Commercial Recordings Research Articles

Eight Artist-Level Violinists Performing Unaccompanied Bach: Are There Consistent Tuning Patterns?

This study was designed to explore the intonation performances of highly regarded concert violinists in an unaccompanied context. I chose eight solo artists representing different generations of performers (Heifetz, Grumiaux, Milstein, Perlman, Hahn, Midori, Barton Pine, and Shaham). Pitch performances were analyzed in commercial recordings spanning 65 years of two unaccompanied pieces composed by Bach, one in d minor and one in E major. I investigated whether similarities in intonation tendencies would occur among these respected artists, and whether the displayed patterns would approximate the theoretical tuning systems that have been studied previously: Just, Pythagorean, or equal temperament. The artists appear to have their own individual tendencies, and none of them conformed consistently to any theoretical tuning system. Although there are average tendencies on isolated intervals that approximate one tuning or the other, multiple repetitions show a wide range both between and within individual performers. However, performances of the thirds and sixths in the major key and less so in the minor key (intervals that illustrate the largest differences in tuning between systems) did display a propensity toward Pythagorean tuning of these scale degrees. Deviations away from all three tuning systems are common, and these artists never play exactly in one tuning or another.

Comprehensive methodology to monitor longitudinal change patterns during EHR implementations: a case study at a large health care delivery network

ObjectiveTo test a systematic methodology to monitor longitudinal change patterns on quality, productivity, and safety outcomes during a large-scale commercial Electronic Health Record (EHR) implementation. Materials and MethodsOur method combines an interrupted time-series design with control sites and 41 consensus outcomes including quality (11 measures), productivity (20 measures), and safety (10 measures). The intervention consisted of a phased commercial EHR implementation at a large health care delivery network. Four medium-size hospitals and 39 clinics from 5 geographic regions implementing the new EHR were compared against a parallel control consisting of one medium-size and one large hospital and 10 clinics that had not implemented the new EHR at the time of this study. We collected monthly data from February 2013 to July 2017. ResultsThe proposed methodology was successfully implemented and significant changes were observed in most measured variables. A significant change attributable to the intervention was observed in 12 (29%) measures in three or more regions; in 32 (78%) measures in two or more regions; and in 40 (98%) measures in at least one region. A similar pattern (i.e., same impact in three or more regions) was detected for nine (22%) measures, a mixed pattern (i.e., same impact in two regions, and different impact in other regions) was detected for nine (22%) measures, and an inconsistent pattern (i.e., did not detect the same impact across regions) was detected for 23 (56%) measures. DiscussionUsing a formal methodology to assess changes in a set of consensus measures, we detected various patterns of impact and mixed time-sensitive effects. With an increasing adoption of EHR systems, it is critical for health care organizations to systematically monitor their EHR implementations. The proposed method provides a robust and consistent approach to monitor EHR implementations longitudinally allowing for continuous monitoring after the system becomes stable in order to avoid unexpected effects. ConclusionOur results and methodology can guide the broader medical and informatics communities by informing what and how to continuously monitor EHR impact on quality, productivity, and safety.

Reduced Effectiveness of Interruptive Drug-Drug Interaction Alerts after Conversion to a Commercial Electronic Health Record.

Drug-drug interaction (DDI) alerts in electronic health records (EHRs) can help prevent adverse drug events, but such alerts are frequently overridden, raising concerns about their clinical usefulness and contribution to alert fatigue. To study the effect of conversion to a commercial EHR on DDI alert and acceptance rates. Two before-and-after studies. 3277 clinicians who received a DDI alert in the outpatient setting. Introduction of a new, commercial EHR and subsequent adjustment of DDI alerting criteria. Alert burden and proportion of alerts accepted. Overall interruptive DDI alert burden increased by a factor of 6 from the legacy EHR to the commercial EHR. The acceptance rate for the most severe alerts fell from 100 to 8.4%, and from 29.3 to 7.5% for medium severity alerts (P < 0.001). After disabling the least severe alerts, total DDI alert burden fell by 50.5%, and acceptance of Tier 1 alerts rose from 9.1 to 12.7% (P < 0.01). Changing from a highly tailored DDI alerting system to a more general one as part of an EHR conversion decreased acceptance of DDI alerts and increased alert burden on users. The decrease in acceptance rates cannot be fully explained by differences in the clinical knowledge base, nor can it be fully explained by alert fatigue associated with increased alert burden. Instead, workflow factors probably predominate, including timing of alerts in the prescribing process, lack of differentiation of more and less severe alerts, and features of how users interact with alerts.

