviest data uses and the terms scientists search for online when trying to find data for those uses. 5) Create search engine optimized (SEO) Web content that corresponds to those searches. Because search engines do not yet search raw data, so Web data portals must include content that ties the data to its likely uses. 6) Create Web designs that best serves data users (user centered design), not for how the organization views itself or its data. Usability testing was conducted for the ASF DAAC Wetlands portal to improve the user experience. 7) Use SEO tips and techniques. The ASF DAAC Seasat portal used numerous SEO techniques, including social media, blogging

  20. [Effect of dopamine on the portal pressure].

    PubMed

    Benko, H; Peschl, L; Schüller, J; Neumayr, A

    1975-01-01

    1. An infusion of 3 gamma/kg/min dopamine causes a significant increase in the renal plasma flow and the glomerulum filtration rate. This dosage does not cause a change of the mean systolic and arterial pressure. This effect may also be observed in patients with hepatic cirrhosis. 2. The wedged hepatic vein pressure, an indicator for the portal pressure, only shows a slight increase (9,46 +/- 9,41%) as compared to the initial pressure produced by the mentioned dose. Measurements of the spleen pulpa pressure, which likewise indicates the portal pressure, showed an increase of pressure up to 100% due to pressing or coughing. 3. If in the case of bleeding oesophageal varices acute renal failure might develop, the advantage of the effect of dopamine in stimulating the blood flow through the kidneys may be considered more important than the minute danger of a slight increase of the portal pressure, which might provoke haemorrhage. PMID:1220517

  1. NORTH PORTAL OF VIADUCT WHERE IT MERGES WITH AURORA AVENUE; ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    NORTH PORTAL OF VIADUCT WHERE IT MERGES WITH AURORA AVENUE; DENNY PARK AT TOP MIDDLE OF PICTURE. TOP OF PORTAL INTERSECTS WITH SEVENTH AVENUE ON THE DIAGONAL. - Alaskan Way Viaduct and Battery Street Tunnel, Seattle, King County, WA

  2. 13. Detail, connection point of end post, top chord, portal ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. Detail, connection point of end post, top chord, portal strut, and tension members at upstream side of west portal, view to northwest. - Dry Creek Bridge, Spanning Dry Creek at Cook Road, Ione, Amador County, CA

  3. 340. Caltrans, Photographer October 14, 1935 "TUNNEL WEST PORTAL"; ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    340. Caltrans, Photographer October 14, 1935 "TUNNEL - WEST PORTAL"; VIEW OF TUNNEL - WEST PORTAL' UNDER CONSTRUCTION SHOWING EXCAVATION OF TUNNEL AFTER POUR. 5-1669 - San Francisco Oakland Bay Bridge, Spanning San Francisco Bay, San Francisco, San Francisco County, CA

  4. Ultrasonographic diagnosis of unusual portal vascular abnormalities in two cats.

    PubMed

    McConnell, J F; Sparkes, A H; Ladlow, J; Doust, R; Davies, S

    2006-06-01

    Two cases of ascites secondary to portal vascular abnormalities associated with portal hypertension are described. In the first case a five-month-old cat was presented with recurrent ascites and investigations showed that the underlying cause was a hepatic arteriovenous fistula. Ultrasonography showed direct communication of the coeliac artery and right branch of the portal vein. There was also hepatofugal flow in the main portal vein consistent with portal hypertension. The ultrasonographic features were similar to those seen in dogs with hepatic arteriovenous fistulae. In the second case, ascites, portal hypertension and an intraluminal mass in the main portal vein was diagnosed in a 16-year-old cat that had been presented with hyperthyroidism and hepatomegaly. Acquired portosystemic collaterals involving the left renal vein were present. Additional diagnostic investigations were not permitted. Ultrasonography was useful in both cases to document portal hypertension and the underlying cause. PMID:16761986

  5. 43. VIEW OF THE RAMP ABOVE LOWER PORTAL AND RAMP, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    43. VIEW OF THE RAMP ABOVE LOWER PORTAL AND RAMP, LOOKING NORTHWEST. THE RAMP WAS USED TO GUIDE RUN-OFF FROM THUNDERSTORMS AWAY FROM THE PORTAL. - Independent Coal & Coke Company, Kenilworth, Carbon County, UT

  6. Application of the smart portal in transportation

    NASA Astrophysics Data System (ADS)

    Kercel, Stephen W.; Baylor, Vivian M.; Dress, William B.; Hickerson, Tim W.; Jatko, William B.; Labaj, Leo E.; Muhs, Jeffrey D.; Pack, Richard M.

    1997-02-01

    Under a program sponsored by the Department of Energy, the Oak Ridge complex is developing a `Portal-of-the-Future', or `smart portal.' This is a security portal for vehicular traffic which is intended to quickly detect explosives, hidden passengers, etc. It uses several technologies, including microwaves, weigh-in-motion, digital image processing, and electroacoustic wavelet-based heartbeat detection. A novel component of particular interest is the Enclosed Space Detection System (ESDS), which detects the presence of persons hiding in a vehicle. The system operates by detecting the presence of a human ballistocardiographic signature. Each time the heart beats, it generates a small but measurable shock wave that propagates through the body. The wave, whose graph is called a ballistocardiogram, is the mechanical analog of the electrocardiograms, which is routinely used for medical diagnosis. The wave is, in turn, coupled to any surface or object with which the body is in contact. If the body is located in an enclosed space, this will result in a measurable deflection of the surface of the enclosure. Independent testing has shown ESDS to be highly reliable. The technologies used in the smart portal operate in real time and allow vehicles to be checked through the portal in much less time than would be required for human inspection. Although not originally developed for commercial transportation, the smart portal has the potential to solve several transportation problems. It could relieve congestion at international highway border crossings by reducing the time required to inspect each vehicle while increasing the level of security. It can reduce highway congestion at the entrance of secure facilities such as prisons. Also, it could provide security at intermodal transfer points, such as airport parking lots and car ferry terminals.

  7. Application of the smart portal in transportation

    SciTech Connect

    Kercel, S.W.; Baylor, V.M.; Dress, W.B.; Hickerson, T.W.; Jatko, W.B.; Labaj, L.E.; Muhs, J.D.; Pack, R.M.

    1996-12-31

    Under a program sponsored by the Department of Energy, the Oak Ridge complex is developed a ``Portal-of-the-Future``, or ``smart portal``. This is a security portal for vehicular traffic which is intended to quickly detect explosives, hidden passengers, etc. It uses several technologies, including microwaves, weigh-in-motion, digital image processing, and electroacoustic wavelet-based heartbeat detection. A novel component of particular interest is the Enclosed Space Detection System (ESDS), which detects the presence of persons hiding in a vehicle. The system operates by detecting the presence of a human ballistocardiographic signature. Each time the heart beats, it generates a small but measurable shock wave that propagates through the body. The wave, whose graph is called a ballistocardiogram, is the mechanical analog of the electrocardiogram, which is routinely used for medical diagnosis. The wave is, in turn, coupled to any surface or object with which the body is in contact. If the body is located in an enclosed space, this will result in a measurable deflection of the surface of the enclosure. Independent testing has shown ESDS to be highly reliable. The technologies used in the smart portal operate in real time and allow vehicles to be checked through the portal in much less time than would be required for human inspection. Although not originally developed for commercial transportation, the smart portal has the potential to solve several transportation problems. It could relieve congestion at international highway border crossings by reducing the time required to inspect each vehicle while increasing the level of security. It can reduce highway congestion at the entrance of secure facilities such as prisons. Also, it could provide security at intermodal transfer points, such as airport parking lots and car ferry terminals.

  8. The CeDRES data portal

    NASA Astrophysics Data System (ADS)

    Albert-Aguilar, Alexandre; Delmotte, Pauline; André, François; Brissebrat, Guillaume; Canonici, Jean-Christophe; Piguet, Bruno

    2016-04-01

    SAFIRE is the French facility dedicated to airborne measurement for environmental research. The SAFIRE steering committee decided that access to its archives should be improved. If certain data, including recent campaigns, are available online, access to them is difficult for users because these data are dispersed in as many data portals as campaigns. Most of projects are not able to keep medium to long term online access to their database. Therefore, many airborne data, particularly the oldest, are not available online, stored on media whose sustainability is not guaranteed. SAFIRE also decided to identify old data stored in Meudon (France) on paper and hard media and to rescue with the help of an archivist. At the same time, the development of a centralized digital archive - containing data collected with the Fokker - 27 " ARAT " and Merlin IV aircraft - associated to a web portal was given to SEDOO. The first part of the project consisted in modelling the database. The second part, still in progess, was the development of the CeDRES (Centre de Données aéRoportées & SAFIRE) portal (http://cedres.sedoo.fr) which is responsive and bilingual (French and English) ; and metadata standardization (iso 19115). The main objectives of this project are data preservation and open data access. A first test version of CeDRES portal will be release in mid-February 2016. And operational version is planned for summer 2016. In the future, CeDRES portal will be able to receive and to distribute metadata and data of aircraft currently in service (FALCON-20, ATR-42 and PiperAztec-23). The interoperability implementation and data homogenization are planned in the medium term. The CeDRES portal is part of the French atmospheric chemistry data center AERIS (http://www.aeris-data.fr). Every scientist is invited to browse the catalog and use CEDRES data. Feel free to contact cedres-contact@sedoo.fr for any question.

  9. Becoming a Learning Organization: New Directions in Science Education Research at the National Science Foundation

    ERIC Educational Resources Information Center

    Ramaley, Judith A.; Olds, Barbara M.; Earle, Janice

    2005-01-01

    The Education and Human Resources (EHR) Directorate at the National Science Foundation has been examining its role in supporting the development of new approaches to science, technology, engineering and mathematics (STEM) education. This article explores what it means to be scientifically literate, what it takes to become a learning organization,…

  10. Framework Development Supporting the Safety Portal

    SciTech Connect

    Prescott, Steven Ralph; Kvarfordt, Kellie Jean; Vang, Leng; Smith, Curtis Lee

    2015-07-01

    In a collaborating scientific research arena it is important to have an environment where analysts have access to a shared repository of information, documents, and software tools, and be able to accurately maintain and track historical changes in models. The new Safety Portal cloud-based environment will be accessible remotely from anywhere regardless of computing platforms given that the platform has available Internet access and proper browser capabilities. Information stored at this environment would be restricted based on user assigned credentials. This report discusses current development of a cloud-based web portal for PRA tools.

  11. The Benefits of a Formative Evaluation for Developing a Highly Innovative Software: The Case of the handoverEHR.

    PubMed

    Przysucha, Mareike; Flemming, Daniel; Hübner, Ursula

    2016-01-01

    Innovations are typically characterised by their relative newness for the user. In order for new eHealth applications to be accepted as innovations more criteria were proposed including "use" and "usability". The handoverEHR is a new approach that allows the user to translate the essentials of a clinical case into a graphical representation, the so-called cognitive map of the patient. This study aimed at testing the software usability. A convenience sample of 23 experienced nurses from different healthcare organisations across the country rated the usability of the handoverEHR after performing typical handover tasks. All usability scales of the IsoMetricsL questionnaire showed positive values (4 "I agree") with the exception of "error tolerance" (3 "neutral statement"). A significant improvement was found in self-descriptiveness as compared to an initial usability testing prior to this study. Different subgroups of users tended to rate the usability of the system differently. This study demonstrated the benefits of formative evaluations in terms of improving the usability of an entirely new approach. It thus helps to transform a novel piece of software towards becoming a real innovation. Our findings also hint at the importance of user characteristics that could affect the usability ratings. PMID:27577458

  12. Portal Hypertension Secondary to Spontaneous Arterio-Portal Venous Fistulas: Transcatheter Arterial Embolization with n-Butyl Cyanoacrylate and Microcoils

    SciTech Connect

    Yamagami, Takuji; Nakamura, Toshiyuki; Nishimura, Tsunehiko

    2000-09-15

    We report a 73-year-old man with recurrent variceal bleeding due to portal hypertension caused by multiple intrahepatic arterio-portal venous fistulas, which were successfully occluded by embolization with n-butyl cyanoacrylate and micro-coils.

  13. User Needs of Digital Service Web Portals: A Case Study

    ERIC Educational Resources Information Center

    Heo, Misook; Song, Jung-Sook; Seol, Moon-Won

    2013-01-01

    The authors examined the needs of digital information service web portal users. More specifically, the needs of Korean cultural portal users were examined as a case study. The conceptual framework of a web-based portal is that it is a complex, web-based service application with characteristics of information systems and service agents. In…

  14. 29 CFR 790.5 - Effect of Portal-to-Portal Act on determination of hours worked.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... or a part of this travel, or if there is a custom or practice to the same effect of the kind... 29 Labor 3 2010-07-01 2010-07-01 false Effect of Portal-to-Portal Act on determination of hours... GENERAL STATEMENT AS TO THE EFFECT OF THE PORTAL-TO-PORTAL ACT OF 1947 ON THE FAIR LABOR STANDARDS ACT...

  15. Nitroglycerine effects on portal vein mechanics and oxidative stress in portal hypertension

    PubMed Central

    Vujanac, Andreja; Jakovljevic, Vladimir; Djordjevic, Dusica; Zivkovic, Vladimir; Stojkovic, Mirjana; Celikovic, Dragan; Andjelkovic, Nebojsa; Skevin, Aleksandra Jurisic; Djuric, Dragan

    2012-01-01

    AIM: Тo examine the effects of nitroglycerine on portal vein haemodynamics and oxidative stress in patients with portal hypertension. METHODS: Thirty healthy controls and 39 patients with clinically verified portal hypertension and increased vascular resistance participated in the study. Liver diameters, portal diameters and portal flow velocities were recorded using color flow imaging/pulsed Doppler detection. Cross-section area, portal flow and index of vascular resistance were calculated. In collected blood samples, superoxide anion radical (O2-), hydrogen peroxide (H2O2), index of lipid peroxidation (measured as TBARS) and nitric oxide (NO) as a marker of endothelial response (measured as nitrite-NO2-) were determined. Time-dependent analysis was performed at basal state and in 10th and 15th min after nitroglycerine (sublingual 0.5 mg) administration. RESULTS: Oxidative stress parameters changed significantly during the study. H2O2 decreased at the end of study, probably via O2- mediated disassembling in Haber Weiss and Fenton reaction; O2- increased significantly probably due to increased diameter and tension and decreased shear rate level. Consequently O2- and H2O2 degradation products, like hydroxyl radical, initiated lipid peroxidation. Increased blood flow was to some extent lower in patients than in controls due to double paradoxes, flow velocity decreased, shear rate decreased significantly indicating non Newtonian characteristics of portal blood flow. CONCLUSION: This pilot study could be a starting point for further investigation and possible implementation of some antioxidants in the treatment of portal hypertension. PMID:22294839

  16. Collaboration Portals for NASA's Airborne Field Campaigns

    NASA Technical Reports Server (NTRS)

    Conover, Helen; Kulkami, Ajinkya; Garrett, Michele; Goodman, Michael; Peterson, Walter Arthur; Drewry, Marilyn; Hardin, Danny M.; He, Matt

    2011-01-01

    The University of Alabama in Huntsville (UAH), in collaboration with the Global Hydrology Resource Center, a NASA Earth Science Data Center, has provided information management for a number of NASA Airborne Field campaigns, both hurricane science investigations and satellite instrument validation. Effective field campaign management requires communication and coordination tools, including utilities for personnel to upload and share flight plans, weather forecasts, a variety of mission reports, preliminary science data, and personal photos. Beginning with the Genesis and Rapid Intensification Processes (GRIP) hurricane field campaign in 2010, we have provided these capabilities via a Drupal-based collaboration portal. This portal was reused and modified for the Midlatitude Continental Convective Clouds Experiment (MC3E), part of the Global Precipitation Measurement mission ground validation program. An end goal of these development efforts is the creation of a Drupal profile for field campaign management. This presentation will discuss experiences with Drupal in developing and using these collaboration portals. Topics will include Drupal modules used, advantages and disadvantages of working with Drupal in this context, and how the science teams used the portals in comparison with other communication and collaboration tools.

