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Canning P, Doyon S, Ali S, Logan SB, Alter A, Hart K, Coler R, Kamin R, Wolf SC, Soto K, Whiteman L, Jenkins M. Using Surveillance With Near-Real-Time Alerts During a Cluster of Overdoses From Fentanyl-Contaminated Crack Cocaine, Connecticut, June 2019. Public Health Rep 2021; 136:18S-23S. [PMID: 34726975 PMCID: PMC8573789 DOI: 10.1177/00333549211015662] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
In 2019, Connecticut launched an opioid overdose-monitoring program to provide rapid intervention and limit opioid overdose-related harms. The Connecticut Statewide Opioid Response Directive (SWORD)-a collaboration among the Connecticut State Department of Public Health, Connecticut Poison Control Center (CPCC), emergency medical services (EMS), New England High Intensity Drug Trafficking Area (HIDTA), and local harm reduction groups-required EMS providers to call in all suspected opioid overdoses to the CPCC. A centralized data collection system and the HIDTA overdose mapping tool were used to identify outbreaks and direct interventions. We describe the successful identification of a cluster of fentanyl-contaminated crack cocaine overdoses leading to a rapid public health response. On June 1, 2019, paramedics called in to the CPCC 2 people with suspected opioid overdose who reported exclusive use of crack cocaine after being resuscitated with naloxone. When CPCC specialists in poison information followed up on the patients' status with the emergency department, they learned of 2 similar cases, raising suspicion that a batch of crack cocaine was mixed with an opioid, possibly fentanyl. The overdose mapping tool pinpointed the overdose nexus to a neighborhood in Hartford, Connecticut; the CPCC supervisor alerted the Connecticut State Department of Public Health, which in turn notified local health departments, public safety officials, and harm reduction groups. Harm reduction groups distributed fentanyl test strips and naloxone to crack cocaine users and warned them of the dangers of using alone. The outbreak lasted 5 days and tallied at least 22 overdoses, including 6 deaths. SWORD's near-real-time EMS reporting combined with the overdose mapping tool enabled rapid recognition of this overdose cluster, and the public health response likely prevented additional overdoses and loss of life.
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Antonucci F, Figorilli S, Costa C, Pallottino F, Raso L, Menesatti P. A review on blockchain applications in the agri-food sector. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2019; 99:6129-6138. [PMID: 31273793 DOI: 10.1002/jsfa.9912] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/25/2019] [Accepted: 07/03/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Food security can benefit from the technology's transparency, relatively low transaction costs and instantaneous applications. A blockchain is a distributed database of records in the form of encrypted blocks, or a public ledger of all transactions or digital events that have been executed and shared among participating parties and can be verified at any time in the future. Generally, the robust and decentralized functionality of the blockchain is used for global financial systems, but it can easily be expanded to contracts and operations such as tracking of the global supply chain. In the precision agriculture context, Information and Communications Technology can be further implemented with a blockchain infrastructure to enable new farm systems and e-agriculture schemes. RESULTS The purpose of this review is to show a panorama of the scientific studies (enriched by a terms mapping analysis) on the use of blockchain in the agri-food sector, from both an entirely computational and an applicative point of view. As evidenced by the network analysis, the reviewed studies mainly focused on software aspects (e.g. the architecture and smart contracts). However, some aspects regarding the different blockchain knots (computers always connected to the blockchain network) having the role to store and distribute an updated copy of each block in a food supply-chain, result of crucial importance. CONCLUSION These technologies appear very promising and rich of great potential showing a good flexibility for applications in several sectors but still immature and hard to apply due to their complexity. © 2019 Society of Chemical Industry.
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Abstract
Jennifer Bryce and the RMM Working Group describe the origin and rationale of the Real-Time Monitoring of Under-Five Mortality Collection.
