Implementation Of System Research Articles

The challenge of adopting a collaborative information system for independent healthcare workers in France: a comprehensive study.

This study aimed to explore the perception of an underutilised collaborative information system through qualitative research, utilizing semi-structured, in-depth interviews with independent midwives and physician. PROSPERO, is a collaborative information system designed to bridge the communication gap between community-based healthcare workers and hospital-based care teams for parturients in Lyon, France. Through 27 semi-structured in-depth interviews with midwives, obstetricians, and general practitioners, we identified key themes related to the system's adoption: implementation challenges, utilisation barriers, interprofessional dynamics, and hidden variables affecting system use. Participants recognised the potential of PROSPERO to improve information sharing and care coordination but expressed concerns about the system's integration into existing workflows, time constraints, and the need for adequate training and technical support. Interprofessional dynamics revealed differing perspectives between hospital and independent practitioners, emphasising the importance of trust-building and professional recognition. Hidden variables, such as hierarchical influences and confidentiality concerns, further complicated the system's adoption. Despite the consensus on the benefits of a collaborative information system, its implementation was hindered by mistrust between healthcare workers (i.e. between independent practitioners and hospital staff). Our findings suggest that fostering trust and addressing the identified barriers are crucial steps towards successful system implementation. The study contributes to understanding the complex interplay of factors influencing the adoption of collaborative healthcare technologies and highlights the need for strategies that support effective interprofessional collaboration and communication.ClinicalTrials ID NCT02593292.

Implementation of a health information technology safety classification system in the Veterans Health Administration's Informatics Patient Safety Office.

Implement the 5-type health information technology (HIT) patient safety concern classification system for HIT patient safety issues reported to the Veterans Health Administration's Informatics Patient Safety Office. A team of informatics safety analysts retrospectively classified 1year of HIT patient safety issues by type of HIT patient safety concern using consensus discussions. The processes established during retrospective classification were then applied to incoming HIT safety issues moving forward. Of 140 issues retrospectively reviewed, 124 met the classification criteria. The majority were HIT failures (eg, software defects) (33.1%) or configuration and implementation problems (29.8%). Unmet user needs and external system interactions accounted for 20.2% and 10.5%, respectively. Absence of HIT safety features accounted for 2.4% of issues, and 4% did not have enough information to classify. The 5-type HIT safety concern classification framework generated actionable categories helping organizations effectively respond to HIT patient safety risks.

The burden of radiation exposure in congenital heart disease: the Italian cohort profile and bioresource collection in HARMONIC project.

The European-funded Health Effects of Cardiac Fluoroscopy and Modern Radiotherapy in Pediatrics (HARMONIC) project aims to improve knowledge on the effects of medical exposure to ionizing radiation (IR) received during childhood. One of its objectives is to build a consolidated European cohort of pediatric patients who have undergone cardiac catheterization (Cath) procedures, with the goal of enhancing the assessment of long-term radiation-associated cancer risk. The purpose of our study is to provide a detailed description of the Italian cohort contributing to the HARMONIC project, including an analysis of cumulative IR exposure, reduction trend over the years and an overview of the prospective collection of biological samples for research in this vulnerable population. In asingle-centerretrospective cohort study, a total of 584 patients (323 males) with a median age of 6 (2-13) years, referred at the Pediatric Cardiology in Niguarda Hospital from January 2015 to October 2023, were included. Biological specimens from asubsetof 60 patients were prospectively collected for biobanking atbaseline, immediately post-procedure and after 12months. Two hundred fifty-nine (44%) patients were under 1year old at their first procedure. The median KAP/weight was 0.09Gy·cm2/kg (IQR: 0.03-0.20), and the median fluoroscopy time was 8.10min (IQR: 4.00-16.25). KAP/weight ratio showed a positive correlation with the fluoroscopy time (Spearman's rho = 0.679, p < 0.001). Significant dose reduction was observed either after implementation of an upgraded technology system and a radiation training among staff. The Italian cohort includes 1858 different types of specimens for Harmonic biobank, including blood, plasma, serum, clot, cell pellet/lymphocytes, saliva. In the Italian Harmonic cohort, radiation dose in cardiac catheterization varies by age and procedure type. An institution's radiological protection strategy has contributed to a reduction in radiation dose over time. Biological samples provide a valuable resource for future research, offering an opportunity to identify potential early biomarkers for health surveillance and personalized risk assessment.

Exploring patient and staff member views on a 'consent for contact' system for sexual health research: A mixed methods study.