  17. Collaboration Portals for NASA's Airborne Field Campaigns

    NASA Astrophysics Data System (ADS)

    Conover, H.; Kulkarni, A.; Garrett, M.; Goodman, M.; Petersen, W. A.; Drewry, M.; Hardin, D. M.; He, M.

    2011-12-01

    The University of Alabama in Huntsville (UAH), in collaboration with the Global Hydrology Resource Center, a NASA Earth Science Data Center, has provided information management for a number of NASA Airborne Field campaigns, both hurricane science investigations and satellite instrument validation. Effective field campaign management requires communication and coordination tools, including utilities for personnel to upload and share flight plans, weather forecasts, a variety of mission reports, preliminary science data, and personal photos. Beginning with the Genesis and Rapid Intensification Processes (GRIP) hurricane field campaign in 2010, we have provided these capabilities via a Drupal-based collaboration portal. This portal was reused and modified for the Midlatitude Continental Convective Clouds Experiment (MC3E), part of the Global Precipitation Measurement mission ground validation program. An end goal of these development efforts is the creation of a Drupal profile for field campaign management. This presentation will discuss experiences with Drupal in developing and using these collaboration portals. Topics will include Drupal modules used, advantages and disadvantages of working with Drupal in this context, and how the science teams used the portals in comparison with other communication and collaboration tools.

  18. Regulations.gov Federal Regulatory Portal

    ERIC Educational Resources Information Center

    Ashlin, John; Davis, Richard; Dalecky, Selene; Grasso, Richard; LaPlant, Lisa; Morales, Oscar; Nelson, Jennifer; White, Michael; Whitt, Sharon A.

    2004-01-01

    The Regulations.gov Online Rulemaking Project is 1 of the 24 e-Government Initiatives on the President's Management Agenda (PMA), which was announced by the White House in 2001. The Regulations.gov Web site is the central electronic rulemaking portal for the federal government. Through a single Web site, citizens can search, view, and comment on…

  19. Portal Schools Project, First Year Report.

    ERIC Educational Resources Information Center

    Lutonsky, Linda

    This document discusses the theory and philosophy of the Portal School strategy. According to the author, that strategy is a process for making an environment responsive to change; a way of providing a setting in which site, specific and locally determined programs, and theories can be adapted, implemented, and diffused; and a method for closing…

  20. Cross-Cultural Dimensions of Internet Portals.

    ERIC Educational Resources Information Center

    Zahir, Sajjad; Dobing, Brian; Hunter, M. Gordon

    2002-01-01

    Discussion of cultural influences on new technologies focuses on an analysis of full-service national Web portals from different countries that investigated whether the adoption of new technologies resulted in cultural convergence or divergence. Results showed differences in appearance and features offered that can be attributed to cultural…

  1. Opening the Portal to Better Relationships

    ERIC Educational Resources Information Center

    Ipri, Tom; Sell, James H.

    2005-01-01

    Integration of library services into the portal that Lasalle University recently implemented for the entire campus is described. In addition to learning the technical aspects was the need to inspire change in the communication culture of the university and to rethink how the library provides services.

  2. Liver surgery in cirrhosis and portal hypertension

    PubMed Central

    Hackl, Christina; Schlitt, Hans J; Renner, Philipp; Lang, Sven A

    2016-01-01

    The prevalence of hepatic cirrhosis in Europe and the United States, currently 250 patients per 100000 inhabitants, is steadily increasing. Thus, we observe a significant increase in patients with cirrhosis and portal hypertension needing liver resections for primary or metastatic lesions. However, extended liver resections in patients with underlying hepatic cirrhosis and portal hypertension still represent a medical challenge in regard to perioperative morbidity, surgical management and postoperative outcome. The Barcelona Clinic Liver Cancer classification recommends to restrict curative liver resections for hepatocellular carcinoma in cirrhotic patients to early tumor stages in patients with Child A cirrhosis not showing portal hypertension. However, during the last two decades, relevant improvements in preoperative diagnostic, perioperative hepatologic and intensive care management as well as in surgical techniques during hepatic resections have rendered even extended liver resections in higher-degree cirrhotic patients with portal hypertension possible. However, there are few standard indications for hepatic resections in cirrhotic patients and risk stratifications have to be performed in an interdisciplinary setting for each individual patient. We here review the indications, the preoperative risk-stratifications, the morbidity and the mortality of extended resections for primary and metastatic lesions in cirrhotic livers. Furthermore, we provide a review of literature on perioperative management in cirrhotic patients needing extrahepatic abdominal surgery and an overview of surgical options in the treatment of hepatic cirrhosis. PMID:26973411

  3. ExPASy: SIB bioinformatics resource portal

    PubMed Central

    Artimo, Panu; Jonnalagedda, Manohar; Arnold, Konstantin; Baratin, Delphine; Csardi, Gabor; de Castro, Edouard; Duvaud, Séverine; Flegel, Volker; Fortier, Arnaud; Gasteiger, Elisabeth; Grosdidier, Aurélien; Hernandez, Céline; Ioannidis, Vassilios; Kuznetsov, Dmitry; Liechti, Robin; Moretti, Sébastien; Mostaguir, Khaled; Redaschi, Nicole; Rossier, Grégoire; Xenarios, Ioannis; Stockinger, Heinz

    2012-01-01

    ExPASy (http://www.expasy.org) has worldwide reputation as one of the main bioinformatics resources for proteomics. It has now evolved, becoming an extensible and integrative portal accessing many scientific resources, databases and software tools in different areas of life sciences. Scientists can henceforth access seamlessly a wide range of resources in many different domains, such as proteomics, genomics, phylogeny/evolution, systems biology, population genetics, transcriptomics, etc. The individual resources (databases, web-based and downloadable software tools) are hosted in a ‘decentralized’ way by different groups of the SIB Swiss Institute of Bioinformatics and partner institutions. Specifically, a single web portal provides a common entry point to a wide range of resources developed and operated by different SIB groups and external institutions. The portal features a search function across ‘selected’ resources. Additionally, the availability and usage of resources are monitored. The portal is aimed for both expert users and people who are not familiar with a specific domain in life sciences. The new web interface provides, in particular, visual guidance for newcomers to ExPASy. PMID:22661580

  4. Measuring Problem Solving Skills in "Portal 2"

    ERIC Educational Resources Information Center

    Shute, Valerie J.; Wang, Lubin

    2013-01-01

    This paper examines possible improvement to problem solving skills as a function of playing the video game "Portal 2." Stealth assessment is used in the game to evaluate students' problem solving abilities--specifically basic and flexible rule application. The stealth assessment measures will be validated against commonly accepted…

  5. Children as Designers of Web Portals.

    ERIC Educational Resources Information Center

    Large, Andrew; Beheshti, Jamshid; Nesset, Valerie; Bowler, Leanne

    2003-01-01

    Describes the process undertaken by a design team comprising both elementary school students and researchers to design a Web portal intended for use by children. The approach adopted by the team was based upon several design theories related to usability studies: contextual inquiry, participatory design, and cooperative inquiry. Presents…

  6. Usefulness of the Medial Portal during Hip Arthroscopy

    PubMed Central

    Kang, Chan; Hwang, Jung-Mo; Park, Eugene J.

    2015-01-01

    The current conventional portals for hip arthroscopic surgery are the anterior, anterolateral, and posterolateral portals. For lesions in the medial anteroinferior or posteroinferior portion of the hip, these portals provide insufficient access to the lesion and consequently lead to incomplete treatment. Thus, in such a situation, a medial portal approach might be helpful. However, operators have avoided this procedure because of the risk of injury to the obturator, femoral neurovascular structures, and the medial femoral circumflex artery. Thus, to overcome the disadvantages of the conventional method for medial lesions of the hip, we performed a cadaveric study to evaluate the technique, usefulness, and risk of the medial portal technique. PMID:26330964

  7. Portal hypertension as portrayed by marked hepatosplenomegaly: case report

    SciTech Connect

    Greene, R.A.

    1987-12-01

    The liver is vulnerable to as host of disease processes, including portal hypertension. This is a severe hepatic condition in which the liver is subject to numerous imbalances: increased hepatic blood flow, increased portal vein pressure due to extrahepatic portal vein obstruction, and/or increases in hepatic blood flow resistance. Although many diseases states may be responsible for the development of portal hypertension, it is most commonly associated with moderately severe or advanced cirrhosis. Advanced, untreated portal hypertension may cause additional complications such as hepatosplenomegaly, gastrointestinal bleeding, and ascites.

  8. Portal vein involvement in hepatocellular carcinoma: dynamic CT features

    SciTech Connect

    Mathieu, D.; Grenier, P.; Larde, D.; Vasile, N.

    1984-07-01

    The authors conducted a retrospective examination of 62 hepatocellular carcinomas, taking dynamic CT scans of selected sections after an intravenous contrast bolus. The proximal portal vein was involved in 40% of cases and distal segment in 16%. Angiographic correlation was available in 23 patients. The characteristic appearance of tumor within the portal vein was noted in many cases; in others, distinction between tumor and bland thrombus could not be made. Peripheral portal vein obstruction was suggested when a small, hypervascular tumor became hypodense during the portal phase of CT. The frequency and significance of these CT signs of portal vein involvement are discussed.

  9. Astronomia.pl: Portal activity in 2006-2007

    NASA Astrophysics Data System (ADS)

    Czart, K.; Pomierny, J.

    2008-06-01

    We present the latest activity of Astronomia.pl - the Polish Astronomy Portal, the most popular internet portal about astronomy in Poland. Astronomia.pl is a wide-ranging portal, covering news, a database of articles, books, lectures, an astronomical calendar, a newsletter, a virtual library of diploma theses, a discussion forum, chat, galleries, a catalogue of websites and other services. The portal also owns several additional services like an on-line lexicon with biographies of astronomers, a website about Polish planetariums and a server for websites created by astronomy amateurs. There is also small part of the portal in English.

  10. Patient Portals: An Underused Resource for Improving Patient Engagement.

    PubMed

    Tulu, Bengisu; Trudel, John; Strong, Diane M; Johnson, Sharon A; Sundaresan, Devi; Garber, Lawrence

    2016-01-01

    The potential of patient portals to improve patient engagement and health outcomes has been discussed for more than a decade. The slow growth in patient portal adoption rates among patients and providers in the United States, despite external incentives, indicates that this is a complex issue. We examined evidence of patient portal use and effects with a focus on the pulmonary domain. We found a paucity of studies of patient portal use in pulmonary practice, and highlight gaps for future research. We also report on the experience of a pulmonary department using a patient portal to highlight the potential of these systems. PMID:26066707

  11. Synteny Portal: a web-based application portal for synteny block analysis.

    PubMed

    Lee, Jongin; Hong, Woon-Young; Cho, Minah; Sim, Mikang; Lee, Daehwan; Ko, Younhee; Kim, Jaebum

    2016-07-01

    Recent advances in next-generation sequencing technologies and genome assembly algorithms have enabled the accumulation of a huge volume of genome sequences from various species. This has provided new opportunities for large-scale comparative genomics studies. Identifying and utilizing synteny blocks, which are genomic regions conserved among multiple species, is key to understanding genomic architecture and the evolutionary history of genomes. However, the construction and visualization of such synteny blocks from multiple species are very challenging, especially for biologists with a lack of computational skills. Here, we present Synteny Portal, a versatile web-based application portal for constructing, visualizing and browsing synteny blocks. With Synteny Portal, users can easily (i) construct synteny blocks among multiple species by using prebuilt alignments in the UCSC genome browser database, (ii) visualize and download syntenic relationships as high-quality images, (iii) browse synteny blocks with genetic information and (iv) download the details of synteny blocks to be used as input for downstream synteny-based analyses, all in an intuitive and easy-to-use web-based interface. We believe that Synteny Portal will serve as a highly valuable tool that will enable biologists to easily perform comparative genomics studies by compensating limitations of existing tools. Synteny Portal is freely available at http://bioinfo.konkuk.ac.kr/synteny_portal. PMID:27154270

  12. Restriction of drinking water abrogates splanchnic vasodilation and portal hypertension in portal vein-ligated rats.

    PubMed

    Heinemann, Akos; Schuligoi, Rufina; Lippe, Irmgard T; Stauber, Rudolf E

    2009-01-01

    Portal hypertension is associated with splanchnic vasodilation which is claimed responsible for the maintenance of chronically elevated portal pressure. Vasopressin analogues are used in the treatment of acute variceal bleeding, since they effectively reduce splanchnic blood flow and portal pressure. Dehydration stimulates the release of endogenous vasopressin release. Here we compared the effects of deprivation of drinking water for 18 h with those of vasopressin infusion on mesenteric hemodynamics in portal vein-ligated (PVL) and sham-operated (SHAM) rats. Blood flow in the superior mesenteric artery was measured with the ultrasonic transit time shift technique. Deprivation of drinking water had no hemodynamic effects in SHAM rats, but completely reversed the mesenteric hyperemia and portal hypertension in PVL rats to figures measured in SHAM rats, without altering blood pressure. Similarly, intravenous infusion of low doses of arginine vasopressin (1-10 pmol/min) selectively reduced mesenteric blood flow in PVL rats but had little effect in SHAM rats. These data suggest that control of water balance or aquaretic drugs might have beneficial effects on splanchnic hemodynamics and portal pressure in advanced liver disease, possibly by stimulating endogenous vasopressin release. PMID:18987488

  13. Synteny Portal: a web-based application portal for synteny block analysis

    PubMed Central

    Lee, Jongin; Hong, Woon-young; Cho, Minah; Sim, Mikang; Lee, Daehwan; Ko, Younhee; Kim, Jaebum

    2016-01-01

    Recent advances in next-generation sequencing technologies and genome assembly algorithms have enabled the accumulation of a huge volume of genome sequences from various species. This has provided new opportunities for large-scale comparative genomics studies. Identifying and utilizing synteny blocks, which are genomic regions conserved among multiple species, is key to understanding genomic architecture and the evolutionary history of genomes. However, the construction and visualization of such synteny blocks from multiple species are very challenging, especially for biologists with a lack of computational skills. Here, we present Synteny Portal, a versatile web-based application portal for constructing, visualizing and browsing synteny blocks. With Synteny Portal, users can easily (i) construct synteny blocks among multiple species by using prebuilt alignments in the UCSC genome browser database, (ii) visualize and download syntenic relationships as high-quality images, (iii) browse synteny blocks with genetic information and (iv) download the details of synteny blocks to be used as input for downstream synteny-based analyses, all in an intuitive and easy-to-use web-based interface. We believe that Synteny Portal will serve as a highly valuable tool that will enable biologists to easily perform comparative genomics studies by compensating limitations of existing tools. Synteny Portal is freely available at http://bioinfo.konkuk.ac.kr/synteny_portal. PMID:27154270

  14. Anatomy of the Portal Vein Bifurcation: Implication for Transjugular Intrahepatic Portal Systemic Shunts

    SciTech Connect

    Kwok, Philip Chong-hei Ng, Wai Fu; Lam, Christine Suk-yee; Tsui, Polly Po; Faruqi, Asma

    2003-06-15

    Purpose: The relationship of the portalvein bifurcation to the liver capsule in Asians, which is an important landmark for transjugular intrahepatic portosystemic shunt, has not previously been described. Methods: The anatomy of the portal vein bifurcation was studied in 70 adult Chinese cadavers; it was characterized as intrahepatic or extrahepatic. The length of the exposed portion of the right and left portal veins was measured when the bifurcation was extrahepatic. Results: The portal vein bifurcation was intrahepatic in 37 cadavers (53%) and extrahepatic in 33 cadavers (47%). The mean length of the right and left extrahepatic portal veins was 0.96 cm and 0.85 cm respectively.Both were less than or equal to 2 cm in 94% of the cadavers with extrahepatic bifurcation. There was no correlation between the presence of cirrhosis and the location of the portal vein bifurcation(p 1.0). There was no statistically significant difference in liver mass in cadavers with either extrahepatic or intrahepatic bifurcation (p =0.40). Conclusions: These findings suggest that fortransjugular intrahepatic portosystemic shunt placement, a portal vein puncture 2 cm from the bifurcation will be safe in most cases.