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Keim RG, Gottlieb EL, Vogels DS, Vogels PB. 2015 JCO Orthodontic Practice Study, Part 1 Trends. JOURNAL OF CLINICAL ORTHODONTICS : JCO 2015; 49:625-639. [PMID: 26562391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Feuerstein P, Adams D. New Technologies Shape the Future of Dentistry. DENTISTRY TODAY 2015; 34:88, 90, 92 passim. [PMID: 26349254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Luongo G. Editorial: Digital Dentistry. EUROPEAN JOURNAL OF ORAL IMPLANTOLOGY 2015; 8:323. [PMID: 26669542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Lee JH, Delbruck T, Pfeiffer M, Park PKJ, Shin CW, Ryu HE, Kang BC. Real-time gesture interface based on event-driven processing from stereo silicon retinas. IEEE TRANSACTIONS ON NEURAL NETWORKS AND LEARNING SYSTEMS 2014; 25:2250-2263. [PMID: 25420246 DOI: 10.1109/tnnls.2014.2308551] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We propose a real-time hand gesture interface based on combining a stereo pair of biologically inspired event-based dynamic vision sensor (DVS) silicon retinas with neuromorphic event-driven postprocessing. Compared with conventional vision or 3-D sensors, the use of DVSs, which output asynchronous and sparse events in response to motion, eliminates the need to extract movements from sequences of video frames, and allows significantly faster and more energy-efficient processing. In addition, the rate of input events depends on the observed movements, and thus provides an additional cue for solving the gesture spotting problem, i.e., finding the onsets and offsets of gestures. We propose a postprocessing framework based on spiking neural networks that can process the events received from the DVSs in real time, and provides an architecture for future implementation in neuromorphic hardware devices. The motion trajectories of moving hands are detected by spatiotemporally correlating the stereoscopically verged asynchronous events from the DVSs by using leaky integrate-and-fire (LIF) neurons. Adaptive thresholds of the LIF neurons achieve the segmentation of trajectories, which are then translated into discrete and finite feature vectors. The feature vectors are classified with hidden Markov models, using a separate Gaussian mixture model for spotting irrelevant transition gestures. The disparity information from stereovision is used to adapt LIF neuron parameters to achieve recognition invariant of the distance of the user to the sensor, and also helps to filter out movements in the background of the user. Exploiting the high dynamic range of DVSs, furthermore, allows gesture recognition over a 60-dB range of scene illuminance. The system achieves recognition rates well over 90% under a variety of variable conditions with static and dynamic backgrounds with naïve users.
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Kollef MH, Chen Y, Heard K, LaRossa GN, Lu C, Martin NR, Martin N, Micek ST, Bailey T. A randomized trial of real-time automated clinical deterioration alerts sent to a rapid response team. J Hosp Med 2014; 9:424-9. [PMID: 24706596 PMCID: PMC4354800 DOI: 10.1002/jhm.2193] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 02/24/2014] [Accepted: 03/14/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Episodes of patient deterioration on hospital units are expected to increasingly contribute to morbidity and healthcare costs. OBJECTIVE To determine if real-time alerts sent to the rapid response team (RRT) improved patient care. DESIGN Randomized, controlled trial. SETTING Eight medicine units (Barnes-Jewish Hospital). PATIENTS Five hundred seventy-one patients. INTERVENTION Real-time alerts generated by a validated deterioration algorithm were sent real-time to the RRT (intervention) or hidden (control). MEASUREMENTS Intensive care unit (ICU) transfer, hospital mortality, hospital duration. RESULTS ICU transfer (17.8% vs 18.2%; odds ratio: 0.972; 95% confidence interval [CI]: 0.635-1.490) and hospital mortality (7.3% vs 7.7%; odds ratio: 0.947; 95% CI: 0.509-1.764) were similar for the intervention and control groups. The number of patients requiring transfer to a nursing home or long-term acute care hospital was similar for patients in the intervention and control groups (26.9% vs 26.3%; odds ratio: 1.032; 95% CI: 0.712-1.495). Hospital duration (8.4 ± 9.5 days vs 9.4 ± 11.1 days; P = 0.038) was statistically shorter for the intervention group. The number of RRT calls initiated by the primary care team was similar for the intervention and control groups (19.9% vs 16.5%; odds ratio: 1.260; 95% CI: 0.823-1.931). CONCLUSIONS Real-time alerts sent to the RRT did not reduce ICU transfers, hospital mortality, or the need for subsequent long term care. However, hospital length of stay was modestly reduced.