Recruitment in sexual health research is challenging. This study explores the potential of a Consent for Contact system (C4C) - generic consent for research contact - to improve participant recruitment and engagement in sexual health research. Our objectives were to understand patient and staff understanding of research, their views on a separate C4C system, and their preferences for its acceptability in a sexual health clinic setting. A two-stage study was conducted at a large urban UK sexual health clinic from November 2021 to July 2022. Stage one involved a self-completed questionnaire administered to all patients and staff. In Stage 2, semi-structured interviews (SSIs) further explored patient concerns and preferences. Survey data were analysed using chi-square and Fisher's exact test and thematic analysis was applied to free-text responses and SSIs. A total of 205/300 patient (68%) and 41/280 staff questionnaires (15%) were completed. Motivations for research participation included altruism and personal interest. Statistically significant differences were found between patients' and staff members' concerns on confidentiality and anticipated feeling of pressure to participate. The majority of staff (n = 38, 93%) and half of patients (n = 100, 49%) supported implementation of a sexual health C4C system. Participants recognised the potential benefits of a sexual health C4C system, including enhanced privacy and increased research opportunities. Concerns were raised about stigma, terminology, and signing-up methods. This study found the C4C system has the potential to enhance participant recruitment and engagement in sexual health research, but implementation support is narrowly divided with concerns around privacy and sign-up processes. These insights call for a patient-centred design approach, emphasising clear communication and privacy. Future research should focus on implementing and evaluating a sexual health C4C system to further explore their effectiveness and acceptability in different contexts.

Evaluation of output factors of different radiotherapy planning systems using Exradin W2 plastic scintillator detector.

This study aims to evaluate the output factors (OPF) of different radiation therapy planning systems (TPSs) using a plastic scintillator detector (PSD). The validation results for determining a practical field size for clinical use were verified. The implemented validation system was an Exradin W2 PSD. The focus was to validate the OPFs of the small irradiation fields of two modeled radiation TPSs using RayStation version 10.0.1 and Monaco version 5.51.10. The linear accelerator used for irradiation was a TrueBeam with three energies: 4, 6, and 10MV. RayStation calculations showed that when the irradiation field size was reduced from 10 × 10 to 0.5 × 0.5cm2, the results were within 2.0% of the measured values for all energies. Similarly, the values calculated using Monaco were within approximately 2.0% of the measured values for irradiation field sizes between 10 × 10 and 1.5 × 1.5cm2 for all beam energies of interest. Thus, PSDs are effective validation tools for OPF calculations in TPS. A TPS modeled with the same source data has different minimum irradiation field sizes that can be calculated. These findings could aid in verification of equipment accuracy for treatment planning requiring highly accurate dose calculations and for third-party evaluation of OPF calculations for TPS.

The Evolution Mechanism of Correctness for Cyber-Physical System

Cyber-physical Systems (CPS) are widely used in all areas of life. Ensuring the correctness of CPS remains an enduring challenge during its development and design phases. One approach to ascertain the correctness of CPS is behavior equivalence based on bisimulation. However, whether the implementation development process develops in the right direction has an important impact on obtaining the correct system implementation. Especially, the development process of complex CPS often yields a multitude of implementation versions, the correlation among these versions partly signifies the correctness of the development process. This paper formalizes the relationship between the implementation versions and establishes a formal description of the development process progressing in the correct direction, leveraging the concept of a “limit idea.” Initially, we introduce the concept of “limit bisimulation” for CPS systems to delineate implementations acquired during the CPS development process. Specific limit bisimulations are demonstrated to represent distinct scenarios within the development process. Subsequently, the convergence mechanism of implementations is modeled through bisimulation limits, encapsulating the CPS’s specification as the ultimate goal of obtained implementations during the development process. Finally, the congruence property of the bisimulation limit is proved, which accounts for the relation between specification and implementation versions can be decomposed into a refinement hierarchy. The limit theorem of bisimulation in CPS can help the designer and developer of CPS to comprehend the development course better.

Analysis of Ethical and Legal Aspects in Implementing a Medical Record System in Hospitals on Patient Health Practices

Implementing a medical record system in a hospital plays an integral role in managing patient health information. This article analyzes the ethical and legal aspects involving medical record management, and their impact on patient health practices in hospitals. Findings regarding breaches of confidentiality, inaccurate information, inappropriate access, delays in patient access, and non-transparency of information are the main focus. Ethical implications involve the risk of losing patient trust and the establishment of a positive doctor-patient relationship, while legal implications include potential lawsuits by patients and administrative sanctions against medical record system administrators. Thus, improvements in regulatory compliance, increased ethical awareness among health workers, and implementation of best practices are recognized as crucial steps in maintaining the integrity of the health system and ensuring ethical and legally compliant health practices. In conclusion, collaboration between stakeholders and a holistic approach are needed to achieve the implementation of a medical record system that prioritizes patient rights and interests, strengthens trust, and improves the quality of health services in hospitals.