  15. Portal hypertension associated with primary hypoplasia of the hepatic portal vein in dogs.

    PubMed

    Van den Ingh, T S; Rothuizen, J; Meyer, H P

    1995-10-21

    Portal hypertension caused by primary hypoplasia of the portal vein was diagnosed in 42 dogs. The portal hypertension was manifested by the presence of multiple portosystemic collateral vessels. The main clinical signs were retarded growth or weight loss, apathy, intermittent diarrhoea and vomiting, anorexia, abdominal distension and polydipsia. Major findings at physical examination were ascites in 23 dogs and neurological signs in 16 dogs. The dogs had increased activities of liver enzymes in plasma and increased fasting levels of total bile acids and ammonia; in many of the dogs the packed red cell volume, total serum protein and albumin were low. Gross inspection of the portal vein revealed a patent but underdeveloped extrahepatic vein in 13 of the dogs. Microscopic examination of the liver revealed hypoplasia of the intrahepatic portal veins in all the dogs, and this was associated with minor arteriolar proliferation and absence of fibrosis in 12 of them, with moderate to marked arteriolar proliferation often combined with ductular proliferation in 13, and with marked portal fibrosis (formerly described as hepatoportal fibrosis) with a varying number of arteriolar and bile ductular structures in 17 of the dogs. The disease affected mainly young dogs, and was most likely to have been of congenital origin. PMID:8560700

  16. Radioisotopic splenoportography in patients with portal hypertension.

    PubMed

    Samejima, N; Ikeda, K; Yokoyama, Y; Hirata, S

    1989-05-01

    Radio-isotopic splenoportography was performed by injecting 99mTcO4- into the spleens of 46 patients with portal hypertension and 14 patients with various disorders not having portal hypertension. No collateral circulation was demonstrated in the 14 patients without portal hypertension whereas some RI-images of portosystemic collaterals were found in 40 (87.0 per cent) of the 46 patients with portal hypertension. Collaterals were divided into an ascending group and a descending group, the appearance rate of ascending collaterals being 80.4 per cent and that of descending collaterals, 41.3 per cent. There were 3 image patterns in the ascending group, namely, an AZ-pattern in which the azygos vein was demonstrated; a SC-pattern in which the RI-bolus ascended along the esophagus to the neck and the subclavian vein; and an EG-pattern which showed stagnation of the RI-bolus in the esophagogastric region. There were 4 patterns in the descending group, namely; a pattern of gastro-renal caval shunt (GR-pattern); reverse flow patterns into the umbilical or paraumbilical veins (UV-pattern); into the superior mesenteric vein (SMV-pattern); and into the inferior mesenteric vein (IMV-pattern). The appearance of the EG-pattern was seen most frequently (74.4 per cent). The usefulness of this method for surveying the collateral circulation in portal hypertension, estimating the risk of esophageal variceal bleeding and evaluating its treatments, was suggested by the results of this study. PMID:2674500

  17. In vitro vascular responsiveness to norepinephrine in experimental portal hypertension.

    PubMed

    Bomzon, A; Jacob, G; Lee, S S; Meddings, J

    1991-02-01

    It has been postulated that loss of response to norepinephrine accounts in part for the portal hypertension, systemic hypotension, and generalised vascular dilatation of chronic liver disease. The in vitro vascular responsiveness to norepinephrine was measured in aortic rings and portal veins excised from four different rat models of hepatic disease with and without portal hypertension, hepatocellular damage, and hyperbilirubinemia--the carbon tetrachloride (CCl4) cirrhotic rat with portal hypertension, the five-week chronic bile duct ligated and resected (CBDL) cirrhotic rat with portal hypertension and hyperbilirubinemia, the 10-day partial ligated portal vein (PVL) portal hypertensive rat without hepatocellular damage and hyperbilirubinemia, and the three-day bile duct ligated (ABDL) rat with acute hepatocellular damage and hyperbilirubinemia but without portal hypertension. Sham-treated or operated groups for each model were also prepared. Vascular reactivity of the aortic rings to norepinephrine was potentiated in the three portal hypertensive groups, and attenuated in the model of acute cholestasis. No consistent pattern of response to norepinephrine was evident in the portal veins. Based upon the presented in vitro data and the discussed limitations of an in vitro study, we conclude that it is unlikely that the loss of response to norepinephrine accounts for the portal hypertension, systemic hypotension, and generalised vascular dilatation of chronic liver disease. PMID:2040106

  18. Understanding Productivity and Technostress for Oncology Nurses Using an Electronic Health Record (EHR) to Increase Safety, Quality, and Effectiveness of Care for Patients with Cancer

    ERIC Educational Resources Information Center

    Evans, Elizabeth M. Wertz

    2013-01-01

    Health information technology has become more prevalent in hospitals, physician offices, clinics, and other areas of medical treatment, especially since the federal government passed legislation to offer incentive payments for the meaningful use of electronic health records (EHRs). Previous research demonstrated a decrease in medical errors as…

  19. Percutaneous Transumbilical Portal Vein Embolization in a Patient with a Ruptured Hepatocellular Carcinoma Supplied by the Portal Vein

    SciTech Connect

    Kim, Soo Chin; Kim, Hyo-Cheol Chung, Jin Wook; Jae, Hwan Jun; Park, Jae Hyung

    2011-02-15

    We describe a case of a ruptured hepatocellular carcinoma supplied by the portal vein that was successfully treated with portal vein embolization via a percutaneous transumbilical approach. A contrast material-enhanced computed tomographic (CT) scan showed the presence of a large hypervascular tumor on portal venous phase as well as right hepatic vein thrombosis and hemoperitoneum that prevented portal vein embolization by the use of the percutaneous and transjugular transhepatic approach. The use of percutaneous transumbilical portal vein embolization can be an alternative option in this situation.

  20. A Proposed Framework to Enrich Norwegian EHR System with Health-trusted Information for Patients and Professionals.

    PubMed

    Konstantinidis, Stathis Th; Kummervold, Per Egil; Luque, Luis Fernandez; Vognild, Lars Kristian

    2015-01-01

    In the era of social media, semantic web and big data, a huge amount of health-related information, knowledge and resources exist on the Web. Patients and healthcare professionals should spend enormous effort and time in order to find health-trusted information, while the appropriate technologies to interlink and retrieve this type of information already exist. In this paper we propose a framework to enrich DIPS, the most deployed Norwegian EHR System, with health-trusted information for patients and state-of-the-art resources for healthcare professionals. The framework based upon the new architecture of DIPS, namely DIPS Arena, and upon the interlinking with the semantic web, social media and open linked data cloud information, knowledge and resources through well-established medical thesauri like SNOMED CT and MeSH. PMID:26152978

  1. Sunshot Initiative High Penetration Solar Portal

    DOE Data Explorer

    The DOE SunShot Initiative is a collaborative national initiative to make solar energy cost-competitive with other forms of energy by the end of the decade. Reducing the installed cost of solar energy systems by about 75% will drive widespread large-scale adoption of this renewable energy and restore U.S. leadership in the global clean energy race. The High Penetration Solar Portal was created as a resource to aggregate the most relevant and timely information related to high penetration solar scenarios and integrating solar into the grid. The site is designed so that utilities, grant awardees, regulators, researchers, and other solar professionals can easily share data, case studies, lessons learned, and demonstration project findings. [from https://solarhighpen.energy.gov/about_the_high_penetration_solar_portal

  2. Photonic dark matter portal and quantum physics

    NASA Astrophysics Data System (ADS)

    Alavi, S. A.; Kazemian, F. S.

    2016-02-01

    We study a model of dark matter in which the hidden sector interacts with standard model particles via a hidden photonic portal. We investigate the effects of this new interaction on the hydrogen atom, including the Stark, Zeeman and hyperfine effects. Using the accuracy of the measurement of energy, we obtain an upper bound for the coupling constant of the model as f ⩽ 10-12. We also calculate the contribution from the hidden photonic portal to the anomalous magnetic moment of the muon as aμ ⩽ 2.2 × 10-23 (for the dark particle mass scale 100 MeV), which provides an important probe of physics beyond the standard model.

  3. Phase contrast portal imaging using synchrotron radiation

    NASA Astrophysics Data System (ADS)

    Umetani, K.; Kondoh, T.

    2014-07-01

    Microbeam radiation therapy is an experimental form of radiation treatment with great potential to improve the treatment of many types of cancer. We applied a synchrotron radiation phase contrast technique to portal imaging to improve targeting accuracy for microbeam radiation therapy in experiments using small animals. An X-ray imaging detector was installed 6.0 m downstream from an object to produce a high-contrast edge enhancement effect in propagation-based phase contrast imaging. Images of a mouse head sample were obtained using therapeutic white synchrotron radiation with a mean beam energy of 130 keV. Compared to conventional portal images, remarkably clear images of bones surrounding the cerebrum were acquired in an air environment for positioning brain lesions with respect to the skull structure without confusion with overlapping surface structures.

  4. Phase contrast portal imaging using synchrotron radiation

    SciTech Connect

    Umetani, K.; Kondoh, T.

    2014-07-15

    Microbeam radiation therapy is an experimental form of radiation treatment with great potential to improve the treatment of many types of cancer. We applied a synchrotron radiation phase contrast technique to portal imaging to improve targeting accuracy for microbeam radiation therapy in experiments using small animals. An X-ray imaging detector was installed 6.0 m downstream from an object to produce a high-contrast edge enhancement effect in propagation-based phase contrast imaging. Images of a mouse head sample were obtained using therapeutic white synchrotron radiation with a mean beam energy of 130 keV. Compared to conventional portal images, remarkably clear images of bones surrounding the cerebrum were acquired in an air environment for positioning brain lesions with respect to the skull structure without confusion with overlapping surface structures.

  5. [Pathophysiology of portal hypertension, what's new?].

    PubMed

    Kim, Moon Young; Baik, Soon Koo

    2010-09-01

    Portal hypertension (PHT) is associated with changes in the intrahepatic, systemic and portosystemic collateral circulations. Alteration in vasoreactivity (vasodilation and vasoconstriction) plays a central role in the pathogenesis of PHT by contributing to increased intrahepatic resistance, hyperdynamic circulation and the expansion of the collateral circulation. PHT is also importantly characterized by changes in vascular structure; termed vascular remodeling, which is an adaptive response of the vessel wall that occurs in response to chronic changes in the environment such as shear stress. Angiogenesis, the sprouting of new blood vessels, also occurs in PHT, especially in the expansion of the portosystemic collateral circulation. These complementary processes of vasoreactivity, vascular remodeling and angiogenesis represent important targets in the research for the treatment of portal hypertension. PMID:20847603

  6. The QUEST Data Portal Visualisation Service

    NASA Astrophysics Data System (ADS)

    Norton, Peter; Pascoe, Stephen; Juckes, Martin

    2010-05-01

    The QUEST (Quantifying and Understanding the Earth System) Data Portal Visualisation Service provides access to a wide range of earth system science datasets, such as: observational climate composites, climate model projections and simulations, a biodiversity index and human population. The user interface allows the user to navigate and view the datasets through Open Geospatial Consortium compliant Web Map Servers. Presenting a wide range of datasets through a generic interface (which needs to work within a range of browsers, their versions and configurations) creates many conflicting demands. This poster describes the strategies adopted to create a portal which gives flexible access to a wide range of datasets, and maintains clear links back to detailed descriptions of the data.

  7. Portal Vein Embolization: What Do We Know?

    SciTech Connect

    Denys, Alban; Prior, John; Bize, Pierre; Duran, Rafael; Baere, Thierry De; Halkic, Nermin; Demartines, Nicolas

    2012-10-15

    Portal vein embolization (PVE) has been developed to increase the size of the future remnant liver (FRL) left in place after major hepatectomy, thus reducing the risk of postoperative liver insufficiency. PVE consist in embolizing preoperatively portal branches of the segments that will be resected. Indication is based on preoperative measurements of the FRL by computed tomography and its ratio with either the theoretical liver volume or by direct measurement of the functional liver volume. After PVE, the volume and function of the FRL increases in 3 to 6 weeks, permitting extensive resections in patients otherwise contraindicated for liver resection. The PVE technique is variable from one center to another; however n-butyl-cyano-acrylate provides an interesting compromise between hypertrophy rate and procedure risk.

  8. Treatment of ectopic varices with portal hypertension.

    PubMed

    Sato, Takahiro

    2015-06-28

    Ectopic varices are unusual with portal hypertension and can involve any site along the digestive tract outside the gastroesophageal region. Hemorrhage from ectopic varices generally are massive and life threatening. Diagnosis of ectopic varices is difficult and subsequent treatment is also difficult; the optimal treatment has not been established. Recently, interventional radiology and endoscopic treatments have been carried out successfully for hemorrhage from ectopic varices. PMID:26140080

  9. On flattening filter-free portal dosimetry.

    PubMed

    Pardo, Eduardo; Castro Novais, Juan; Molina López, María Yolanda; Ruiz Maqueda, Sheila

    2016-01-01

    Varian introduced (in 2010) the option of removing the flattening filter (FF) in their C-Arm linacs for intensity-modulated treatments. This mode, called flattening filter-free (FFF), offers the advantage of a greater dose rate. Varian's "Portal Dosimetry" is an electronic portal imager device (EPID)-based tool for IMRT verification. This tool lacks the capability of verifying flattening filter-free (FFF) modes due to saturation and lack of an image prediction algorithm. (Note: the latest versions of this software and EPID correct these issues.) The objective of the present study is to research the feasibility of said verifications (with the older versions of the software and EPID). By placing the EPID at a greater distance, the images can be acquired without saturation, yielding a linearity similar to the flattened mode. For the image prediction, a method was optimized based on the clinically used algorithm (analytical anisotropic algorithm (AAA)) over a homogeneous phantom. The depth inside the phantom and its electronic density were tailored. An application was developed to allow the conversion of a dose plane (in DICOM format) to Varian's custom format for Portal Dosimetry. The proposed method was used for the verification of test and clinical fields for the three qualities used in our institution for IMRT: 6X, 6FFF and 10FFF. The method developed yielded a positive verification (more than 95% of the points pass a 2%/2 mm gamma) for both the clinical and test fields. This method was also capable of "predicting" static and wedged fields. A workflow for the verification of FFF fields was developed. This method relies on the clinical algorithm used for dose calculation and is able to verify the FFF modes, as well as being useful for machine quality assurance. The procedure described does not require new hardware. This method could be used as a verification of Varian's Portal Dose Image Prediction. PMID:27455487

  10. Diavideos: a diabetes health video portal.

    PubMed

    Sánchez-Bocanegra, C L; Rivero-Rodriguez, A; Fernández-Luque, L; Sevillano, J L

    2013-01-01

    Diavideos is a web platform that collects trustworthy diabetes health videos from YouTube and offers them in a easy way. YouTube is a big repository of health videos, but good content is sometimes mixed with misleading and harmful videos such as promoting anorexia [1]. Diavideos is a web portal that provides easy access to a repository of trustworthy diabetes videos. This poster describes Diavideos and explains the crawling method used to retrieve these videos from trusted channels. PMID:23920715

  11. Capsule Endoscopy for Portal Hypertensive Enteropathy

    PubMed Central

    2016-01-01

    Portal hypertensive enteropathy (PHE) is a mucosal abnormality of the small bowel that is observed in patients with portal hypertension (PH) and can lead to gastrointestinal bleeding and anemia. The pathogenesis is still not completely understood. The introduction of new endoscopic methods, including capsule endoscopy (CE) or balloon-assisted enteroscopy, has increased the detection of these abnormalities. CE can also serve as a road map for deciding subsequent interventions and evaluating the treatment effect. The prevalence of PHE is reportedly 40–70% in patients with PH. Endoscopic findings can be roughly divided into vascular and nonvascular lesions such as inflammatory-like lesions. Traditionally, PHE-associated factors include large esophageal varices, portal hypertensive gastropathy or colopathy, Child-Turcotte-Pugh class B or C, a history of variceal treatment, and acute gastrointestinal bleeding. More recently, on using scoring systems, a high computed tomography or transient elastography score was reportedly PHE-related factors. However, the prevalence of PHE and its related associated factors remain controversial. The management of PHE has not yet been standardized. It should be individualized according to each patient's situation, the availability of therapy, and each institutional expertise. PMID:26819613

  12. The DIRAC Web Portal 2.0

    NASA Astrophysics Data System (ADS)

    Mathe, Z.; Casajus Ramo, A.; Lazovsky, N.; Stagni, F.