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Esposito M. In which direction will future clinical research go? EUROPEAN JOURNAL OF ORAL IMPLANTOLOGY 2014; 7:123. [PMID: 24977246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Leventhal R. Delivering data in real time. How Martin's Point Health Care has leveraged its data for effective population health management. HEALTHCARE INFORMATICS : THE BUSINESS MAGAZINE FOR INFORMATION AND COMMUNICATION SYSTEMS 2013; 30:34-36. [PMID: 24490322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Bailey TC, Chen Y, Mao Y, Lu C, Hackmann G, Micek ST, Heard KM, Faulkner KM, Kollef MH. A trial of a real-time alert for clinical deterioration in patients hospitalized on general medical wards. J Hosp Med 2013; 8:236-42. [PMID: 23440923 DOI: 10.1002/jhm.2009] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 10/03/2012] [Accepted: 12/12/2012] [Indexed: 11/10/2022]
Abstract
BACKGROUND With limited numbers of intensive care unit (ICU) beds available, increasing patient acuity is expected to contribute to episodes of inpatient deterioration on general wards. OBJECTIVE To prospectively validate a predictive algorithm for clinical deterioration in general-medical ward patients, and to conduct a trial of real-time alerts based on this algorithm. DESIGN Randomized, controlled crossover study. SETTING/PATIENTS Academic center with patients hospitalized on 8 general wards between July 2007 and December 2011. INTERVENTIONS Real-time alerts were generated by an algorithm designed to predict the need for ICU transfer using electronically available data. The alerts were sent by text page to the nurse manager on intervention wards. MEASUREMENTS Intensive care unit transfer, hospital mortality, and hospital length of stay. RESULTS Patients meeting the alert threshold were at nearly 5.3-fold greater risk of ICU transfer (95% confidence interval [CI]: 4.6-6.0) than those not satisfying the alert threshold (358 of 2353 [15.2%] vs 512 of 17678 [2.9%]). Patients with alerts were at 8.9-fold greater risk of death (95% CI: 7.4-10.7) than those without alerts (244 of 2353 [10.4%] vs 206 of 17678 [1.2%]). Among patients identified by the early warning system, there were no differences in the proportion of patients who were transferred to the ICU or who died in the intervention group as compared with the control group. CONCLUSIONS Real-time alerts were highly specific for clinical deterioration resulting in ICU transfer and death, and were associated with longer hospital length of stay. However, an intervention notifying a nurse of the risk did not result in improvement in these outcomes.
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Ogedegbe C, Morchel H, Hazelwood V, Chaplin WF, Feldman J. Development and evaluation of a novel, real time mobile telesonography system in management of patients with abdominal trauma: study protocol. BMC Emerg Med 2012; 12:19. [PMID: 23249290 PMCID: PMC3546944 DOI: 10.1186/1471-227x-12-19] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 12/07/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Despite the use of e-FAST in management of patients with abdominal trauma, its utility in prehospital setting is not widely adopted. The goal of this study is to develop a novel portable telesonography (TS) system and evaluate the comparability of the quality of images obtained via this system among healthy volunteers who undergo e-FAST abdominal examination in a moving ambulance and at the ED. We hypothesize that: (1) real-time ultrasound images of acute trauma patients in the pre-hospital setting can be obtained and transmitted to the ED via the novel TS system; and (2) Ultrasound images transmitted to the hospital from the real-time TS system will be comparable in quality to those obtained in the ED. METHODS Study participants are three healthy volunteers (one each with normal, overweight and obese BMI category). The ultrasound images will be obtained by two ultrasound-trained physicians The TS is a portable sonogram (by Sonosite) interfaced with a portable broadcast unit (by Live-U). Two UTPs will conduct e-FAST examinations on healthy volunteers in moving ambulances and transmit the images via cellular network to the hospital server, where they are stored. Upon arrival in the ED, the same UTPs will obtain another set of images from the volunteers, which are then compared to those obtained in the moving ambulances by another set of blinded UTPs (evaluators) using a validated image quality scale, the Questionnaire for User Interaction Satisfaction (QUIS). DISCUSSION Findings from this study will provide needed data on the validity of the novel TS in transmitting live images from moving ambulances to images obtained in the ED thus providing opportunity to facilitate medical care of a patient located in a remote or austere setting.
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Morrow T. Using virtual assistant technology to improve outcomes, adherence. MANAGED CARE (LANGHORNE, PA.) 2012; 21:61-62. [PMID: 22393606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Thede LQ. Informatics: where is it? ONLINE JOURNAL OF ISSUES IN NURSING 2012; 17:10. [PMID: 22320882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Carlson J. Keeping an eye out for trouble. Internal controls are key, fraud investigators say. MODERN HEALTHCARE 2011; 41:12. [PMID: 21853568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Abstract
The role of computers in dental practice has dramatically changed over the past 30 years. We have witnessed the progression from administrative roles to complete integration leading to chartless offices. As the dental community gradually adopts this contemporary development, the move to electronic health records is imminent because of upcoming changes in the health care system. The past, present, and future of dental office computer systems is explored in this article. An understanding of the benefits and current challenges of contemporary dental practice software is also reviewed.