“Attractor Tempi” in Brahms’s Symphony No. 2/III

This analysis assesses tempo choice in the third movement of Brahms’s Second Symphony. It is shown that, at key moments of the movement, the average tempi used in a sample of commercial recordings align closely with those suggested by the “attractor” model of cognitively preferable (easiest) tempi (Gotham 2015). Between these stable checkpoints, the movement navigates through a variety of other metrical structures at (formally) the same tempo, each with their own attractor tempi. These necessarily align less well with the tempi used, thus providing a pattern of relative tension/relaxation, which the new model helps to elucidate.

Gap-mode-assisted light-induced switching of sub-wavelength magnetic domains

Creating sub-micron hotspots for applications such as heat-assisted magnetic recording (HAMR) is a challenging task. The most common approach relies on a surface-plasmon resonator (SPR), whose design dictates the size of the hotspot to always be larger than its critical dimension. Here, we present an approach which circumvents known geometrical restrictions by resorting to electric field confinement via excitation of a gap-mode (GM) between a comparatively large Gold (Au) nano-sphere (radius of 100 nm) and the magnetic medium in a grazing-incidence configuration. Operating a λ=785 nm laser, sub-200 nm hot spots have been generated and successfully used for GM-assisted magnetic switching on commercial CoCrPt perpendicular magnetic recording media at laser powers and pulse durations comparable to SPR-based HAMR. Lumerical electric field modelling confirmed that operating in the near-infrared regime presents a suitable working point where most of the light's energy is deposited in the magnetic layer, rather than in the nano-particle. Further, modelling is used for predicting the limits of our method which, in theory, can yield sub-30 nm hotspots for Au nano-sphere radii of 25–50 nm for efficient heating of FePt recording media with a gap of 5 nm.

Afterlives of BBC Radio Features

BBC Radio feature programmes written by established literary figures in the mid-twentieth century enjoyed richly creative afterlives across many decades and in a variety of media—for example, in print, as commercial recordings, in theatre performance and on television—as well as in a succession of new productions on radio. This activity kept works alive in the public imagination beyond the ephemeral moment of first broadcast and, it is argued, contributed to the sense (for audiences past and scholars present) of an informal canon of literary radio features. This essay explores the intermedial afterlives of three such literary features—Sackville-West’s The Rescue (1943), MacNeice’s The Dark Tower (1946) and Thomas’ Under Milk Wood (1954)—in order to demonstrate the significance of the form as a site for exploration of social issues, politics and cultural life. The essay concludes with a call for more wide-ranging attention to the protean feature form, including work that may not have persisted in the schedules, or had rich, intermedial afterlives, but that may still offer significant insights into the history of social, political and cultural life in mid-twentieth-century Britain.

Comparing the Received Pronunciation of J. R. Firth and Daniel Jones: A sociophonetic perspective

This study focuses on a corpus assembled from commercial recordings of 1929 and 1932 featuring the two British linguists J. R. Firth (1890–1960) and Daniel Jones (1881–1967). The aim is to analyse and quantify differences in the Received Pronunciation (RP) used by the two men, in relation to sociolinguistic and stylistic variation within RP of the period. A systematic acoustic analysis reveals that whereas the vowel systems of the two speakers are closely similar in most respects, there are significant differences in the realizations of the trap, price and dress qualities. We show that each of these has a well-documented history of variation in RP, and find that in each case Firth is employing the higher-class or more prestigious variant, which is a reversal of expectations based on what is known about the social and regional origins of the two. We consider the possible roles of social background, avoidance of regional features and hypercorrection. The outcomes of our work are (i) an illustration of RP used in the interwar period for the purposes of teaching English as a foreign language, (ii) empirical evidence for internal variation within the accent, (iii) additional insights into the stylistic and social correlates of this variation, and (iv) a demonstration that satisfactory formant analyses can be conducted with recordings from as early as the 1920s. Overall, it is hoped that this case-study will both throw light on the ‘standard’ accent of the era and inspire further sociophonetic investigations with legacy recordings.