Reinforcement of DC Electrified Railways by a Modular Battery Energy Storage System

DC railway electrification was deployed at the beginning of the 20th century in several countries in Europe. Today, this power system is no longer adapted to the demands of increased rail traffic. Due to the relatively low voltage level, the current consumed by the trains reaches several kAs. So, in the worst case, the locomotives cannot operate at their rated power due to the voltage drop along the contact line. Conventional solutions to reduce the voltage drop consist of increasing the cross-section of overhead lines or reducing the length of sectors by installing additional substations. Nevertheless, these solutions are expensive and not always feasible. The implementation of a Modular Battery Energy Storage System (MBESS) can be an alternative solution to reinforce the railway power supply. This paper first presents an MBESS based on elementary blocks associating Full-SiC Isolated DC-DC converter and battery racks. The electrical models of a railway sector and an elementary block are described, and simulations are performed considering real railroad traffic on two sectors of the French National Rail Network, electrified at 1.5 kV. The results show that the installation of an MBESS in the railway sector boosts the locomotive’s voltage while also increasing overall system efficiency.

Implementation of a Customer Relationship Management Information System in the Activities of an IT Company Using the Example of Trust LLC

Implementation of a Customer Relationship Management Information System in the Activities of an IT Company Using the Example of Trust LLC

Pelatihan Penerapan Learning Management System (LMS) bagi Guru Dalam Tantangan Era Blended Learning

This community service aims to increase teacher understanding and optimize the implementation of the Learning Management System (LMS) in the blended learning era. The method for implementing this service uses training in the form of webinars with 119 teachers spread across 40 cities in Indonesia. The evaluation instrument for this activity uses a questionnaire, which is analyzed descriptively. The results of this service activity show an increase in teachers' understanding of implementing LMS. The results are evidenced by teachers' increasing knowledge about making LMS an online classroom, especially in providing teaching materials and setting student assignments and exams.

Development of a Curriculum for Emergency Physicians to Teach Transesophageal Echocardiography for Cardiac Arrests: A Kern Six-Step Model

BACKGROUND: The Kern model facilitates the development, implementation, and evaluation of successful educational systems in medicine. It involves six steps that link curricular content to health care needs. One such need is the design of a curriculum to teach emergency physicians practical use of focused transesophageal echocardiography employing a limited number of views for management of out-of-hospital cardiac arrests. The objective of this analysis was to describe the components of such a curriculum based on a Kern model that could be employed to train emergency department providers in this diagnostic modality. METHODS: We predicated our analysis on the American College of Emergency Physicians’ recommendations and goals for use of transesophageal echocardiography to guide emergency department cardiac arrest resuscitation. We then detailed an asynchronous pre-didactic learning experience followed by a synchronous didactic and simulation-based curriculum to teach emergency physicians how to acquire and interpret images for this purpose based upon steps set forth by a Kern model. RESULTS: The component steps in designing a curriculum constructed to teach focused transesophageal echocardiography for out-of-hospital cardiac arrests to emergency physicians are rigorously outlined. These components based on a Kern model include problem identification and a general needs assessment, a targeted needs assessment, defining goals and objectives, choosing educational strategies, curricular implementation, and program evaluation. CONCLUSIONS: Use of a six-step Kern model as a template can facilitate the development and dissemination of a curriculum to teach emergency physicians successfully to employ focused transesophageal echocardiography in the treatment of cardiac arrests. In order to promote its widest dissemination, this model should be pursued in a “train-the-trainer” fashion. In so doing, appropriate education of emergency physicians and their use of transesophageal echocardiography to manage cardiac arrests likely can be rapid and impactful, especially among providers with training and experience in transthoracic echocardiography.

Information System for Operational Goods Management at the Career Guidance and Entrepreneurship Center Malikussaleh University

Managing operational goods manually leads to slow and inefficient work performance, hence the design and implementation of an information system that can efficiently manage operational goods needs to be done in a structured manner and work optimally. Analysis of operational goods needs is conducted through observation and interviews with relevant parties to discuss the problems faced and identify the required features. Some key features implemented in this system include complaint management for operational goods needs, which can be managed and utilized for effective procurement or requests for goods according to requirements. This system is designed using the PHP programming language with the Codeigniter framework and MySQL database for database management. With this system in place, it is expected to assist in the more effective and systematic management of operational goods needs at the Career Guidance and Entrepreneurship Center of Malikussaleh University.