    2015-12-01

    For many years the DIRAC interware (Distributed Infrastructure with Remote Agent Control) has had a web interface, allowing the users to monitor DIRAC activities and also interact with the system. Since then many new web technologies have emerged, therefore a redesign and a new implementation of the DIRAC Web portal were necessary, taking into account the lessons learnt using the old portal. These new technologies allowed to build a more compact, robust and responsive web interface that enables users to have better control over the whole system while keeping a simple interface. The web framework provides a large set of “applications”, each of which can be used for interacting with various parts of the system. Communities can also create their own set of personalised web applications, and can easily extend already existing ones with a minimal effort. Each user can configure and personalise the view for each application and save it using the DIRAC User Profile service as RESTful state provider, instead of using cookies. The owner of a view can share it with other users or within a user community. Compatibility between different browsers is assured, as well as with mobile versions. In this paper, we present the new DIRAC Web framework as well as the LHCb extension of the DIRAC Web portal.

  13. Interventional Radiologic Treatment for Idiopathic Portal Hypertension

    SciTech Connect

    Hirota, Shozo; Ichikawa, Satoshi; Matsumoto, Shinichi; Motohara, Tomofumi; Fukuda, Tetsuya; Yoshikawa, Takeshi

    1999-07-15

    Purpose: To evaluate the usefulness of interventional radiological treatment for idiopathic portal hypertension. Methods: Between 1995 and 1998, we performed an interventional radiological treatment in five patients with idiopathic portal hypertension, four of whom had refused surgery and one of whom had undergone surgery. Three patients with gastroesophageal varices (GEV) were treated by partial splenic embolization (PSE), one patient with esophageal varices (EV) and massive ascites by transjugular intrahepatic portosytemic shunt (TIPS) and PSE, and one patient with GEV by percutaneous transhepatic obliteration (PTO). Midterm results were analyzed in terms of the effect on esophageal and/or gastric varices. Results: In one woman with severe GEV who underwent three sessions of PSE, there was endoscopic confirmation that the GEV had disappeared. In one man his EV shrunk markedly after two sessions of PSE. In two patients slight reduction of the EV was obtained with one application of PSE combined with endoscopic variceal ligation therapy. PTO for GV in one patient resulted in good control of the varices. All patients have survived for 16-42 months since the first interventional treatment, and varices are well controlled. Conclusion: Interventional radiological treatment is effective for patients with idiopathic portal hypertension, whether or not they have undergone surgery.

  14. Capsule Endoscopy for Portal Hypertensive Enteropathy.

    PubMed

    Jeon, Seong Ran; Kim, Jin-Oh

    2016-01-01

    Portal hypertensive enteropathy (PHE) is a mucosal abnormality of the small bowel that is observed in patients with portal hypertension (PH) and can lead to gastrointestinal bleeding and anemia. The pathogenesis is still not completely understood. The introduction of new endoscopic methods, including capsule endoscopy (CE) or balloon-assisted enteroscopy, has increased the detection of these abnormalities. CE can also serve as a road map for deciding subsequent interventions and evaluating the treatment effect. The prevalence of PHE is reportedly 40-70% in patients with PH. Endoscopic findings can be roughly divided into vascular and nonvascular lesions such as inflammatory-like lesions. Traditionally, PHE-associated factors include large esophageal varices, portal hypertensive gastropathy or colopathy, Child-Turcotte-Pugh class B or C, a history of variceal treatment, and acute gastrointestinal bleeding. More recently, on using scoring systems, a high computed tomography or transient elastography score was reportedly PHE-related factors. However, the prevalence of PHE and its related associated factors remain controversial. The management of PHE has not yet been standardized. It should be individualized according to each patient's situation, the availability of therapy, and each institutional expertise. PMID:26819613

  15. ENCODE data at the ENCODE portal.

    PubMed

    Sloan, Cricket A; Chan, Esther T; Davidson, Jean M; Malladi, Venkat S; Strattan, J Seth; Hitz, Benjamin C; Gabdank, Idan; Narayanan, Aditi K; Ho, Marcus; Lee, Brian T; Rowe, Laurence D; Dreszer, Timothy R; Roe, Greg; Podduturi, Nikhil R; Tanaka, Forrest; Hong, Eurie L; Cherry, J Michael

    2016-01-01

    The Encyclopedia of DNA Elements (ENCODE) Project is in its third phase of creating a comprehensive catalog of functional elements in the human genome. This phase of the project includes an expansion of assays that measure diverse RNA populations, identify proteins that interact with RNA and DNA, probe regions of DNA hypersensitivity, and measure levels of DNA methylation in a wide range of cell and tissue types to identify putative regulatory elements. To date, results for almost 5000 experiments have been released for use by the scientific community. These data are available for searching, visualization and download at the new ENCODE Portal (www.encodeproject.org). The revamped ENCODE Portal provides new ways to browse and search the ENCODE data based on the metadata that describe the assays as well as summaries of the assays that focus on data provenance. In addition, it is a flexible platform that allows integration of genomic data from multiple projects. The portal experience was designed to improve access to ENCODE data by relying on metadata that allow reusability and reproducibility of the experiments. PMID:26527727

  16. ENCODE data at the ENCODE portal

    PubMed Central

    Sloan, Cricket A.; Chan, Esther T.; Davidson, Jean M.; Malladi, Venkat S.; Strattan, J. Seth; Hitz, Benjamin C.; Gabdank, Idan; Narayanan, Aditi K.; Ho, Marcus; Lee, Brian T.; Rowe, Laurence D.; Dreszer, Timothy R.; Roe, Greg; Podduturi, Nikhil R.; Tanaka, Forrest; Hong, Eurie L.; Cherry, J. Michael

    2016-01-01

    The Encyclopedia of DNA Elements (ENCODE) Project is in its third phase of creating a comprehensive catalog of functional elements in the human genome. This phase of the project includes an expansion of assays that measure diverse RNA populations, identify proteins that interact with RNA and DNA, probe regions of DNA hypersensitivity, and measure levels of DNA methylation in a wide range of cell and tissue types to identify putative regulatory elements. To date, results for almost 5000 experiments have been released for use by the scientific community. These data are available for searching, visualization and download at the new ENCODE Portal (www.encodeproject.org). The revamped ENCODE Portal provides new ways to browse and search the ENCODE data based on the metadata that describe the assays as well as summaries of the assays that focus on data provenance. In addition, it is a flexible platform that allows integration of genomic data from multiple projects. The portal experience was designed to improve access to ENCODE data by relying on metadata that allow reusability and reproducibility of the experiments. PMID:26527727

  17. Campus Portals: Supportive Mechanisms for University Communication, Collaboration, and Organizational Change.

    ERIC Educational Resources Information Center

    Eisler, David L.

    2001-01-01

    University portals provide a new computerized interface between colleges and constituent groups. This article discusses: campus portals and possible features they may contain, nine strategies for portal projects, collaborative mechanisms to develop and implement portal projects, criteria for determination of campus portal readiness, potential…

  18. Explosives detection portal for high-volume personnel screening

    NASA Astrophysics Data System (ADS)

    Parmeter, John E.; Linker, Kevin L.; Rhykerd, Charles L.; Hannum, David W.; Bouchier, Francis A.

    1998-12-01

    We discuss a trace explosive detection portal for high-volume personnel screening, which has been developed recently at Sandia National Laboratories (SNL), using funding provided by the Federal Aviation Administration (FAA) and the Department of Energy (DOE) Office of Safeguards and Security (OSS). This portal screens individuals for explosives using noninvasive means to collect explosive residue in the forms of vapor and particulate contamination. The portal combines a commercially available ion mobility spectrometer (IMS) with a preconcentrator developed at SNL to perform detection of explosives. The prototype portal has undergone one series of tests at the Albuquerque International Airport, and we are now proceeding to develop an improved, second-generation portal, and to find a company to market the portal.

  19. The portal immunosuppressive storm: relevance to islet transplantation?

    PubMed

    Shapiro, A M James; Gallant, Heather L; Hao, Er Geng; Lakey, Jonathan R T; McCready, Tara; Rajotte, Ray V; Yatscoff, Randall W; Kneteman, Norman M

    2005-02-01

    Outcomes in clinical islet transplantation improved substantially with the introduction of combined sirolimus and tacrolimus immunosuppression. However, multiple islet preparations are often required to achieve insulin independence, suggesting that islet engraftment may not be optimal when these agents are absorbed via the portal vein. The current study was designed to assess the differential concentrations of immunosuppressive drugs within the portal and systemic circulations of a large animal model, to assess the local concentrations of drugs to which islets are exposed early after implantation. Chronic catheters were placed in the portal vein and carotid artery of 6 mongrel dogs, and immunosuppressants were administered orally. Blood samples were drawn simultaneously from portal and systemic catheters, and drug concentrations were analyzed. Peak immunosuppressant levels as well as area under the curve were dramatically elevated in portal blood relative to systemic levels for all drugs tested. This "portal storm" of immunosuppression may be relevant to intrahepatic islet transplantation. PMID:15665744

  20. Development of a trace explosives detection portal for personnel screening

    SciTech Connect

    Parmeter, J.E.; Linker, K.L.; Rhykerd, C.L. Jr.; Bouchier, F.A.; Hannum, D.W.

    1998-08-01

    The authors discuss the development, design, and operation of a walk-through trace detection portal designed to screen personnel for explosives. Developed at Sandia National Laboratories (SNL) with primary funding from the Federal Aviation Administration (FAA) and additional support from the Department of Energy office of Safeguards and Security, this portal is intended primarily for use in airport terminals and in other localities where a very high throughput of pedestrian traffic is combined with stringent security requirements. The portal is capable of detecting both vapor and particulate contamination, with the collection of explosive material being based upon the entrainment of that material in air flows over the body of the person being screened. This portal is capable of detecting most types of common high explosives of interest to the FAA. The authors discuss the results of field testing of the portal in the Albuquerque International Airport in September, 1997 and more recent steps towards commercialization of the portal.

  1. Disastrous Portal Vein Embolization Turned into a Successful Intervention

    SciTech Connect

    Dobrocky, Tomas; Kettenbach, Joachim; Lopez-Benitez, Ruben Kara, Levent

    2015-10-15

    Portal vein embolization (PVE) may be performed before hemihepatectomy to increase the volume of future liver remnant (FLR) and to reduce the risk of postoperative liver insufficiency. We report the case of a 71-year-old patient with hilar cholangiocarcinoma undergoing PVE with access from the right portal vein using a mixture of n-butyl-2-cyanoacrylate and ethiodized oil. During the procedure, nontarget embolization of the left portal vein occurred. An aspiration maneuver of the polymerized plug failed; however, the embolus obstructing portal venous flow in the FLR was successfully relocated into the right portal vein while carefully bypassing the plug with a balloon catheter, inflating the balloon, and pulling the plug into the main right portal vein.

  2. EMODnet Physical Parameters (EMODNet PP) Portal

    NASA Astrophysics Data System (ADS)

    Novellino, A.; Schaap, D.; Manzella, G. M. R.; Pouliquen, S.; Gorringe, P.

    2012-04-01

    In December 2007 the European Parliament and Council adopted a common text for the Marine Strategy Framework Directive which aims to achieve environmentally healthy marine waters by 2020. This Directive includes an initiative for an overarching European Marine Observation and Data Network (EMODNet). During the one-year consultation phase that followed the release of the EU Green Paper on a Future Maritime Policy for the European Union, stakeholders gave an overwhelming positive response. Facilitating access to high quality marine data will resolve difficulties and stimulate an expansion of value-added public and commercial services, lay the foundations for sound governance and reduce uncertainties on human impact on the planet as well as of forecasts relating to the future state of the marine environment. Better and linked marine data will have an immediate impact on the planning of environmental policy and mitigation measures, and will also facilitate impact assessments and scientific work. The overall objectives of the EMODnet Physical Parameters (EMODNet PP) preparatory action is to provide access to archived and near real-time data on physical conditions in Europe's seas and oceans by means of a dedicated Pilot Portal and to determine how well the data meet the needs of users from industry, public authorities and scientists. The latter implicates that it is also an objective to identify data gaps and arguments why these gaps should be filled in future monitoring. This project will contribute towards the definition of an operational European Marine Observation and Data Network (EMODnet). This is done done by: 1. providing through a portal: a. access to marine data from measurement stations and ferryboxes. Both near real-time and archived data of time series are to be made available. b. metadata for these data sets using EMODnet/INSPIRE standards. c. metadata maps and overviews for whole sea-basins showing the availability of data and monitoring intensity of that

  3. A Climate Information Portal for Copernicus: a central portal for European climate services?

    NASA Astrophysics Data System (ADS)

    Juckes, Martin; Swart, Rob; Thysse, Peter; Som de Cerff, Wim; Groot, Annemarie; Bennett, Victoria; Costa, Luis; Lückenkötter, Johannes; Callaghan, Sarah

    2015-04-01

    The FP7 project "Climate Information Portal for Copernicus" (CLIPC) is developing a demonstration portal for the Copernicus Climate Change Service (C3S). This project is one of a suite of FP7 research activities which are administratively independent of Copernicus, focussed on creating the technical and scientific building blocks needed for the service. It is to be expected that at EGU 2015 there will be many presentations describing portals delivering new and innovative ranges of services. It would be unwise to seek to replace all this creative activity with a single portal -- instead CLIPC is designing a portal to make distributed resources more accessible through flexible discovery systems. CLIPC needs to deliver more than a directory of resources: resources need to be presented in common protocols so that users can access multiple datasets. More information about the project objectives is available at www.clipc.eu. The gulf between the climate science communities and the end user communities is a central challenge being addressed in the project. It is important to understand that there is significant diversity and multiple communication barriers within these two sets of communities as well as between them. The CLIPC services must presentation will provide a review of progress towards this ambitious goal, through a discussion of user requirements activities, an overview of the proposed architecture, work on assessing and adjusting model biasses, and a discussion of the climate impact indicators which will be provided through the portal. When looking at the usability of data for the various users, CLIPC will implement a set of services functioning as a "knowledge base" supplying information to users about the data, including definitions of terminology used, quality of datasets, versioning, and user annotations.

  4. [Surgical treatment of portal hypertension: the state of art].

    PubMed

    Shertsinger, A G; Zhigalova, S B; Lebezev, V M; Manukian, G V; Kitsenko, E A

    2013-01-01

    The article highlights modern approaches to the treatment of portal hypertension. The differential tactics is based on the type of portal hypertension, functional liver state, urgency of the situation and severity of blood loss, localization and stage of varices, concomitant diseases, etc. The role of miniinvasive methods is stressed. The reasonability of general treatment algorithm of portal hypertention in specialized centers is proved. PMID:23503380

  5. Nurse Educators' Consensus Opinion on Using an Academic Electronic Health Record: A Delphi Study

    ERIC Educational Resources Information Center

    Hanson, Darlene S.