Development and evaluation of a novel user interface for reviewing clinical microbiology results.

Microbiology laboratory results are complex and cumbersome to review. We sought to develop a new review tool to improve the ease and accuracy of microbiology results review. We observed and informally interviewed clinicians to determine areas in which existing microbiology review tools were lacking. We developed a new tool that reorganizes microbiology results by time and organism. We conducted a scenario-based usability evaluation to compare the new tool to existing legacy tools, using a balanced block design. The average time-on-task decreased from 45.3 min for the legacy tools to 27.1 min for the new tool (P < .0001). Total errors decreased from 41 with the legacy tools to 19 with the new tool (P = .0068). The average Single Ease Question score was 5.65 (out of 7) for the new tool, compared to 3.78 for the legacy tools (P < .0001). The new tool scored 88 ("Excellent") on the System Usability Scale. The new tool substantially improved efficiency, accuracy, and usability. It was subsequently integrated into the electronic health record and rolled out system-wide. This project provides an example of how clinical and informatics teams can innovative alongside a commercial Electronic Health Record (EHR).

Evaluating the usability of speech recognition to create clinical documentation using a commercial electronic health record

ObjectiveTo conduct a usability study exploring the value of using speech recognition (SR) for clinical documentation tasks within an electronic health record (EHR) system. MethodsThirty-five emergency department clinicians completed a system usability scale (SUS) questionnaire. The study was undertaken after participants undertook randomly allocated clinical documentation tasks using keyboard and mouse (KBM) or SR. SUS scores were analyzed and the results with KBM were compared to SR results. ResultsSignificant difference in SUS scores between EHR system use with and without SR were observed (KBM 67, SR 61; P = 0.045; CI, 0.1 to 12.0). Nineteen of 35 participants scored higher for EHR with KBM, 11 higher for EHR with SR and 5 gave the same score for both. Factor analysis showed no significant difference in scores for the sub-element of usability (EHR with KBM 65, EHR with SR 62; P = 0.255; CI, −2.6 to 9.5). Scores for the sub-element of learnability were significantly different (KBM 72, SR 55; P < 0.001; CI, 9.8 to 23.5). A significant correlation was found between the perceived usability of the two system configurations (EHR with KBM or SR) and the efficiency of documentation (time to document) (P = 0.002; CI, 10.5 to −0.1) but not with safety (number of errors) (P = 0.90; CI, −2.3 to 2.6). DiscussionSR was associated with significantly reduced overall usability scores, even though it is often positioned as ease of use technology. SR was perceived to impose larger costs in terms of learnability via training and support requirements for EHR based documentation when compared to using KBM. Lower usability scores were significantly associated with longer documentation times. ConclusionThe usability of EHR systems with any input modality is an area that requires continued development. The addition of an SR component to an EHR system may cause a significant reduction in terms of perceived usability by clinicians.

“Accordin’ to the Gospel of Etymology”: Burlesque Sermons on Early Commercial Sound Recordings

AbstractAmong the most highly esteemed verbal artists in late nineteenth- and early twentieth-century American society were preachers, some of whom attained a remarkable degree of celebrity. As Bak...

The Self-Assessed Békesy Procedure: Validation of a Method to Measure Intelligibility of Connected Discourse.