Urban Resilience Index for Critical Infrastructure: A Scenario-Based Approach to Disaster Risk Reduction in Road Networks

Floods pose a significant threat to road networks globally, disrupting transportation, isolating communities, and causing economic losses. This study proposes a four-stage methodology (avoidance, endurance, recovery, and adaptability) to enhance the resilience of road networks. We combine analysis of constructed assets and asset system performance with multiple disaster scenarios (Reactive Flood Response, Proactive Resilience Planning, and Early Warning Systems). Advanced flood Geospatial-AI models and open data sources pinpoint high-risk zones affecting crucial routes. The study investigates how resilient assets and infrastructure scenarios improve outcomes within Urban Resilience Index (CRI) planning, integrating performance metrics with cost–benefit analysis to identify effective and economically viable solutions. A case study on the Lisbon Road network subjected to flood risk analyzes the effectiveness and efficiency of these scenarios, through loss and gain cost analysis. Scenario 2, Proactive Resilience Planning, demonstrates a 7.6% increase compared to Scenario 1, Reactive Flood Response, and a 3.5% increase compared to Scenario 3, Early Warning Systems Implementation. By considering asset performance, risk optimization, and cost, the study supports resilient infrastructure strategies that minimize economic impacts, while enabling communities to withstand and recover from flood events. Integrating performance and cost–benefit analysis ensures the sustainability and feasibility of risk reduction measures.

Analyzing factors affecting positivity in drive-through COVID-19 testing: a cross-sectional study

BackgroundDemand for COVID-19 testing prompted the implementation of drive-through testing systems. However, limited research has examined factors influencing testing positivity in this setting.MethodsFrom October 2020 to March 2023, a total of 1,341 patients, along with their clinical information, were referred from local clinics to the Sasebo City COVID-19 drive-through PCR center for testing. Association between clinical information or factors related to the drive-through center and testing results was analyzed by Fisher’s exact test and logistic regression models.ResultsIndividuals testing positive exhibited higher frequencies of upper respiratory symptoms; cough (OR 1.5 (95% CI 1.2–1.8), p < 0.001, q = 0.005), sore throat (OR 2.4 (95% CI 1.9-3.0), p < 0.001, q < 0.001), runny nose (OR 1.4 (95% CI 1.1–1.8), p = 0.002, q = 0.009), and systemic symptoms; fever (OR 1.5 (95% CI 1.1-2.0), p = 0.006, q = 0.02), headache (OR 1.9 (95% CI 1.4–2.5), p < 0.001, q < 0.001), and joint pain (OR 2.7 (95% CI 1.8–4.1), p < 0.001, q < 0.001). Conversely, gastrointestinal symptoms; diarrhea (OR 0.2 (95% CI 0.1–0.4), p < 0.001, q < 0.001) and nausea (OR 0.3 (95% CI 0.1–0.6), p < 0.001, q < 0.001) were less prevalent among positives. During omicron strain predominant period, higher testing positivity rate (OR 20 (95% CI 13–31), p < 0.001) and shorter period from symptom onset to testing (3.2 vs. 6.0 days, p < 0.001) were observed compared to pre-omicron period. Besides symptoms, contact history with infected persons at home (OR 4.5 (95% CI 3.1–6.5), p < 0.001, q < 0.001) and in office or school (OR 2.9 (95% CI 2.1–4.1), p < 0.001, q < 0.001), as well as the number of sample collection experiences by collectors (B 7.2 (95% CI 2.8–12), p = 0.002) were also associated with testing results.ConclusionsThese findings underscore the importance of factors related to drive-through centers, especially contact history interviews and sample collection skills, for achieving higher rates of COVID-19 testing positivity. They also contribute to enhanced preparedness for next infectious disease pandemics.

Evaluating Cognitive Impairment in a Large Health Care System: The Cognition in Primary Care Program.

The prevalence of Alzheimer's disease and related disorders (ADRD) is rising. Primary care providers (PCPs) will increasingly be required to play a role in its detection but lack the training to do so. To develop a model for cognitive evaluation which is feasible in primary care and evaluate its implementation in a large health system. The Cognition in Primary Care Program consists of web-based training together with integrated tools built into the electronic record. We implemented the program among PCPs at 14 clinics in a large health system. We (1) surveyed PCPs to assess the impact of training on their confidence to evaluate cognition, (2) measured the number of cognitive assessments they performed, and (3) tracked the number of patients diagnosed with mild cognitive impairment (MCI). Thirty-nine PCPs completed the training which covered how to evaluate cognition. Survey response rate from those PCPs was 74%. Six months after the end of the training, they reported confidence in assessing cognition (mean 4.6 on 5-point scale). Cognitive assessments documented in the health record increased from 0.8 per month before the training to 2.5 in the six months after the training. Patients who were newly diagnosed with MCI increased from 4.2 per month before the training to 6.0 per month in the six months after the training. This model for cognitive evaluation in a large health system was shown to increase cognitive testing and increase diagnoses of MCI. Such improvements are essential for the timely detection of ADRD.