    2013-01-01

    The purpose of this study was to determine the opinions of nurse educators in the state of North Dakota (ND) who were using the academic Electronic Health Record (EHR) known as SimChart. In this dissertation research study, factors that either hindered or facilitated the introduction of SimChart in nursing programs in ND were examined.…

  6. User-Friendly Handbook for Project Dissemination: Science, Mathematics, Engineering, and Technology Education.

    ERIC Educational Resources Information Center

    Ely, Donald P.; Huberman, A. Michael

    This document was developed to provide principal investigators and project evaluators working with the National Science Foundation's Directorate for Education and Human Resource Development (EHR) with a basic understanding of dissemination. It is aimed at people who want to learn more about both developing and implementing a dissemination plan. It…

  7. The Impact of an eHealth Portal on Health Care Professionals’ Interaction with Patients: Qualitative Study

    PubMed Central

    Faxvaag, Arild; Svanæs, Dag

    2015-01-01

    writings and revelations thereby capturing patient challenges and acting and implementing measures. Interacting with patients through the portal can prevent dropouts and deterioration of patients’ health. However, professionals report on organizational challenges and personal constraints related to communicating with patients in writing online. Further development of guidelines and education of health care professionals about how to handle, prioritize, communicate, and facilitate patients online is required in addition to increased attention to the organizational infrastructures and incentives for enabling such solutions in health care. PMID:26601678

  8. Instructions for Uploading Data to the Assay Portal - Instructions for Uploading Data to the Assay Portal

    Cancer.gov

    This document provides instructions for configuring and uploading data files to the CPTAC Assay Portal. It is divided into sections, with an overview checklist provided at the end. If help is needed at any stage of the process, please use the support page: https://assays.cancer.gov/support/

  9. 29 CFR 785.24 - Principles noted in Portal-to-Portal Bulletin.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Section 785.24 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR... regarded as work and as compensable under the Fair Labor Standards Act, remain so under the Portal Act... of Principles Preparatory and Concluding Activities § 785.24 Principles noted in...

  10. The wave As federal EHR incentives recede, the next surge in health IT spending begins to take shape.

    PubMed

    Conn, Joseph

    2013-05-20

    Presbyterian Intercommunity hospital, part of PHI Health, is on the leading edge of a new surge in healthcare information technology. The hospital's plans include setting up a data warehouse for patient records and a patient portal, which is seen as key to involving patients in their own care. "It's really about patient engagement," said Dr. Davis Lee of PIH Health, left. "There are benefits to get the patients to go online and communicate with providers." PMID:23947264

  11. Open source portal to distributed image repositories

    NASA Astrophysics Data System (ADS)

    Tao, Wenchao; Ratib, Osman M.; Kho, Hwa; Hsu, Yung-Chao; Wang, Cun; Lee, Cason; McCoy, J. M.

    2004-04-01

    In large institution PACS, patient data may often reside in multiple separate systems. While most systems tend to be DICOM compliant, none of them offer the flexibility of seamless integration of multiple DICOM sources through a single access point. We developed a generic portal system with a web-based interactive front-end as well as an application programming interface (API) that allows both web users and client applications to query and retrieve image data from multiple DICOM sources. A set of software tools was developed to allow accessing several DICOM archives through a single point of access. An interactive web-based front-end allows user to search image data seamlessly from the different archives and display the results or route the image data to another DICOM compliant destination. An XML-based API allows other software programs to easily benefit from this portal to query and retrieve image data as well. Various techniques are employed to minimize the performance overhead inherent in the DICOM. The system is integrated with a hospital-wide HIPAA-compliant authentication and auditing service that provides centralized management of access to patient medical records. The system is provided under open source free licensing and developed using open-source components (Apache Tomcat for web server, MySQL for database, OJB for object/relational data mapping etc.). The portal paradigm offers a convenient and effective solution for accessing multiple image data sources in a given healthcare enterprise and can easily be extended to multi-institution through appropriate security and encryption mechanisms.

  12. The NOAO NVO Portal: Overall Design & Implementation

    NASA Astrophysics Data System (ADS)

    Fuentes, E.; Miller, C. J.; Gasson, D.

    2007-10-01

    We present an overview and design of the NOAO National Virtual Observatory (NVO) Portal. This is a web application providing one-stop discovery, analysis, and access to VO-compliant imaging data and services. It strictly follows the Model-View-Controller (MVC) design pattern and relies heavily on Asynchronous Javascript And XML (AJAX) in the browser. Because of the heavy use of AJAX, the relatively simple database schemas, and, most importantly, the rapid development/iteration schedule, Ruby-on-Rails (RoR) was chosen as the implementation language and PostgreSQL as the database engine.

  13. [Pathology of liver cirrhosis and portal hypertension].

    PubMed

    Bläker, H; Theuer, D; Otto, H F

    2001-10-01

    Cirrhosis is a late stage finding in chronic liver diseases of different aetiology. It is defined morphologically as a diffuse process with the presence of fibrosis and structurally abnormal nodules. The consequences of cirrhosis are both, mechanical and functional. The mechanical complications result from intra- and extrahepatic shunting of blood and portal hypertension while the functional relevance bases upon a failure of liver cells to perform their physiological role in metabolism, synthesis and secretion. Beside these complications that are directly linked to liver function cirrhosis in itself is a risk factor for hepatocellular carcinoma. PMID:11715574

  14. Clinical use of electronic portal imaging.

    PubMed

    Herman, Michael G

    2005-07-01

    Accurate and routine target localization is necessary for successful outcome in radiation therapy treatments. Electronic portal imaging devices (EPIDs) provide an advanced tool with digital technology to improve target localization and maintain clinical efficiency. EPIDs are ubiquitous in the radiation therapy clinic, and they provide a powerful and flexible tool to collect and process data in a quantitative manner to improve treatment accuracy for virtually any treatment site. This manuscript provides an overview of the clinical implementation process for effective use of EPIDs. It continues with a review of correction strategies and finally highlights numerous examples of effective clinical application of EPID. PMID:15983941

  15. Palliative Portal Vein Stent Placement in Malignant and Symptomatic Extrinsic Portal Vein Stenosis or Occlusion

    SciTech Connect

    Novellas, Sebastien; Denys, Alban Bize, Pierre; Brunner, Philippe; Motamedi, Jean Paul; Gugenheim, Jean; Caroli, Francois-Xavier; Chevallier, Patrick

    2009-05-15

    This article evaluates the results of portal vein (PV) stent placement in patients with malignant extrinsic lesions stenosing or obstructing the PV and causing symptomatic PV hypertension (PVHT). Fourteen patients with bile duct cancer (n = 7), pancreatic adenocarcinoma (n = 4), or another cancer (n = 3) underwent percutaneous transhepatic portal venous stent placement because of gastroesophageal or jejunal varices (n = 9), ascites (n = 7), and/or thrombocytopenia (n = 2). Concurrent tumoral obstruction of the main bile duct was treated via the transhepatic route in the same session in four patients. Changes in portal venous pressure, complications, stent patency, and survival were evaluated. Mean {+-} standard deviation (SD) gradient of portal venous pressure decreased significantly immediately after stent placement from 11.2 mmHg {+-} 4.6 to 1.1 mmHg {+-} 1.0 (P < 0.00001). Three patients had minor complications, and one developed a liver abscess. During a mean {+-} SD follow-up of 134.4 {+-} 123.3 days, portal stents remained patent in 11 patients (78.6%); stent occlusion occurred in 3 patients, 2 of whom had undergone previous major hepatectomy. After stent placement, PVHT symptoms were relieved in four (57.1%) of seven patients who died (mean survival, 97 {+-} 71.2 days), and relieved in six (85.7%) of seven patients still alive at the end of follow-up (mean follow-up, 171.7 {+-} 153.5 days). Stent placement in the PV is feasible and relatively safe. It helped to relieve PVHT symptoms in a single session.

  16. Constriction rate variation produced by partial ligation of the portal vein at pre-hepatic portal hypertension induced in rats

    PubMed Central

    RODRIGUES, Daren Athiê Boy; da SILVA, Aline Riquena; SERIGIOLLE, Leonardo Carvalho; FIDALGO, Ramiro de Sousa; FAVERO, Sergio San Gregorio; LEME, Pedro Luiz Squilacci

    2014-01-01

    Background Partial portal vein ligation causes an increase in portal pressure that remains stable even after the appearance of collateral circulation, with functional adaptation to prolonged decrease in portal blood flow. Aim To assess whether different constriction rates produced by partial ligation of the vein interfere with the results of this experimental model in rats. Methods Three groups of five rats each were used; in group 1 (sham-operated), dissection and measurement of portal vein diameters were performed. Portal hypertension was induced by partial portal vein ligation, reducing its size to 0.9 mm in the remaining 10 animals, regardless of the initial diameter of the veins. Five animals with portal hypertension (group 2) underwent reoperation after 15 days and the rats in group 3 after 30 days. The calculation of the constriction rate was performed using a specific mathematical formula (1 - π r 2 / π R2) x 100% and the statistical analysis with the Student t test. Results The initial diameter of the animal's portal vein was 2.06 mm, with an average constriction rate of the 55.88%; although the diameter of the veins and the constriction rate in group 2 were lower than in group 3 (2.06 mm - 55,25% and 2.08 mm - 56.51%, respectively), portal hypertension was induced in all rats and no significant macroscopic differences were found between the animals that were reoperated after 15 days and after 30 days respectively, being the shorter period considered enough for the evaluation. Comparing the initial diameter of the vein and the rate of constriction performed in groups 2 and 3, no statistic significance was found (p>0.05). Conclusion Pre-hepatic portal hypertension in rat can be induced by the reduction of the portal vein diameter to 0.9 mm, regardless the initial diameter of the vein and the vessel constriction rate. PMID:25626939

  17. 3. East portal of Tunnel 39, view to west with ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. East portal of Tunnel 39, view to west with east portal of Tunnel 38 (HAER CA-211) visible in distance, 135mm lens with electronic flash fill. - Central Pacific Transcontinental Railroad, Tunnel No. 39, Milepost 180.95, Cisco, Placer County, CA

  18. Westfacing portals within Open Cut No. 2 (South Bergen Tunnel ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    West-facing portals within Open Cut No. 2 (South Bergen Tunnel on right, North Bergen Tunnel see HAER No. NJ-136) on left), from within the opposite portal of the South Bergen Tunnel, looking east - Delaware, Lackawanna & Western Railroad, South Bergen Tunnel, Jersey City, Hudson County, NJ

  19. An Analysis of Knowledge Management Mechanisms in Healthcare Portals

    ERIC Educational Resources Information Center

    Lee, Chei Sian; Goh, Dion Hoe-Lian; Chua, Alton Y. K.

    2010-01-01

    Healthcare portals are becoming increasingly popular with Internet users since they play an important role in supporting interaction between individuals and healthcare organizations with a Web presence. Additionally, many of these organizations make use of knowledge management mechanisms on their healthcare portals to manage the abundance of…

  20. 2. West portal of Tunnel 18, oblique view to northnortheast, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. West portal of Tunnel 18, oblique view to north-northeast, 135mm lens. Note the use of concrete face and wingwalls, with dressed stone voussoirs, wingwall coping, parapet with stone belt course and coping, and coursed stone masonry slope protection flanking the portal. - Southern Pacific Railroad Natron Cutoff, Tunnel No. 18, Milepost 410, Dorris, Siskiyou County, CA

  1. Connections: A Comprehensive Student Portal. Concept Paper and Proposal.

    ERIC Educational Resources Information Center

    Harr, Gary Lynn

    A student Web portal is a personalized, student-centric view of College Web resources. The "Artemis" system at Florida Community College at Jacksonville (FCCJ), represents movement toward realization of the efficiencies and student service possibilities of a Web portal. This proposal recommends a radical expansion of Artemis functions, one that…

  2. North portal and deck view, from north, showing inclined endposts, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    North portal and deck view, from north, showing inclined endposts, Pratt through trusses, north portal strut, overhead bracing, pipe rails and posts, and concrete deck with bituminous wearing surface - Castle Garden Bridge, Township Route 343 over Bennetts Branch of Sinnemahoning Creek, Driftwood, Cameron County, PA

  3. South portal and deck view from south, showing inclined endposts, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    South portal and deck view from south, showing inclined endposts, Pratt through trusses, south portal strut, overhead bracing, pipe rails and posts, and concrete deck with bituminous wearing surface - Castle Garden Bridge, Township Route 343 over Bennetts Branch of Sinnemahoning Creek, Driftwood, Cameron County, PA

  4. 1. West portal of Tunnel 35, contextual view to eastnortheast ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. West portal of Tunnel 35, contextual view to east-northeast with west portal of Tunnel 36 (HAER CA-209) visible in distance at left, 135mm lens. - Central Pacific Transcontinental Railroad, Tunnel No. 35, Milepost 176.62, Yuba Pass, Nevada County, CA

  5. 8. FIGUEROA STREET TUNNEL NO. 2, SOUTH PORTAL SEEN FROM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. FIGUEROA STREET TUNNEL NO. 2, SOUTH PORTAL SEEN FROM ABOVE NORTH PORTAL OF TUNNEL NO. 3. LOOKING 12°N. - Figueroa Street Tunnels, Mileposts 24.90, 25.14, 25.28, & 25.37 on Arroyo Seco Parkway, Los Angeles, Los Angeles County, CA

  6. 6. East portal of Tunnel 17, oblique view to westsouthwest, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. East portal of Tunnel 17, oblique view to west-southwest, 90mm lens. This view shows to advantage the stepped concrete wingwalls and fitted stone masonry coping protection flanking the portal, features typical of the Southern Pacific Common Standard tunnels of this period. - Southern Pacific Railroad Natron Cutoff, Tunnel No. 17, Milepost 408, Dorris, Siskiyou County, CA

  7. 1. West portal of Tunnel 38, contextual view to east, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. West portal of Tunnel 38, contextual view to east, 135mm lens. West portal of Tunnel 3 (HAER CA-212) on original Central Pacific Transcontinental line visible in distance at left. - Central Pacific Transcontinental Railroad, Tunnel No. 38, Milepost 180.58, Cisco, Placer County, CA

  8. 1. West portal of Tunnel 39, contextual view to east, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. West portal of Tunnel 39, contextual view to east, 135mm lens. West portal of Tunnel 4 (HAER CA-214) on the original Central Pacific Transcontinental line is visible at left. - Central Pacific Transcontinental Railroad, Tunnel No. 39, Milepost 180.95, Cisco, Placer County, CA

  9. 6. East portal of Tunnel 18, oblique view to northwest, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. East portal of Tunnel 18, oblique view to northwest, 135mm lens. This view shows to advantage the stepped ashlar granite wingwalls and fitted rubble slab slope protection flanking the portal, features typical of the Southern Pacific Common Standard tunnels. - Central Pacific Transcontinental Railroad, Tunnel No. 18, Milepost 120.5, Newcastle, Placer County, CA

  10. 1. West portal of Tunnel 27 in distance, contextual view ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. West portal of Tunnel 27 in distance, contextual view to northeast looking past Tunnel 26 (HAER CA-202) from atop east portal of Tunnel 25 (HAER CA-201), 380mm lens. - Central Pacific Transcontinental Railroad, Tunnel No. 27, Milepost 133.9, Applegate, Placer County, CA

  11. Continued Use of a Chinese Online Portal: An Empirical Study

    ERIC Educational Resources Information Center

    Shih, Hung-Pin

    2008-01-01

    The evolution of the internet has made online portals a popular means of surfing the internet. In internet commerce, understanding the post-adoption behaviour of users of online portals can help enterprises to attract new users and retain existing customers. For predicting continued use intentions, this empirical study focused on applying and…

  12. A Community of Practice: Web Portals and Faculty Development.

    ERIC Educational Resources Information Center

    Carlson, Patricia A.

    2002-01-01

    Describes a Web portal constructed by Rose-Hulman Institute of Technology dedicated to improving middle school science, mathematics, and technology instruction. The portal emulates emerging corporate practices of knowledge management and process reinvention through information technology, and offers middle school teachers across Indiana a…

  13. Measuring Campus Portal Effectiveness and the Contributing Factors

    ERIC Educational Resources Information Center

    Masrek, Mohamad Noorman bin

    2007-01-01

    Purpose: The purpose of the paper is to evaluate the effectiveness or success of universities' portal implementation from the perspective of students as users. Adopting the model developed by Delone and McLean, portal effectiveness is defined as being composed of information quality, systems quality and service quality. In addition, the paper also…

  14. [Aspects of pathogenetc pharmacotherapy for portal hypertension in liver cirrhosis].