In clinical practice and research, speech intelligibility is generally measured by instructing the participant to recall sentences. Although this is a reliable and highly repeatable measure, it cannot be used to measure intelligibility of connected discourse. Therefore, we developed a new method, the self-assessed Békesy procedure, which is an adaptive procedure that uses intelligibility ratings to converge to a person’s speech reception threshold. In this study, we describe the new procedure and the validation in young, normal-hearing listeners. First, we compared the results on the self-assessed Békesy procedure to a recall procedure for standardized sentences. Next, we evaluated the inter- and intrasubject variability of our procedure. Furthermore, we compared the thresholds for sentences in three masker types between the self-assessed Békesy and a recall procedure to verify if these procedures resulted in similar conclusions. Finally, we compared the thresholds for two types of sentences and commercial recordings of stories. In general, the self-assessed Békesy procedure is shown to be a valid and reliable procedure as similar thresholds (difference < 1 dB) and test–retest reliability (< 1.5 dB) were observed compared with standard speech audiometry tests. In addition, the time efficiency and similar differences between maskers to a recall procedure support the potential of this procedure to be implemented in research. Finally, significant differences between the thresholds of sentences and connected discourse materials were found, indicating the importance of controlling for differences in intelligibility when presenting these materials at the same signal-to-noise ratios or when comparing studies.

Noise benefits in the array of brain-computer interface classification systems

Abstract This paper shows that noise can improve the accuracy of brain-computer interface (BCI) systems. Additive Gaussian noise can benefit arrays of ensemble support vector machines (ESVMs) that classify P300 or motor imagery (MI) activities in electroencephalogram (EEG) signals. We show these noise benefits in 64-channel EEG signals from the BCI Competitions II dataset IIb and BCI Competitions III dataset II for the P300 speller paradigm and in 3-channel EEG signals from the BCI Competitions II dataset III and BCI Competitions III dataset IIIa for MI classification systems. We also show that noise can improve the accuracy of EEG classifications based on restricted channel positions in commercial recording systems, such as the 14-channel Emotiv Epoc headset. The experimental results show that noise can provide classifiers with higher accuracy and can reduce the data collection time for P300 classification. The results also show that training ESVMs with a concatenated original dataset and noise-added datasets can improve MI classification. Noise can improve the accuracy of P300 classification for both intra-subject and inter-subject classification systems for multiple users. Addition of noise can significantly affect the parameters of polynomial kernel functions and the number of support vectors of the SVM. This leads to an expansion of the margin between two parallel hyperplanes that eventually improve the classification accuracy. Particle swarm optimization (PSO) can be used to search for the optimal noise intensity.

Graduate Employability and Entrepreneurship in Records Management: Unexplored Potential Business in Commercial Records Center

This paper aimed to determine if records management students/graduates (RMS) in records management program (RMP) and their academic-acquired skills and competencies are related to their field of study and their present occupations. Three (3) years of Graduate Tracer Study instrument was analyzed to gather the quantitative data focusing on the students of Records Management Program (RMP) in UniversitiTeknologi MARA (UiTM), Malaysia. The results further proved that RMP produces marketable and appropriately trained graduates but the majority landing NOT in course-related jobs within a short period of time after graduation. RMS is still low in initiating their own business like what been offered by Commercial Records Center (CRC). RMS should consider initiating a business offered by CRC. Therefore, in-depth understanding of the benefits of the CRC and their services is needed to ensure the potential of CRC business and services for RMS to consider initiating their own business in future.

Using voice to create hospital progress notes: Description of a mobile application and supporting system integrated with a commercial electronic health record

We describe the development and design of a smartphone app-based system to create inpatient progress notes using voice, commercial automatic speech recognition software, with text processing to recognize spoken voice commands and format the note, and integration with a commercial EHR. This new system fits hospital rounding workflow and was used to support a randomized clinical trial testing whether use of voice to create notes improves timeliness of note availability, note quality, and physician satisfaction with the note creation process. The system was used to create 709 notes which were placed in the corresponding patient’s EHR record. The median time from pressing the Send button to appearance of the formatted note in the Inbox was 8.8 min. It was generally very reliable, accepted by physician users, and secure. This approach provides an alternative to use of keyboard and templates to create progress notes and may appeal to physicians who prefer voice to typing.