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Georgieff P, Friedewald M. [Facing the challenges of ubiquitous computing in the health care sector]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2010; 104:715-720. [PMID: 21147433 DOI: 10.1016/j.zefq.2010.07.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Revised: 07/23/2010] [Accepted: 07/23/2010] [Indexed: 05/30/2023]
Abstract
The steady progress of microelectronics, communications and information technology will enable the realisation of the vision for "ubiquitous computing" where the Internet extends into the real world embracing everyday objects. The necessary technical basis is already in place. Due to their diminishing size, constantly falling price and declining energy consumption, processors, communications modules and sensors are being increasingly integrated into everyday objects today. This development is opening up huge opportunities for both the economy and individuals. In the present paper we discuss possible applications, but also technical, social and economic barriers to a wide-spread use of ubiquitous computing in the health care sector.
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Castillo M. Forecast: [cloud]. AJNR Am J Neuroradiol 2010; 31:979-80. [PMID: 20056906 DOI: 10.3174/ajnr.a1965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Garten Y, Altman RB. Teaching computers to read the pharmacogenomics literature ... so you don't have to. Pharmacogenomics 2010; 11:515-8. [PMID: 20350132 PMCID: PMC3478760 DOI: 10.2217/pgs.10.48] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Chatterjee S, Price A. Healthy living with persuasive technologies: framework, issues, and challenges. J Am Med Inform Assoc 2009; 16:171-8. [PMID: 19074300 PMCID: PMC2649327 DOI: 10.1197/jamia.m2859] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Accepted: 12/05/2008] [Indexed: 11/10/2022] Open
Abstract
While our Y2K worries about old computers "retiring" at midnight captured the television and news media attention, a more significant "old age" phenomenon snuck onto the scene with hardly a headline: the dawn of the age of the aged. (1) The over burdened health care system will face a worldwide wave of retirees who will live longer, cost more to treat, and demand new goods and services to help them stay healthy, active, and independent. Research in persuasive technologies and the associated usage of a computing system, device, or application intentionally designed to change a person's attitude or behavior in a predetermined way is showing the potential to assist in improving healthy living, reduce the costs on the health care system, and allow the aged to maintain a more independent life. This article gives a deeper insight into the evolution of persuasive technologies and presents a framework that can guide a researcher or practitioner in comprehending more effectively the work being done in this novel research field. It also provides categories of domains within health care in which these technologies are used and surveys exemplars from published literature. The article's goal is to provide greater understanding by addressing the challenges that lie ahead for all key stakeholders that design and/or use persuasive technologies in health care.
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Raum R. The future as I see it. THE JOURNAL OF THE AMERICAN COLLEGE OF DENTISTS 2009; 76:17-20. [PMID: 20415125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Predicting the future is always chancy, but when a young practitioner begins a career in dentistry, it is worthwhile to have some well-reasoned expectations. The critical dimensions in the next several decades in dentistry will include technology, marketing, and society.
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Manning BRM, McCann J, Benton S, Bougourd J. Active ageing: independence through technology assisted health optimisation. Stud Health Technol Inform 2008; 137:257-262. [PMID: 18560086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The potential doubling in the percentage of the elderly within the populations of Europe and beyond over the next decades has focused informatics research on the development Assistive Technologies and Smart Homes. However its concentration on creating a supportive home environment also has the potential for makings its users over dependent on its facilities and as a result trapped within it. This paper outlines an approach that extends the smart homes concept out into the wider community to create a smart environment that not only maintains contact with all their home-based services, but also expands these to include other facilities needed to assist them whilst on the move. This involves the convergence of physiological monitoring, communications and computing with leading-edge textile technologies, which uses a multi-layered, multi-functional clothing system as a mobile and extended variant of a smart home IP hub. In addition to variable functionality capabilities of the clothing layers in terms of thermal, shock-absorbent and other characteristics, wireless IP connectivity is provided between layers with external links typically being WiFi enabled. Health optimisation is provided by on-going lifestyle guidance/action feedback based on auto-diagnostic analysis.
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Carrajo L, Penas A, Melcón R, González FJ, Couto E. From documents on paper to electronic medical records. Stud Health Technol Inform 2008; 136:395-400. [PMID: 18487763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This paper describes the creation process of an electronic medical records (EMR) application in the Juan Canalejo University Hospital Complex (CHUJC). From the knowledge acquired through the observation of the traditional processes of managing the Patients medical records on paper a tool was developed which in principle was thought of to classify electronic documents associated to a patient and to which different functions of medical work have been subsequently added: visualizing clinical documents of patients, creation of new documents and following the development of patients.
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