Multiple Personnel Research Articles

Improved Casualty Depiction System for Simulated Mass Casualty Exercises.

Assessing military medical teams' ability to respond to large-scale mass casualty (MASCAL) events has become a priority in preparing for future conflicts. MASCAL exercises rely on large numbers of simulated patients with limited medical training. Role-players must be appropriately prepared to ensure that medical exercises adequately assess the expected capabilities of military medical units. The Uniformed Services University of the Health Sciences (USUHS) has evaluated future military providers for decades using a large-scale, multiday, immersive simulation called Bushmaster. Despite a robust casualty training system, the fidelity of the portrayals remained limited. Through collaboration with national military medical experts, a comprehensive casualty depiction system was developed. This system relied on structured casualty cards linked to time-based illness scripts. Structured casualty cards included an appropriate balance of disease non-battle injuries and trauma, included multipatient presentations based on shared events (i.e., multiple injured personnel due to an aircraft crash), normal and pathologic combat stress, population/unit considerations, requirements for different roles within the medical unit, and expected clinical outcomes. Illness scripts, supplemented by video guides, included time-based courses of illness/injury and prescribed responses to different typical treatments. This system was piloted during an annual MASCAL exercise (Operation Bushmaster) at USUHS. Clinical faculty were queried on the fidelity of this new system while role-players were evaluated on feasibility. Three hundred casualty cards linked to 49 illness scripts were created, peer-reviewed, and piloted at Bushmaster. A total of 170 military members with limited medical training portrayed simulated patients utilizing the new casualty depiction system. Clinical faculty members strongly agreed that the improved casualty depiction system improved the realism of individual patient presentations (96%). Eighty-three percent of role-players strongly agreed that the casualty depiction system was easy to understand. This improved casualty depiction system was a feasible approach to enhance the fidelity of a MASCAL exercise. It has since been shared with military medical units around the globe to assist with their MASCAL exercises, making future multisite evaluations of this casualty depiction system possible.

Professional Issues in the Interpreted Education of Deaf and Hard of Hearing Students

Abstract: Through in-depth interviews, this qualitative study explored the perceptions of seven teachers of students who are d/Deaf and hard of hearing (D/HH) regarding inclusive and interpreted education. The findings revealed central themes of concern including inadequate support in inclusive placements, communication modality mismatches, and insufficient quality of interpreted education. The teachers' experiences underscore the need for more comprehensive educational support systems and the development of robust support mechanisms to effectively navigate the challenges of inclusive placements for students who are D/HH. Specifically, further attention must be given to improving the qualifications, training, support, and supervision of educational interpreters facilitating education in inclusive settings. These findings have implications for multiple stakeholders, including policymakers, educators, and supportive personnel involved in shaping inclusive education practices to ensure equitable access and the creation of supportive spaces where all students can thrive.

Multi-unit PSA based risk evaluation framework for utilizing cross-tie systems for nuclear power plants

The Fukushima accident showed that the safety of multiple nuclear power plants (NPPs) at the same site could be jeopardized simultaneously. Since then, many studies have focused on developing strategies to prevent the spread of multi-unit accidents, with numerous countries establishing strategies to use mobile equipment. However, mobile equipment strategies are inherently accompanied by a high degree of uncertainty regarding operation success and duration because multiple organizations and personnel interact in various ways during multi-unit accident situations. Furthermore, supplementing current fixed equipment with additional mobile equipment requires extra resources. Therefore, cross-tie strategies that use currently installed fixed equipment can provide additional means to manage site risk with relatively few additional costs. This study proposes a multi-unit probabilistic safety assessment–based risk evaluation framework for utilizing cross-tie systems in NPPs and a modeling methodology to quantify the effectiveness of the cross-tie strategies. A case study was conducted to evaluate the risk reduction from using cross-tie strategies for emergency diesel generators and alternate AC diesel generators, which are power systems utilized in multi-unit loss of offsite power initiating events. It is expected that the developed framework and methodology can be utilized for other types of cross-tie strategies as well.

Comparative analysis of the wake flow characteristics of single human and single column personnel walking indoors

The spread of pollutants caused by personnel walking is an important factor affecting the indoor environment. Investigating the disturbance of multiple personnel on the flow field is highly important. In this study, experimentation and numerical simulation are used to study the flow field and vortex structure of human wakes. Large eddy simulation (LES) is used to simulate the unsteady wake flow of single and single column personnel. The results show that due to secondary disturbances, the wake fluctuation region of single column personnel is larger than that of a single person, and the wake characteristics are more complex. Moreover, the wake vortex distribution of single column personnel is more discrete than that of a single person, and the vortex structure distribution region of single column personnel on the longitudinal section is twice that of a single person. The small-scale wake vortex is densely distributed, and the wake vortex dissipates faster.