Design and test of Geophonino-3D: A low-cost three-component seismic noise recorder for the application of the H/V method

Earthquake effects are strongly related with the properties of the local geology, amplifying the ground motion, especially in soft soils. This amplification is connected with the resonant frequency, which can be estimated applying the horizontal-to-vertical spectral ratio (H/V) method on seismic noise measurements. In this work, a low-cost user-friendly data acquisition system (Geophonino-3D) has been designed for three-component seismic noise recording. The developed system consists of the signal conditioning circuit and the Arduino Due with an SD Shield for data storage. The suitability of the equipment for the application of the H/V method has been first assessed in the laboratory, according to the experimental sensitivity, the internal noise stability and the channel consistency. Subsequently, experimental verification has been carried out by recording seismic noise at eight different sites along the province of Alicante (southeast Spain), with different soil characteristics. The performance of the developed acquisition system has been evaluated in terms of the power spectral density and the H/V peaks by comparison with the results obtained through a commercial seismic recorder. The obtained results show the applicability of the developed acquisition system to record seismic noise and to apply the H/V method. Geophonino-3D is an open source and open hardware system and the price of its components is much lower than any other commercial equipment, which becomes a significant advance especially for small research groups with reduced economic support.

Broadcasting Children’s Music

Broadcasting children’s music on television and radio is motivated by, and aims to serve, adults’ perceptions of children’s wants and needs. Children’s music in general is shaped by the understanding of what ‘childhood’ means and, in turn, supports adults’ assumptions about childhood. This article develops these ideas in an analysis of examples from the history of British radio and television, beginning in the 1920s and continuing until the growing penetration of online interactive media challenged the status of broadcasting in the early 21st century. The article discusses examples of different kinds of children’s music in a broadcast context, including the broadcast of commercial recordings of music for children, such as versions of traditional songs and nursery rhymes as well as pop music aimed at children. It also considers the significance of signature tunes and repeated musical sequences from long-lived and well-loved children’s programmes, because they play key roles in differentiating children’s programmes from each other and distinguishing children’s music from music aimed at adults. Broadcast programmes frequently include music that does not play a central role, when it is used as an accompaniment to drama, entertainment performance or animation. But such music contributes to programmes’ tone and shapes their mode of address to an imagined child audience. Entertainment shows or magazine programmes include music performances alongside non-musical sequences and can use music to, for example, mark an occasion for sing-along activities or accompany games. The social function of broadcasting for children watching or listening at home or at school, usually with an adult or other children, is constituted in part by these varied forms of children’s music. These forms of music shape conceptions of childhood through particular kinds of listening practices and ways of belonging to an audience.

Primary Care Providers' Opening of Time-Sensitive Alerts Sent to Commercial Electronic Health Record InBaskets.

Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. We analyzed data for 799 automated alerts. Alerts highlighted actionable medication concerns for older patients post-hospital discharge (2010-2011). These were study-generated alerts sent 3days post-discharge to InBaskets for 75 PCPs across a multisite healthcare system, and represent a subset of all urgent InBasket notifications. Using EHR access and audit logs to track alert opening, we performed bivariate and multivariate analyses calculating associations between patient characteristics, provider characteristics, contextual factors at the time of alert delivery (number of InBasket notifications, weekday), and alert opening within 24h. At the time of alert delivery, the PCPs had a median of 69 InBasket notifications and had received a median of 379.8 notifications (IQR 295.0, 492.0) over the prior 7days. Of the 799 alerts, 47.1% were opened within 24h. Patients with longer hospital stays (>4days) were marginally more likely to have alerts opened (OR 1.48 [95% CI 1.00-2.19]). Alerts delivered to PCPs whose InBaskets had a higher number of notifications at the time of alert delivery were significantly less likely to be opened within 24h (top quartile >157 notifications: OR 0.34 [95% CI 0.18-0.61]; reference bottom quartile ≤42). Alerts delivered on Saturdays were also less likely to be opened within 24h (OR 0.18 [CI 0.08-0.39]). The number of total InBasket notifications and weekend delivery may impact the opening of time-sensitive EHR alerts. Further study is needed to support safe and effective approaches to care team management of InBasket notifications.

The Impact of a Computerized Clinical Decision Support Tool on Inappropriate Clostridium difficile Testing.