    PubMed

    Garbuzenko, D V

    2016-01-01

    The review of literature considers the principles of medical treatment for portal hypertension in liver cirrhosis, which are based on the current views of its development mechanisms. It describes both current pharmacotherapy methods for portal hypertension and drugs, the efficacy of which is being investigated. PMID:27135108

  15. 3. VIEW SOUTHEAST VIEW OF EAST PORTAL SHOWING SKEW AND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. VIEW SOUTHEAST- VIEW OF EAST PORTAL SHOWING SKEW AND PORTAL BRACING. - National Docks Branch Bridge N.D.2F, Spans former Central Railroad of New Jersey , west of New Jersey Turnpike, north of Communipaw Avenue near Johnson Avenue, Jersey City, Hudson County, NJ

  16. Concepts for a standard based cross-organisational information security management system in the context of a nationwide EHR.

    PubMed

    Mense, Alexander; Hoheiser-Pförtner, Franz; Schmid, Martin; Wahl, Harald

    2013-01-01

    Working with health related data necessitates appropriate levels of security and privacy. Information security, meaning ensuring confidentiality, integrity, and availability, is more organizational, than technical in nature. It includes many organizational and management measures, is based on well-defined security roles, processes, and documents, and needs permanent adaption of security policies, continuously monitoring, and measures assessment. This big challenge for any organization leads to implementation of an information security management system (ISMS). In the context of establishing a regional or national electronic health record for integrated care (ICEHR), the situation is worse. Changing the medical information exchange from on-demand peer-to-peer connections to health information networks requires all organizations participating in the EHR system to have consistent security levels and to follow the same security guidelines and rules. Also, the implementation must be monitored and audited, establishing cross-organizational information security management systems (ISMS) based on international standards. This paper evaluates requirements and defines basic concepts for an ISO 27000 series-based cross-organizational ISMS in the healthcare domain and especially for the implementation of the nationwide electronic health record in Austria (ELGA). PMID:23920615

  17. Stent Recanalization of Chronic Portal Vein Occlusion in a Child

    SciTech Connect

    Cwikiel, Wojciech; Solvig, Jan; Schroder, Henrik

    2000-07-15

    An 8-year-old boy with a 21/2 year history of portal hypertension and repeated bleedings from esophageal varices, was referred for treatment. The 3.5-cm-long occlusion of the portal vein was passed and the channel created was stabilized with a balloon-expandable stent; a portosystemic stent-shunt was also created. The portosystemic shunt closed spontaneously within 1 month, while the recanalized segment of the portal vein remained open. The pressure gradient between the intrahepatic and extrahepatic portal vein branches dropped from 17 mmHg to 0 mmHg. The pressure in the portal vein dropped from 30 mmHg to 17 mmHg and the bleedings stopped. The next dilation of the stent was performed 12 months later due to an increased pressure gradient; the gastroesophageal varices disappeared completely. Further dilation of the stent was planned after 2, 4, and 6 years.

  18. The NOAO NVO Portal: Client-Side VO

    NASA Astrophysics Data System (ADS)

    Gasson, D.; Fuentes, E.; Miller, C. J.

    2007-10-01

    The NOAO National Virtual Observatory (NVO) portal is a recently deployed web application for one-stop discovery, analysis, and access to VO-compliant imaging data and services. The NOAO NVO portal utilizes Simple Image Access Protocol (SIAP) services provided by some astronomical archives. The portal also utilizes a number of SOAP-based VO web services (WESIX, Sesame, etc). We discuss the design decisions and technology choices that were made in the NOAO NVO portal code to facilitate the use of IVOA standards and VO data/services. This includes a new Virtual Observatory library written for Ruby: an interpreted scripting language for quick and easy object-oriented programming. We provide an overview of VORuby and how it is utilized in the NOAO NVO Portal.

  19. A Web portal for CMS Grid job submission and management

    NASA Astrophysics Data System (ADS)

    Braun, David; Neumeister, Norbert

    2010-04-01

    We present a Web portal for CMS Grid submission and management. The portal is built using a JBoss application server. It has a three tier architecture; presentation, business logic and data. Bean based business logic interacts with the underlying Grid infrastructure and pre-existing external applications, while the presentation layer uses AJAX to offer an intuitive, functional interface to the back-end. Application data aggregating information from the portal as well as the external applications is persisted to the server memory cache and then to a backend database. We describe how the portal exploits standard, off-the-shelf commodity software together with existing Grid infrastructures in order to facilitate job submission and monitoring for the CMS collaboration. This paper describes the design, development, current functionality and plans for future enhancements of the portal.

  20. Advances in the treatment of portal hypertension in cirrhosis.

    PubMed

    Kimer, N; Wiese, S; Mo, S; Møller, S; Bendtsen, F

    2016-08-01

    Non-selective beta-blockers and handling of esophageal varices has been key elements in the treatment of portal hypertension in recent decades. Liver vein catheterization has been essential in diagnosis and monitoring of portal hypertension, but ongoing needs for noninvasive tools has led to research in areas of both biomarkers, and transient elastography, which displays promising results in discerning clinically significant portal hypertension. Novel research into the areas of hepatic stellate cell function and the dynamic components of portal hypertension has revealed promising areas of treatment modalities, targeting intestinal decontamination, angiogenesis, inflammation and oxidative stress. Future studies may reveal if these initiatives lead to developments of new drugs for treatment of portal hypertension. PMID:26982499

  1. Portal Hypertension as Immune Mediate Disease

    PubMed Central

    Manti, Sara; Marseglia, Lucia; D'Angelo, Gabriella; Filippelli, Martina; Cuppari, Caterina; Gitto, Eloisa; Romano, Claudio; Arrigo, Teresa; Salpietro, Carmelo

    2014-01-01

    Context: Portal Hypertension (PH) is a progressive complication due to chronic liver disease. In addition to pathophysiologic changes in the micro-circulation, in PH are established fibrous tissue (periportal fibrous septal) and regenerative hyperplastic nodules (from micro- to macro-nodules) promoting hepatic architectural distortion. Evidence Acquisition: A literature search of electronic databases was undertaken for the major studies published from 1981 to today. The databases searched were: PubMed, EMBASE, Orphanet, Midline and Cochrane Library. We used the keywords: "portal hypertension, children, immune system, endocrine system, liver fibrosis". Results: It is believed that PH results from three “phenotype”: ischemia-reperfusion, involving nervous system (NS); edema and oxidative damage, involving immune system; inflammation and angiogenesis, involving endocrine system. However, its exact cause still underdiagnosed and unknown. Conclusions: PH is a dynamic and potentially reversible process. Researchers have tried to demonstrate mechanisms underlying PH and its related-complications. This review focuses on the current knowledge regarding the pathogenesis, and immune, endocrine-metabolic factors of disease. The strong positive association between immune system and development of PH could be efficient to identify non-invasive markers of disease, to modify prognosis of PH, and to development and application of specific and individual anti-inflammatory therapy. PMID:24976841

  2. Management of rectal varices in portal hypertension

    PubMed Central

    Al Khalloufi, Kawtar; Laiyemo, Adeyinka O

    2015-01-01

    Rectal varices are portosystemic collaterals that form as a complication of portal hypertension, their prevalence has been reported as high as 94% in patients with extrahepatic portal vein obstruction. The diagnosis is typically based on lower endoscopy (colonoscopy or sigmoidoscopy). However, endoscopic ultrasonography has been shown to be superior to endoscopy in diagnosing rectal varices. Color Doppler ultrasonography is a better method because it allows the calculation of the velocity of blood flow in the varices and can be used to predict the bleeding risk in the varices. Although rare, bleeding from rectal varices can be life threatening. The management of patients with rectal variceal bleeding is not well established. It is important to ensure hemodynamic stability with blood transfusion and to correct any coagulopathy prior to treating the bleeding varices. Endoscopic injection sclerotherapy has been reported to be more effective in the management of active bleeding from rectal varices with less rebleeding rate as compared to endoscopic band ligation. Transjugular intrahepatic portsystemic shunt alone or in combination with embolization is another method used successfully in control of bleeding. Balloon-occluded retrograde transvenous obliteration is an emerging procedure for management of gastric varices that has also been successfully used to treat bleeding rectal varices. Surgical procedures including suture ligation and porto-caval shunts are considered when other methods have failed. PMID:26730278

  3. The Anatomy of a Grid portal

    NASA Astrophysics Data System (ADS)

    Licari, Daniele; Calzolari, Federico

    2011-12-01

    In this paper we introduce a new way to deal with Grid portals referring to our implementation. L-GRID is a light portal to access the EGEE/EGI Grid infrastructure via Web, allowing users to submit their jobs from a common Web browser in a few minutes, without any knowledge about the Grid infrastructure. It provides the control over the complete lifecycle of a Grid Job, from its submission and status monitoring, to the output retrieval. The system, implemented as client-server architecture, is based on the Globus Grid middleware. The client side application is based on a java applet; the server relies on a Globus User Interface. There is no need of user registration on the server side, and the user needs only his own X.509 personal certificate. The system is user-friendly, secure (it uses SSL protocol, mechanism for dynamic delegation and identity creation in public key infrastructures), highly customizable, open source, and easy to install. The X.509 personal certificate does not get out from the local machine. It allows to reduce the time spent for the job submission, granting at the same time a higher efficiency and a better security level in proxy delegation and management.

  4. Management of rectal varices in portal hypertension.

    PubMed

    Al Khalloufi, Kawtar; Laiyemo, Adeyinka O

    2015-12-28

    Rectal varices are portosystemic collaterals that form as a complication of portal hypertension, their prevalence has been reported as high as 94% in patients with extrahepatic portal vein obstruction. The diagnosis is typically based on lower endoscopy (colonoscopy or sigmoidoscopy). However, endoscopic ultrasonography has been shown to be superior to endoscopy in diagnosing rectal varices. Color Doppler ultrasonography is a better method because it allows the calculation of the velocity of blood flow in the varices and can be used to predict the bleeding risk in the varices. Although rare, bleeding from rectal varices can be life threatening. The management of patients with rectal variceal bleeding is not well established. It is important to ensure hemodynamic stability with blood transfusion and to correct any coagulopathy prior to treating the bleeding varices. Endoscopic injection sclerotherapy has been reported to be more effective in the management of active bleeding from rectal varices with less rebleeding rate as compared to endoscopic band ligation. Transjugular intrahepatic portsystemic shunt alone or in combination with embolization is another method used successfully in control of bleeding. Balloon-occluded retrograde transvenous obliteration is an emerging procedure for management of gastric varices that has also been successfully used to treat bleeding rectal varices. Surgical procedures including suture ligation and porto-caval shunts are considered when other methods have failed. PMID:26730278

  5. Software tool for portal dosimetry research.

    PubMed

    Vial, P; Hunt, P; Greer, P B; Oliver, L; Baldock, C

    2008-09-01

    This paper describes a software tool developed for research into the use of an electronic portal imaging device (EPID) to verify dose for intensity modulated radiation therapy (IMRT) beams. A portal dose image prediction (PDIP) model that predicts the EPID response to IMRT beams has been implemented into a commercially available treatment planning system (TPS). The software tool described in this work was developed to modify the TPS PDIP model by incorporating correction factors into the predicted EPID image to account for the difference in EPID response to open beam radiation and multileaf collimator (MLC) transmitted radiation. The processes performed by the software tool include; i) read the MLC file and the PDIP from the TPS, ii) calculate the fraction of beam-on time that each point in the IMRT beam is shielded by MLC leaves, iii) interpolate correction factors from look-up tables, iv) create a corrected PDIP image from the product of the original PDIP and the correction factors and write the corrected image to file, v) display, analyse, and export various image datasets. The software tool was developed using the Microsoft Visual Studio.NET framework with the C# compiler. The operation of the software tool was validated. This software provided useful tools for EPID dosimetry research, and it is being utilised and further developed in ongoing EPID dosimetry and IMRT dosimetry projects. PMID:18946980

  6. Amyloidosis: an unusual cause of portal hypertension

    PubMed Central

    Laborda, Lorena Silva; Bernardelli, Raquel; Pinesi, Henrique Trombini; Silva, Marilia Polo Minguete e; Chiavelli, Viviane; Simões, Angélica Braz; Felipe-Silva, Aloisio

    2016-01-01

    Amyloidosis comprises a group of diseases that occurs in five to nine cases per million patients per year worldwide irrespective of its classification. Although the hepatic involvement in primary amyloidosis is frequent, the clinical manifestations of liver amyloidosis are mild or even absent. The authors report the case of an aged man who complained of diffuse abdominal pain and marked weight loss and presented clinical signs of hepatopathy. Clinical workup revealed portal hypertension with ascites, hemorrhoids, and esophageal varices. The laboratory tests showed the cholestatic pattern of liver enzymes, hyperbilirubinemia, renal insufficiency and massive proteinuria accompanied by the presence of serum pike of monoclonal lambda light chain protein. The outcome was unfavorable, and the patient died. The autopsy findings revealed the diagnosis of amyloidosis predominantly involving the liver and kidneys. The bone marrow examination demonstrated the deposition of amyloid material associated with clonal plasma cells infiltration. The authors call attention to portal hypertension as a rare manifestation of primary amyloidosis. Meanwhile, this diagnosis should be taken into account whenever the hepatopathy is accompanied by laboratory abnormalities consistent with hepatic space-occupying lesions concomitantly with other organs involvement. In the case reported herein, kidney involvement was also present with renal failure, massive proteinuria with monoclonal serum gammopathy, what reinforced the diagnostic possibility of primary amyloidosis. PMID:27547738

  7. Hepatic myospherulosis complicating portal vein embolisation

    PubMed Central

    Lui, P C W; Luk, I S C; Lee, C K L; Lui, Y H; Leung, C Y; Choi, C H

    2004-01-01

    Aims: Myospherulosis is a rare condition characterised by sac-like structures containing spheroid bodies in cysts or cystic spaces in the tissue. This condition has not previously been reported in the liver. The association with previous portal vein embolisation using a mixture of butyl 2-cyanoacrylate and ethiodised oil and the proposed mechanism of pathogenesis are discussed. Methods: Samples from 8 patients treated by hepatectomy after portal vein embolisation using a mixture of butyl 2-cyanoacrylate and ethiodised oil were retrieved from the archives of the United Christian Hospital, Hong Kong. The histological specimens were reviewed. A panel of histochemical and immunohistochemical stains was used. Results: All cases showed hepatic myospherulosis within the veins. The veins were denuded of endothelium, which was replaced by granulation tissue and fibrous tissue with a lymphoplasmacytic infiltrate. Foreign body-type giant cells (six cases) and eosinophilic infiltrates (seven cases) were noted in most cases. Both parent bodies and endobodies were stained red by Papanicolaou and Masson’s trichrome and stained blue by solochrome cyanine. The endobodies showed immunoreactivity towards glycophorin A. They were negative for Alcian blue, periodic acid Schiff, Grocott, and Ziehl-Neelsen stains. Conclusions: The endobodies of myospherulosis may be misdiagnosed as fungi or algae by the unwary. The clinical history, intravascular location, lack of staining with periodic acid Schiff and Grocott stains, and positive glycophorin A staining are generally sufficient for a confident diagnosis of myospherulosis. PMID:14747440

  8. Amyloidosis: an unusual cause of portal hypertension.

    PubMed

    Takayasu, Vilma; Laborda, Lorena Silva; Bernardelli, Raquel; Pinesi, Henrique Trombini; Silva, Marilia Polo Minguete E; Chiavelli, Viviane; Simões, Angélica Braz; Felipe-Silva, Aloisio