Criminology Internship Program of Mountain Province State Polytechnic College

This study evaluated the implementation of Mountain Province State Polytechnic CollegeInternship Program (MPSPC-CIP) to identify the weaknesses that need to be addressed using a quantitative descriptive method. It employed survey questionnaire to gather data from 121 respondents. This study determined that the MPSPC-CIP has been effectively implemented. It was discovered that the weekly report submission is sometimes observed, but most indicators are effectively implemented. Respondents were aware of their duties and the significance of implementing community regulations. Except for the inadequacy of communication equipment in the program’s implementation, the respondents deemed the extent of the effects of the problems encountered in the performance of the CIP to be less severe; however, this issue needs to be addressed. The social cognitive career theory encapsulates the findings, as the CIP provides students with opportunities to acquire practical experience in the field with the assistance of multiple agency personnel.

Operational pressure and the SHP framework: Connecting the dots for safety

Operational pressure refers to pressure, whether induced or self-induced, that can affect the (flight) operation and may also impact safety. It is a hot topic in many sectors, being an important reason for multiple personnel strikes - the aviation sector is no exception here. Given the rapid evolution of these different operational pressures as the world adapts, continuous attention will be necessary for addressing the concept of operational pressure and discovering new mitigation strategies. Therefore, this paper delves deeper into both current and future factors influencing operational pressure, as well as mentioning some potential mitigating measures. Moreover, the case of operational pressure is structured and visualised using NLR’s Safety & Human Performance (SHP) framework. The result provides a structured overview of the impacts of different operational pressures on safety, which can aid in developing mitigations to lessen the effect of such pressures.

Overview of the innovative Family Treatment Drug Court model in Kentucky

AbstractFamily Treatment Drug Courts (FTDCs) have been implemented to assist families involved with the child welfare system due to substance use. This article describes an enhanced version of a Family Treatment Drug Court intervention which builds on the traditional FTDC model but includes adaptations that add theoretically driven components to the basic FTDC model that aim to strengthen not only permanency outcomes but also address child well‐being including several precursors to child well‐being: parent well‐being and family well‐being so that the additional child welfare outcome of child well‐being can be met. The enhanced FTDC model described in this paper offers three phases of treatment but also utilizes data gathered for evaluation purposes as continuous quality improvement information to inform providers regarding participant engagement so that targeted re‐engagement efforts can occur to reduce dropouts. Thus, this paper also describes the measures utilized in the comprehensive evaluation. Data include 33 standardized scales from multiple sources, including clients, therapists/treatment providers, court personnel, and child welfare workers, at multiple points ranging from weekly to quarterly. Implications are discussed regarding how this enhanced FTDC model and use of evaluation/CQI data impact client engagement and multiple outcomes.

Intraoperative Direct Sonication of Implants and Soft Tissue for the Diagnosis of Periprosthetic Joint Infection.

Sonication is very efficacious for the microbiological diagnosis of periprosthetic joint infection (PJI), but it involves many steps and multiple workplaces and personnel and therefore carries a potential contamination risk. We present an innovative version of the sonication culture method that involves direct sonication of the retrieved implant and soft tissue, without a sonication tube, intraoperatively and incubation using a BACT/ALERT 3D blood culture system to enhance the efficacy of microbiological diagnosis of PJI. We performed a prospective study of consecutive patients requiring implant removal and classified them as having PJI or aseptic failure according to standard criteria. The removed prosthetic components and adjacent soft tissue were directly sonicated in a small metal container, without a sonication tube, during the operation. The sonication fluid was immediately incubated in blood culture bottles in the operating room and cultured in the BACT/ALERT 3D blood culture system. The synovial fluid was also cultured in the BACT/ALERT 3D system to serve as a comparison. Of the 64 included patients, 36 had PJI and 28 had aseptic failure. Fluid from direct sonication and conventional synovial fluid showed sensitivities of 91.7% and 55.6% (p < 0.001) and specificities of 82.1% and 92.9%, respectively. Fourteen cases of PJI were detected by culture of fluid from direct sonication but not by culture of synovial fluid. Higher sensitivity was obtained by direct sonication of only tissue than by direct sonication of only the implant (88.9% versus 75.0%). No significant difference in detection time was found between Staphylococcus aureus and coagulase-negative Staphylococcus. When combined with incubation in BACT/ALERT bottles, direct intraoperative sonication of implants and soft tissues without a sonication tube was more sensitive than conventional synovial fluid culture and could reliably and rapidly detect the bacteria commonly found in PJI. Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Lightning in Brunei: a follow-up of a single strike affecting 29 serving personnel of the Royal Gurkha Rifles.