OBJECTIVE To evaluate the effectiveness of a computerized clinical decision support intervention aimed at reducing inappropriate Clostridium difficile testing DESIGN Retrospective cohort study SETTING University of Pennsylvania Health System, comprised of 3 large tertiary-care hospitals PATIENTS All adult patients admitted over a 2-year period INTERVENTION Providers were required to use an order set integrated into a commercial electronic health record to order C. difficile toxin testing. The order set identified patients who had received laxatives within the previous 36 hours and displayed a message asking providers to consider stopping laxatives and reassessing in 24 hours prior to ordering C. difficile testing. Providers had the option to continue or discontinue laxatives and to proceed with or forgo testing. The primary endpoint was the change in inappropriate C. difficile testing, as measured by the number of patients who had C. difficile testing ordered while receiving laxatives. RESULTS Compared to the 1-year baseline period, the intervention resulted in a decrease in the proportion of inappropriate C. difficile testing (29.6% vs 27.3%; P=.02). The intervention was associated with an increase in the number of patients who had laxatives discontinued and did not undergo C. difficile testing (5.8% vs 46.4%; P<.01) and who had their laxatives discontinued and underwent testing (5.4% vs 35.2%; P<.01). We observed a nonsignificant increase in the proportion of patients with C. difficile related complications (5.0% vs 8.9%; P=.11). CONCLUSIONS A C. difficile order set was successful in decreasing inappropriate C. difficile testing and improving the timely discontinuation of laxatives. Infect Control Hosp Epidemiol 2017;38:1204-1208.

Clinical decisions support malfunctions in a commercial electronic health record.

Determine if clinical decision support (CDS) malfunctions occur in a commercial electronic health record (EHR) system, characterize their pathways and describe methods of detection. We retrospectively examined the firing rate for 226 alert type CDS rules for detection of anomalies using both expert visualization and statistical process control (SPC) methods over a five year period. Candidate anomalies were investigated and validated. Twenty-one candidate CDS anomalies were identified from 8,300 alert-months. Of these candidate anomalies, four were confirmed as CDS malfunctions, eight as false-positives, and nine could not be classified. The four CDS malfunctions were a result of errors in knowledge management: 1) inadvertent addition and removal of a medication code to the electronic formulary list; 2) a seasonal alert which was not activated; 3) a change in the base data structures; and 4) direct editing of an alert related to its medications. 154 CDS rules (68%) were amenable to SPC methods and the test characteristics were calculated as a sensitivity of 95%, positive predictive value of 29% and F-measure 0.44. CDS malfunctions were found to occur in our EHR. All of the pathways for these malfunctions can be described as knowledge management errors. Expert visualization is a robust method of detection, but is resource intensive. SPC-based methods, when applicable, perform reasonably well retrospectively. CDS anomalies were found to occur in a commercial EHR and visual detection along with SPC analysis represents promising methods of malfunction detection.

Adaptation of Radiology Software to Improve Cardiology Results Reporting.

Twenty-four hour ambulatory electrocardiograms ("Holter" monitors) are a key diagnostic test in cardiology. Commercial electronic medical record (EMR) tools have not been designed for pediatric Holter monitor reporting and paper-based methods are inefficient. Our tertiary pediatric hospital adapted a radiology EMR tool to a cardiology workflow in order to report Holter monitor results. A retrospective review was performed at 4 time points: prior to intervention, immediately post-intervention, at 6 months and at 12 months post-intervention. The primary outcome variable was time to reporting of Holter findings. Holter reports were reviewed on 527 studies (patient ages: 1 day to 42 years). The time between the date the patient returned the Holter monitor until the date the referring physician received a final report improved from 19.8 days to 1.5 days (p<0.001). This result was durable over the next 12 months of follow-up. Physician interpretation time improved from 2.1 days to 0.6 days (p=0.01). Transcriptionist time and result scanning time were eliminated (removing 1.9 days and 14 days from the workflow, respectively). EMR systems are not typically designed for pediatric cardiology, but existing systems can be adapted, yielding important gains for patient care. In specialties like pediatric cardiology, there is insufficient volume nationally to drive development of commercial systems. This study demonstrates the general principle that creative adaptation of EMR systems can improve result reporting in pediatric cardiology and likely in other cardiology practices.Citation: Webster G, Ward K, Deal BJ, Anderson JB, Tsao S. Adaptation of Radiology Software to Improve Cardiology Results Reporting. Appl Clin Inform 2017; 8: 936-944 https://doi.org/10.4338/ACI-2017-03-RA-0051.