Comparative Study of the MPPT Control for the Photovoltaic Water Pumping System between FSS-P&amp;O and VSS-P&amp;O

This paper describes the implementation of a renewable energy system that operates independently. It comprises a photovoltaic generator (PV) that supplies power to a solar pumping system, driven by a permanent magnet direct current motor (PMDC) via a DC-DC Buck converter. Consequently, the objective is to maintain steady operation with continuous power supply despite changes in two environmental parameters, including solar irradiation and absolute temperature. The maximal power extraction of the PV panel using the usual perturbation and observation (P&amp;O) technique achieves this objective. This method must provide appropriate duty cycle control for the DC-DC buck converter when the user-selected Fixed-Step Size (FSS) is used, unfortunately, selecting an insufficient fixed-step size led to a power ripple issue with the PV panel. Incorporating a new Variable Step-Size (VSS) into the traditional P&amp;O algorithm shows the occurrence of the enhanced P&amp;O-MPPT control approach. The proposed technique is validated by utilizing the PROTEUS/ISIS software. For various climatic situations, the results demonstrate that the proposed control technique is preferable to the one based on the standard P&amp;O-MPPT.

The Contemporary Landscape of Narrations and Jurisprudence: The Legal Imagination and Nomos and Narrative half a century later

Abstract In 1973, James Boyd White published The Legal Imagination, broadly credited with the foundation of a new discipline, law and literature, which underlined the importance of narratives in legal thinking and practice. A decade later, in an introduction to the review of the 1982 SCOTUS term, Robert Cover identified the need for further discussion regarding the close connection between norms and narratives. ‘Nomos and Narrative’ set a precedent by launching a more in-depth investigation into the role of stories as the foundation of normativity and its participation in dealing with competing normative claims. Since then, various strands of jurisprudence have struggled with the view of law as a set of interpretive commitments. By taking a closer look at both, this article reflects on the relevance and significance of these texts half a century later. As the article argues, despite a significant following among the scholars, the arguments posed by White and Cover did not find broad implementation in the juridico-political systems around the world. On the contrary, the opposite tendencies seem to dominate today. Thus, the article reflects on the contemporary relevance of both texts in critical, constructive, and explorative terms.

Development of a Low-Cost Web-Based Information System for Managing a University Department Chemical Warehouse

Herein, we present the implementation of a low-cost web-based information system tailored to manage a university department chemical warehouse. The system provides a centralized platform for cataloging, tracking, and managing chemical inventory data, while also facilitating purchasing and various administrative tasks associated with laboratory operations. The system has been developed within the Campusnet platform and has the following functionalities: (i) an efficient way for cataloging the extensive array of products available in the warehouse; (ii) an intuitive web interface with a device-responsive layout to facilitate browsing and purchasing of products by students, researchers, and technical staff; (iii) an inventory transaction recording system to simplify the attribution of costs; (iv) a simple procedure to streamline the process of joint purchases; and (v) a low deployment cost and ease of maintenance. Key design considerations, including regulatory compliance and safety, are also presented.

Exploring Antibiotic Resistance Through Artificial Intelligence: A Novel Perspective

Exploring Antibiotic Resistance Through Artificial Intelligence: A Novel Perspective

Parametric study of organic Rankine working fluids via Bayesian optimization of a preference learning ranking for a waste heat recovery system applied to a case study marine engine

This work presents an analysis of environmentally friendly organic Rankine cycle (ORC) fluids and their application in a marine waste heat recovery system (WHRS) to reduce the utilization of fuel, thus reducing the emission of harmful pollutants. The proposed WHRS consists of four subsystems: steam Rankine, organic Rankine, Seebeck effect heat to electricity conversion and desalination. Among the 80 ORC working fluids analyzed, R1233zd(E), Novec 649 and SES36 exhibit the best overall performance in terms of power output, efficiency, safety and environmental impact. The results indicate that the implementation of innovative energy efficiency systems that comply with MEPC.1-Circ.896, such as this proposal, can reduce the IMO technical energy efficiency index (EEXI) up to 7.26 % and the operational carbon intensity indicator (CII) up to 14.24 %.