    2016-01-01

    Amyloidosis comprises a group of diseases that occurs in five to nine cases per million patients per year worldwide irrespective of its classification. Although the hepatic involvement in primary amyloidosis is frequent, the clinical manifestations of liver amyloidosis are mild or even absent. The authors report the case of an aged man who complained of diffuse abdominal pain and marked weight loss and presented clinical signs of hepatopathy. Clinical workup revealed portal hypertension with ascites, hemorrhoids, and esophageal varices. The laboratory tests showed the cholestatic pattern of liver enzymes, hyperbilirubinemia, renal insufficiency and massive proteinuria accompanied by the presence of serum pike of monoclonal lambda light chain protein. The outcome was unfavorable, and the patient died. The autopsy findings revealed the diagnosis of amyloidosis predominantly involving the liver and kidneys. The bone marrow examination demonstrated the deposition of amyloid material associated with clonal plasma cells infiltration. The authors call attention to portal hypertension as a rare manifestation of primary amyloidosis. Meanwhile, this diagnosis should be taken into account whenever the hepatopathy is accompanied by laboratory abnormalities consistent with hepatic space-occupying lesions concomitantly with other organs involvement. In the case reported herein, kidney involvement was also present with renal failure, massive proteinuria with monoclonal serum gammopathy, what reinforced the diagnostic possibility of primary amyloidosis. PMID:27547738

  9. The SmartGeo Portal: A retrospective

    NASA Astrophysics Data System (ADS)

    Heilmann, Zeno; Satta, Guido; Bonomi, Ernesto

    2016-04-01

    The SmartGeo portal was created in a follow-up project that evolved from the geophysical data imaging services of a Grid computing portal for Geoscience, called GRIDA3. The scope of the project was to support commercial geotechnical service providers as well as academic researchers working in near-surface geoscience. Starting from the existing services, the SmartGeo portal was set up on new hardware, using the latest version of the grid portal environment EnginFrame. After a first working version was established, the services were reviewed, updated and accompanied by new services according to the feedback we received from our partners. One partner for instance experienced large difficulties in a project that aimed at delineating the aquifer for finding water pollutant substances in an industrial area of Basel. The seismic imaging service inherited from the previous portal was employing a data-driven algorithm optimized to provide, directly during data acquisition, nearly in real-time a first image of the subsurface structure. Different to this, our user needed for his data from a geologically very complex and noisy urban environment the maximum lateral resolution and noise reduction possible. For this purpose we added two cutting edge data imaging algorithms able to deliver such high precision results by simultaneously optimizing, for every single image point, all parameters of the mathematical model---a procedure which increased the computational effort by one or two magnitudes, respectively. Thus, parallel computing on grid infrastructure served for maximizing the image resolution instead for generating real-time results. This proved also very useful for the data of an academic partner, recorded for imaging the structure of a shallow sedimentary basin, where we could obtain strongly improved seismic velocity information using these new algorithms. A general user request was to implement interactive data visualization tools. To fulfill this demand we took

  10. Altered blood-brain barrier permeability in rats with prehepatic portal hypertension turns to normal when portal pressure is lowered

    PubMed Central

    Eizayaga, Francisco; Scorticati, Camila; Prestifilippo, Juan P; Romay, Salvador; Fernandez, Maria A; Castro, José L; Lemberg, Abraham; Perazzo, Juan C

    2006-01-01

    AIM: To study the blood-brain barrier integrity in prehepatic portal hypertensive rats induced by partial portal vein ligation, at 14 and 40 d after ligation when portal pressure is spontaneously normalized. METHODS: Adult male Wistar rats were divided into four groups: Group I: Sham14d , sham operated; Group II: PH14d , portal vein stenosis; (both groups were used 14 days after surgery); Group III: Sham40d, Sham operated and Group IV: PH40d Portal vein stenosis (Groups II and IV used 40 d after surgery). Plasma ammonia, plasma and cerebrospinal fluid protein and liver enzymes concentrations were determined. Trypan and Evans blue dyes, systemically injected, were investigated in hippocampus to study blood-brain barrier integrity. Portal pressure was periodically recorded. RESULTS: Forty days after stricture, portal pressure was normalized, plasma ammonia was moderately high, and both dyes were absent in central nervous system parenchyma. All other parameters were reestablished. When portal pressure was normalized and ammonia level was lowered, but not normal, the altered integrity of blood-brain barrier becomes reestablished. CONCLUSION: The impairment of blood-brain barrier and subsequent normalization could be a mechanism involved in hepatic encephalopathy reversibility. Hemodynamic changes and ammonia could trigger blood-brain barrier alterations and its reestablishment. PMID:16552803

  11. Culture Model of Rat Portal Myofibroblasts.

    PubMed

    El Mourabit, Haquima; Loeuillard, Emilien; Lemoinne, Sara; Cadoret, Axelle; Housset, Chantal

    2016-01-01

    Myofibroblasts are matrix-producing cells with contractile properties, usually characterized by de novo expression of alpha-smooth muscle actin, that arise in fibrotic diseases. Hepatic stellate cells (HSCs), known as perisinusoidal cells containing auto-fluorescent vitamin A, are the major although not exclusive source of myofibroblasts in the injured liver. Portal myofibroblasts (PMFs) have been defined as liver myofibroblasts derived from cells that are distinct from HSCs and located in the portal tract. Here, we describe the protocol we have established to obtain rat PMFs in culture. In this method, the biliary tree is (i) separated from the liver parenchyma by in situ enzymatic perfusion of the liver, (ii) minced and further digested in vitro, until bile duct segments are isolated by sequential filtration. Bile duct isolates free of HSC contaminants, form small cell clusters, which initially comprise a large majority of epithelial cells. In culture conditions (fetal bovine serum) that provide a growth advantage to mesenchymal cells over epithelial cells, the epithelial cells die and detach from the substrate, while spindle-shaped cells outgrow from the periphery of the cell clusters, as shown by video-microscopy. These cells are highly proliferative and after 4-5 days, the culture is composed exclusively of fully differentiated myofibroblasts, which express alpha-smooth muscle actin and collagen 1, and secrete abundant collagen. We found no evidence for epithelial-mesenchymal transition, i.e., no co-expression of alpha-smooth muscle actin and cytokeratin at any stage, while cytokeratin becomes undetectable in the confluent cells. PMFs obtained by this method express the genes that were previously reported to be overexpressed in non-HSC or portal fibroblast-derived liver myofibroblasts as compared to HSC-derived myofibroblasts, including the most discriminant, collagen 15, fibulin 2, and Thy-1. After one passage, PMFs retain the same phenotypic features as in

  12. Culture Model of Rat Portal Myofibroblasts

    PubMed Central

    El Mourabit, Haquima; Loeuillard, Emilien; Lemoinne, Sara; Cadoret, Axelle; Housset, Chantal

    2016-01-01

    Myofibroblasts are matrix-producing cells with contractile properties, usually characterized by de novo expression of alpha-smooth muscle actin, that arise in fibrotic diseases. Hepatic stellate cells (HSCs), known as perisinusoidal cells containing auto-fluorescent vitamin A, are the major although not exclusive source of myofibroblasts in the injured liver. Portal myofibroblasts (PMFs) have been defined as liver myofibroblasts derived from cells that are distinct from HSCs and located in the portal tract. Here, we describe the protocol we have established to obtain rat PMFs in culture. In this method, the biliary tree is (i) separated from the liver parenchyma by in situ enzymatic perfusion of the liver, (ii) minced and further digested in vitro, until bile duct segments are isolated by sequential filtration. Bile duct isolates free of HSC contaminants, form small cell clusters, which initially comprise a large majority of epithelial cells. In culture conditions (fetal bovine serum) that provide a growth advantage to mesenchymal cells over epithelial cells, the epithelial cells die and detach from the substrate, while spindle-shaped cells outgrow from the periphery of the cell clusters, as shown by video-microscopy. These cells are highly proliferative and after 4–5 days, the culture is composed exclusively of fully differentiated myofibroblasts, which express alpha-smooth muscle actin and collagen 1, and secrete abundant collagen. We found no evidence for epithelial-mesenchymal transition, i.e., no co-expression of alpha-smooth muscle actin and cytokeratin at any stage, while cytokeratin becomes undetectable in the confluent cells. PMFs obtained by this method express the genes that were previously reported to be overexpressed in non-HSC or portal fibroblast-derived liver myofibroblasts as compared to HSC-derived myofibroblasts, including the most discriminant, collagen 15, fibulin 2, and Thy-1. After one passage, PMFs retain the same phenotypic features as in

  13. Enabling OpenID Authentication for VO-integrated Portals

    NASA Astrophysics Data System (ADS)

    Plante, R.; Yekkirala, V.; Baker, W.

    2012-09-01

    To support interoperating services that share proprietary data and other user-specific information, the VAO Project provides login services for browser-based portals built on the open standard, OpenID. To help portal developers take advantage of this service, we have developed a downloadable toolkit for integrating OpenID single sign-on support into any portal. This toolkit provides APIs in a few languages commonly used on the server-side as well as a command-line version for use in any language. In addition to describing how to use this toolkit, we also discuss the general VAO framework for single sign-on. While a portal may, if it wishes, support any OpenID provider, the VAO service provides a few extra features to support VO interoperability. This includes a portal's ability to retrieve (with the user's permission) an X.509 certificate representing the authenticated user so that the portal can access other restricted services on the user's behalf. Other standard features of OpenID allow portals to request other information about the user; this feature will be used in the future for sharing information about a user's group membership to enable sharing within a group of collaborating scientists.

  14. Utility of endoscopic ultrasound in patients with portal hypertension.

    PubMed

    Hammoud, Ghassan M; Ibdah, Jamal A

    2014-10-21

    Endoscopic ultrasound (EUS) has revolutionized the diagnostic and therapeutic approach to patients with gastrointestinal disorders. Its application in patients with liver disease and portal hypertension is increasing. Patients with chronic liver disease are at risk for development of portal hypertension sequale such as ascites, spontaneous bacterial peritonitis and gastroesophageal varices. Bleeding esophageal and gastric varices are among the most common causes of mortality in patients with cirrhosis. Thus, early detection and treatment improve the outcome in this population. EUS can improve the detection and diagnosis of gastroesophageal varices and collateral veins and can provide endoscopic therapy of gastroesophageal varices such as EUS-guided sclerotherapy of esophageal collateral vessels and EUS-guided cynoacrylate (Glue) injection of gastric varices. EUS can also provide knowledge on the efficacy of pharmacotherapy of portal hypertension. Furthermore, EUS can provide assessment and prediction of variceal recurrence after endoscopic therapy and assessment of portal hemodynamics such as E-Flow and Doppler study of the azygous and portal veins. Moreover, EUS-guided fine needle aspiration may provide cytologic diagnosis of focal hepatic tumors and analysis of free abdominal fluid. Using specialized EUS-guided needle biopsy, a sample of liver tissue can be obtained to diagnose and evaluate for chronic liver disease. EUS-guided fine needle injection can be used to study portal vein pressure and hemodynamics, and potentially could be used to assist in exact measurement of portal vein pressure and placement of intrahepatic portosystemic shunt. PMID:25339809

  15. [Kidney issues web portal--a project proposal].

    PubMed

    Susnjara, Ivana Marasović

    2011-10-01

    Chronic kidney disease is a serious medical condition associated with premature mortality, decreased quality of life and increased health care needs. The increasing number of patients, an increasing number of kidney decease replacement therapy and increased total cost of treating end-stage disease are the characteristics ofthis important public health problem. In order to solve this problem the public health approach could be to promote health as a process of training individuals and companies to increase control over determinants of health and so improve their own health. In this case public health service proposed project is "Kidney issues web portal," which would consist of two parts, a public and official. The public portion would allow the education and health promotion by informing the entire population, and an official one would serviced the health professionals with the information needed. The project would be implemented in a series of planned activities throughout seven months. This project would include physicians who participate in the treatment of persons suffering from kidney disease, public health professionals, representatives of health institutions, industry, local authorities and associations of patients as co-operators. The project and the financing of the project would be implemented in three phases (teams formation, project design and implementation phase), and funding would be possible from several sources. The different type of evaluation would be carried out in two phases, process evaluation and finished project evaluation. PMID:23120823

  16. Portal provides access for carbon reduction.

    PubMed

    Baillie, Jonathan

    2012-01-01

    How the lessons learned from a concerted Marks & Spencer sustainability drive that was established, and subsequently enthusiastically championed by, the retailer's then CEO and chairman, Sir Stuart Rose, could be translated to an NHS under fierce pressure to cut its own carbon footprint, was the subject of a morning keynote session at November's Healthcare Estates 2011 conference in Manchester. The session also saw the official launch of a new online portal, established jointly by BRE and the University College London Hospitals NHS Foundation Trust, which will enable NHS Trusts to share experience, and obtain valuable advice and guidance, to assist them in their efforts to be 'greener'. HEJ editor Jonathan Baillie reports. PMID:22332312

  17. Radiation portal monitor system and method

    DOEpatents

    Morris, Christopher; Borozdin, Konstantin N.; Green, J. Andrew; Hogan, Gary E.; Makela, Mark F.; Priedhorsky, William C.; Saunders, Alexander; Schultz, Larry J.; Sossong, Michael J.

    2009-12-15

    A portal monitoring system has a cosmic ray charged particle tracker with a plurality of drift cells. The drift cells, which can be for example aluminum drift tubes, can be arranged at least above and below a volume to be scanned to thereby track incoming and outgoing charged particles, such as cosmic ray muons, whilst also detecting gamma rays. The system can selectively detect devices or materials, such as iron, lead, gold and/or tungsten, occupying the volume from multiple scattering of the charged particles passing through the volume and can also detect any radioactive sources occupying the volume from gamma rays emitted therefrom. If necessary, the drift tubes can be sealed to eliminate the need for a gas handling system. The system can be employed to inspect occupied vehicles at border crossings for nuclear threat objects.

  18. Portal hypertension in kala-azar

    PubMed Central

    Datta, D. V.; Saha, S.; Grover, S. L.; Singh, Samant A.; Chakravarti, R. N.; Chhuttani, P. N.

    1972-01-01

    The present study records haemodynamic studies in three patients with kala-azar, a parasitic disease. All the three patients had high intrasplenic pressure, mild to moderate elevation of wedged hepatic vein pressure, and increased or normal estimated hepatic blood flow. Liver histology showed marked proliferation and swelling of Kupffer cells in the sinusoids. One patient was studied serially for nine months following treatment which showed persistent elevation of intrasplenic pressure though wedge pressure and liver blood flow touched normal levels. Liver biopsy was essentially normal at this stage. These findings may have some relevance to the role of different parasitic infections in the pathogenesis of a heterogeneous group of non-cirrhotic portal fibroses. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 6 PMID:5045707

  19. Vibration of x-braced portal frames

    NASA Astrophysics Data System (ADS)

    Chang, C. H.; Wang, P. Y.; Lin, Y. W.

    1987-09-01

    Both free and forced vibrations of elastic X-braced portal frames are investigated. Solutions of the Euler-Bernoulli equation for the transverse vibration coupled with the axial vibration are used. The first five natural frequencies, with the angle of inclination, α, of the bracing bars ranging from 15° to 75°, with different slenderness ratios, R, of the columns, and different stiffness of the floor beam and crossing bars, are presented along with two sets of the natural modes of the frames with α = 45°. For the forced vibration, the dynamic responses of the frames with a concentrated horizontal time dependent force acting at a top joint are studied. The responses of the frames with α = 45° are analyzed in detail.

  20. Tsunami.gov: NOAA's Tsunami Information Portal

    NASA Astrophysics Data System (ADS)

    Shiro, B.; Carrick, J.; Hellman, S. B.; Bernard, M.; Dildine, W. P.

    2014-12-01

    We present the new Tsunami.gov website, which delivers a single authoritative source of tsunami information for the public and emergency management communities. The site efficiently merges information from NOAA's Tsunami Warning Centers (TWC's) by way of a comprehensive XML feed called Tsunami Event XML (TEX). The resulting unified view allows users to quickly see the latest tsunami alert status in geographic context without having to understand complex TWC areas of responsibility. The new site provides for the creation of a wide range of products beyond the traditional ASCII-based tsunami messages. The publication of modern formats such as Common Alerting Protocol (CAP) can drive geographically aware emergency alert systems like FEMA's Integrated Public Alert and Warning System (IPAWS). Supported are other popular information delivery systems, including email, text messaging, and social media updates. The Tsunami.gov portal allows NOAA staff to easily edit content and provides the facility for users to customize their viewing experience. In addition to access by the public, emergency managers and government officials may be offered the capability to log into the portal for special access rights to decision-making and administrative resources relevant to their respective tsunami warning systems. The site follows modern HTML5 responsive design practices for optimized use on mobile as well as non-mobile platforms. It meets all federal security and accessibility standards. Moving forward, we hope to expand Tsunami.gov to encompass tsunami-related content currently offered on separate websites, including the NOAA Tsunami Website, National Tsunami Hazard Mitigation Program, NOAA Center for Tsunami Research, National Geophysical Data Center's Tsunami Database, and National Data Buoy Center's DART Program. This project is part of the larger Tsunami Information Technology Modernization Project, which is consolidating the software architectures of NOAA's existing TWC's into

  1. Combined portal vein resection for hilar cholangiocarcinoma

    PubMed Central

    Bai, Tao; Chen, Jie; Xie, Zhi-Bo; Ma, Liang; Liu, Jun-Jie; Zhu, Shao-Liang; Wu, Fei-Xiang; Li, Le-Qun

    2015-01-01

    Background: Surgery is the only curative therapy for patients with hilar cholangiocarcinoma (HCCA). Combined portal vein resection (PVR) could achieve negative resection margins in HCCA patients with portal vein invasion. This systematic review aimed to analysis the efficiency of combined PVR for HCCA. Methods: MEDLINE, EMBASE, the Cochrane Library, the Chinese National Knowledge Infrastructure database, and clinical trial registries were searched through April 2015. Risk ratios (RRs), and 95% confidence intervals (CIs) were calculated. Results: The analysis included 21 retrospective studies, altogether involving 2403 patients (patients with PVR, n=637; patients without PVR, n=1766). Patients with PVR were likely to have more advanced HCCA (lymphatic invasion: RR=1.14, 95% CI 1.02 to 1.28; perineural invasion: RR=1.31, 95% CI 1.05 to 1.63) and suffered less curative resections (RR=0.89, 95% CI 0.75 to 0.99). Postoperative morbidity was similar between patients with or without PVR (RR=1.06, 95% CI 0.94 to 1.02). Patients with PVR suffered higher mortality rate (RR=1.52, 95% CI 1.06 to 2.18), and worse 5-year survival rate (RR=0.67, 95% CI 0.49 to 0.91). Conclusion: Combined PVR for HCCA patients would not increase postoperative morbidity rate. However, ascribed to PVR group concluded more advanced HCCA patients; patients with PVR had increased postoperative mortality rate and worse survival rate. The results still need further high quality trails for validation. PMID:26885035

  2. Development of Geospatial Map Based Election Portal

    NASA Astrophysics Data System (ADS)

    Gupta, A. Kumar Chandra; Kumar, P.; Vasanth Kumar, N.

    2014-11-01

    The Geospatial Delhi Limited (GSDL), a Govt. of NCT of Delhi Company formed in order to provide the geospatial information of National Capital Territory of Delhi (NCTD) to the Government of National Capital Territory of Delhi (GNCTD) and its organs such as DDA, MCD, DJB, State Election Department, DMRC etc., for the benefit of all citizens of Government of National Capital Territory of Delhi (GNCTD). This paper describes the development of Geospatial Map based Election portal (GMEP) of NCT of Delhi. The portal has been developed as a map based spatial decision support system (SDSS) for pertain to planning and management of Department of Chief Electoral Officer, and as an election related information searching tools (Polling Station, Assembly and parliamentary constituency etc.,) for the citizens of NCTD. The GMEP is based on Client-Server architecture model. It has been developed using ArcGIS Server 10.0 with J2EE front-end on Microsoft Windows environment. The GMEP is scalable to enterprise SDSS with enterprise Geo Database & Virtual Private Network (VPN) connectivity. Spatial data to GMEP includes delimited precinct area boundaries of Voters Area of Polling stations, Assembly Constituency, Parliamentary Constituency, Election District, Landmark locations of Polling Stations & basic amenities (Police Stations, Hospitals, Schools and Fire Stations etc.). GMEP could help achieve not only the desired transparency and easiness in planning process but also facilitates through efficient & effective tools for management of elections. It enables a faster response to the changing ground realities in the development planning, owing to its in-built scientific approach and open-ended design.

  3. Portal annular pancreas: the pancreatic duct ring sign on MRCP.

    PubMed

    Lath, Chinar O; Agrawal, Dilpesh S; Timins, Michael E; Wein, Melissa M

    2015-12-01

    Portal annular pancreas is a rare pancreatic variant in which the uncinate process of the pancreas extends and fuses to the dorsal surface of the body of the pancreas by surrounding the portal vein. It is asymptomatic, but it can be mistaken for a pancreatic head mass on imaging and could also have serious consequences during pancreatic surgery, if unrecognized. We report this case of a 53-year-old female patient who was diagnosed to have portal annular pancreas on the basis of an unusual course (ring appearance) of the main pancreatic duct on magnetic resonance cholangiopancreatography, not described earlier in the radiology literature. PMID:26649117

  4. 3. East portal of Tunnel 27, view to northeast from ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. East portal of Tunnel 27, view to northeast from atop cut bank, 210mm lens. This view shows to good effect the original construction of the Harriman period tunnels, which were concreted fifty feet in from the portals with the balance being timber lined. In 1965 the east end of the tunnel collapsed, with the result that approximately 115 feet of the east end was 'daylighted' and the original east portal and concreted end were left in place, free-standing as seen here. - Central Pacific Transcontinental Railroad, Tunnel No. 27, Milepost 133.9, Applegate, Placer County, CA

  5. Portal dosimetry for VMAT using integrated images obtained during treatment

    SciTech Connect

    Bedford, James L. Hanson, Ian M.; Hansen, Vibeke Nordmark

    2014-02-15

    Purpose: Portal dosimetry provides an accurate and convenient means of verifying dose delivered to the patient. A simple method for carrying out portal dosimetry for volumetric modulated arc therapy (VMAT) is described, together with phantom measurements demonstrating the validity of the approach. Methods: Portal images were predicted by projecting dose in the isocentric plane through to the portal image plane, with exponential attenuation and convolution with a double-Gaussian scatter function. Appropriate parameters for the projection were selected by fitting the calculation model to portal images measured on an iViewGT portal imager (Elekta AB, Stockholm, Sweden) for a variety of phantom thicknesses and field sizes. This model was then used to predict the portal image resulting from each control point of a VMAT arc. Finally, all these control point images were summed to predict the overall integrated portal image for the whole arc. The calculated and measured integrated portal images were compared for three lung and three esophagus plans delivered to a thorax phantom, and three prostate plans delivered to a homogeneous phantom, using a gamma index for 3% and 3 mm. A 0.6 cm{sup 3} ionization chamber was used to verify the planned isocentric dose. The sensitivity of this method to errors in monitor units, field shaping, gantry angle, and phantom position was also evaluated by means of computer simulations. Results: The calculation model for portal dose prediction was able to accurately compute the portal images due to simple square fields delivered to solid water phantoms. The integrated images of VMAT treatments delivered to phantoms were also correctly predicted by the method. The proportion of the images with a gamma index of less than unity was 93.7% ± 3.0% (1SD) and the difference between isocenter dose calculated by the planning system and measured by the ionization chamber was 0.8% ± 1.0%. The method was highly sensitive to errors in monitor units and

  6. Portal annular pancreas: the pancreatic duct ring sign on MRCP

    PubMed Central

    Lath, Chinar O.; Agrawal, Dilpesh S.; Timins, Michael E.; Wein, Melissa M.

    2015-01-01

    Portal annular pancreas is a rare pancreatic variant in which the uncinate process of the pancreas extends and fuses to the dorsal surface of the body of the pancreas by surrounding the portal vein. It is asymptomatic, but it can be mistaken for a pancreatic head mass on imaging and could also have serious consequences during pancreatic surgery, if unrecognized. We report this case of a 53-year-old female patient who was diagnosed to have portal annular pancreas on the basis of an unusual course (ring appearance) of the main pancreatic duct on magnetic resonance cholangiopancreatography, not described earlier in the radiology literature. PMID:26649117

  7. The Modified Mid-Anterior Portal for Hip Arthroscopy

    PubMed Central

    Matsuda, Dean K.; Villamor, Angel

    2014-01-01

    The modified mid-anterior portal is a utilitarian hip arthroscopy working portal that permits dual-portal comprehensive surgery for femoroacetabular impingement and related chondrolabral procedures without the need for interportal exchange. Its distal location facilitates labral reparative and reconstructive procedures while minimizing iatrogenic acetabular chondral damage. The relatively lateral location permits instrument navigation not only along the anterosuperior acetabular rim and anterolateral proximal femur typically required for acetabuloplasty and femoroplasty but even to the posterior regions of the hip in cases of global pincer femoroacetabular impingement and posterior extensions of cam morphology and the anteromedial proximal femur while avoiding direct injury to the lateral femoral cutaneous nerve. PMID:25276606

  8. The National Oceanic and Atmospheric Administration (NOAA) Climate Services Portal: A New Centralized Resource for Distributed Climate Information

    NASA Astrophysics Data System (ADS)

    Burroughs, J.; Baldwin, R.; Herring, D.; Lott, N.; Boyd, J.; Handel, S.; Niepold, F.; Shea, E.

    2010-09-01

    With the rapid rise in the development of Web technologies and climate services across NOAA, there has been an increasing need for greater collaboration regarding NOAA's online climate services. The drivers include the need to enhance NOAA's Web presence in response to customer requirements, emerging needs for improved decision-making capabilities across all sectors of society facing impacts from climate variability and change, and the importance of leveraging climate data and services to support research and public education. To address these needs, NOAA (during fiscal year 2009) embarked upon an ambitious program to develop a NOAA Climate Services Portal (NCS Portal). Four NOAA offices are leading the effort: 1) the NOAA Climate Program Office (CPO), 2) the National Ocean Service's Coastal Services Center (CSC), 3) the National Weather Service's Climate Prediction Center (CPC), and 4) the National Environmental Satellite, Data, and Information Service's (NESDIS) National Climatic Data Center (NCDC). Other offices and programs are also contributing in many ways to the effort. A prototype NCS Portal is being placed online for public access in January 2010, http://www.climate.gov. This website only scratches the surface of the many climate services across NOAA, but this effort, via direct user engagement, will gradually expand the scope and breadth of the NCS Portal to greatly enhance the accessibility and usefulness of NOAA's climate data and services.

  9. THE NSF National Science, Technology, Engineering, and Mathematics Education Digital Library (NSDL) Program; Software for Building a Full-Featured Discipline-Based Web Portal; A Metadata Framework Developed at the Tsinghua University Library To Aid in the Preservation of Digital Resources; A Scalable Architecture for Harvest-Based Digital Libraries; The Design and Evaluation of Interactivities in a Digital Library.

    ERIC Educational Resources Information Center

    Zia, Lee L.; Almasy, Edward; Sleasman, David; Bower, Rachael; Niu, Jingfang; Liu, Xiaoming; Maly, Kurt; Zubair, Mohammad; Nelson, Michael L.; Brody, Tim; Harnard, Stevan; Carr, Les; Budhu, Muniram; Coleman, Anita

    2002-01-01

    Includes five articles that discuss digital library programs related to the National Science Foundation; software for building Web portals; metadata developed at Tsinghua University Library (China) for preserving digital resources; the Open Archives Initiative for metadata and the need for a common infrastructure; and interactivity in a digital…

  10. Portal vein occlusion after biliary metal stent placement in hilar cholangiocarcinoma.

    PubMed

    Woo, Kyung Hee; Kim, Jin Bae; Chang, Yoon Jung; Kim, Hyo Jung; Baek, Il Hyun; Ko, Jin Seok; Woo, Ji Young; Kim, Hong Dae; Lee, Myung Seok

    2008-06-01

    Acute symptomatic portal vein obstruction related to biliary stenting is an extremely rare but life-threatening complication. This usually occurs in patients with either tumor invasion into the portal vein or pre-existing portal vein thrombus. Therefore, the portal vein should be carefully evaluated before placing a biliary metallic stent in such patients. We describe a case of acute portal vein obstruction after placing metallic biliary stents in a patient with a periductal-infiltrating type of hilar cholangiocarcinoma. PMID:20485610

  11. 2. PORTAL VIEW OF BRIDGE FROM NORTH SIDE OF SANITARY ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. PORTAL VIEW OF BRIDGE FROM NORTH SIDE OF SANITARY AND SHIP CANAL, LOOKING SOUTHEAST. - Chicago, Madison & Northern Railroad, Sanitary & Ship Canal Bridge, Spanning Sanitary & Ship Canal, east of Kedzie Avenue, Chicago, Cook County, IL

  12. 4. West portal of Tunnel 5, view to the northwest ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. West portal of Tunnel 5, view to the northwest from within the mudshed, 135mm lens with electronic flash fill. - Southern Pacific Railroad Natron Cutoff, Tunnel 5, Milepost 545.2, McCredie Springs, Lane County, OR

  13. 2. CONFLUENCE POOL, DETAIL OF TUNNEL PORTAL WITH WATER ENTERING ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. CONFLUENCE POOL, DETAIL OF TUNNEL PORTAL WITH WATER ENTERING FROM SANTA ANA RIVER. VIEW TO NORTHEAST. - Santa Ana River Hydroelectric System, Bear Creek Diversion Dam & Confluence Pool, Redlands, San Bernardino County, CA

  14. 5. East portal of Tunnel 5, contextual view to the ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. East portal of Tunnel 5, contextual view to the northeast from the west end of Cruzette Siding, 210mm lens. - Southern Pacific Railroad Natron Cutoff, Tunnel 5, Milepost 545.2, McCredie Springs, Lane County, OR

  15. Patient portals - An online tool for your health

    MedlinePlus

    ... gov/ency/patientinstructions/000880.htm Patient portals - An online tool for your health To use the sharing ... a website for your personal health care. The online tool helps you to keep track of your ...

  16. 4. APPROACH OF CARRS MILL ROAD TO THE SOUTH PORTAL ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. APPROACH OF CARRS MILL ROAD TO THE SOUTH PORTAL OF THE MITCHELLS MILL BRIDGE; VIEW TO NORTH. - Mitchell's Mill Bridge, Spanning Winter's Run on Carrs Mill Road, west of Bel Air, Bel Air, Harford County, MD

  17. 7. NORTH WEB AND WEST PORTAL. VIEW TO SOUTHEAST FROM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    7. NORTH WEB AND WEST PORTAL. VIEW TO SOUTHEAST FROM BLAIR RAILROAD BRIDGE. - Abraham Lincoln Memorial Bridge, Spanning Missouri River on Highway 30 between Nebraska & Iowa, Blair, Washington County, NE

  18. 15. SOUTH WEB AND WEST PORTAL OF MIDDLE THROUGH TRUSS. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. SOUTH WEB AND WEST PORTAL OF MIDDLE THROUGH TRUSS. VIEW TO NORTHEAST. - Abraham Lincoln Memorial Bridge, Spanning Missouri River on Highway 30 between Nebraska & Iowa, Blair, Washington County, NE

  19. Cut at eastern approach, with portal obscured by train entering ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Cut at eastern approach, with portal obscured by train entering tunnel, looking NNW. - Philadelphia & Reading Railroad, Black Rock Tunnel, Beneath Black Rock Hill, southwest of Black Rock Dam, Phoenixville, Chester County, PA

  20. East portal of Tunnel No. 1292, Indigo Tunnel, showing interior ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    East portal of Tunnel No. 1292, Indigo Tunnel, showing interior timber framing, looking southwest. - Western Maryland Railway, Cumberland Extension, Pearre to North Branch, from WM milepost 125 to 160, Pearre, Washington County, MD