On 25 August 2020, 29 British Forces Brunei (BFB) service personnel were hospitalised after being struck by lightning during a company-level training exercise in the Brunei jungle. This paper observes both the initial injury pattern of the personnel and their occupational health status at the 22-month point. All 29 of the personnel affected by the lightning strike on 25 August 2020 were followed up until the 22-month point, allowing observation of injury patterns and management as well as the long-term outcomes. They were all members of two Royal Gurkha Rifles and received local hospital care and British Defence Healthcare input. Initial data were collected for mandatory reporting processes, and cases were followed up as a routine part of the Unit Health processes. Of the 29 identified as having lightning-related injuries, 28 returned to Medically Fully Deployable status. Acoustic trauma was the most common injury which was treated in several cases by oral steroids with some receiving intratympanic steroids. Multiple personnel suffered transient or short-lasting sensory changes and pain. 1756 service personnel days were covered by restrictions. The pattern of the lightning-related injuries was different to that which would be expected from previous reports. This is likely due to the unique nature of each lightning strike, combined with the ample unit support, the fit and resilient cohort and the rapid initiation of treatment, especially with regard to hearing.Brunei is at high risk of lightning strikes, planning for them is now standard for BFB. Despite lightning strikes having the potential to cause mortality and mass casualty events, this case study shows that such events do not necessarily result in severe long-term injury or mortality.

Cross-Departmental Collaboration Approach for Earthquake Emergency Response Based on Synchronous Intersection between Traditional and Logical Petri Nets

In order to reduce the harm of earthquakes to human society, all governments actively promote the construction and development of earthquake emergency rescue work. The earthquake emergency response involves many departments, multiple personnel and large rescue forces, which presents a great challenge to the ability to carry out cross-departmental rescue work in a collaborative and joint manner. A novel collaboration approach based on traditional and logical Petri nets is proposed to improve the cross-departmental collaboration in earthquake emergency response. The approach extends the synchronization of transitions in traditional Petri nets to that of traditional and logical transitions in traditional and logical Petri nets, and defines the intersection of related logical functions. The approach builds a model for the earthquake emergency response plans of various departments with the help of traditional and logical Petri net models, and then performs synchronous intersection operations on the two kinds of Petri nets and merges the two kinds of Petri nets into new logical Petri nets. Meanwhile, through realizing the collaboration ability of cross-departmental work, the approach improves the rescue efficiency and reduces the damage of the earthquake emergency.

Ventilation improvement and evaluation of its effectiveness in a Japanese manufacturing factory

A coronavirus disease 2019 (COVID-19) cluster emerged in a manufacturing factory in early August 2021. In November 2021, we conducted a ventilation survey using the tracer gas method. Firstly, we reproduce the situation at the time of cluster emergence and examined whether the ventilation in the office was in a condition that increased the risk of aerosol transmission. Secondly, we verified the effectiveness of the factory’s own countermeasure implemented immediately after the August cluster outbreak. Furthermore, we verified the effectiveness of several additional improvement measures on the factory’s own countermeasures already installed in August. Under the conditions of the cluster emergence, the air changes per hour (ACH) value was 0.73 ACH on average. The ACH value was less than 2 ACH recommended by the Ministry of Health, Labour, and Welfare, suggesting an increased risk of aerosol transmission. The factory’s own countermeasures taken immediately in August were found to be effective, as the ACH value increased to 3.41 ACH on average. Moreover, it was confirmed that additional improvement measures on the factory’s own countermeasures increased the ACH value to 8.33 ACH on average. In order to prevent the re-emergence of COVID-19 clusters due to aerosol infection in the office, it was found that while continuing the factory’s own countermeasure, additional improvement measures should also be added depending on the number of workers in the room. In a company, it is important that workers themselves continue to take infection control measures autonomously, and confirming the effectiveness of the measures will help maintain workers’ motivation. We believe it is helpful that external researchers in multiple fields and internal personnel in charge of the health and safety department and occupational health work together to confirm the effectiveness of conducted measures, such as in this case.

Effect of donor blood storage on gel column crossmatch in dogs.

Compared with fresh blood, stored equine donor blood results in spurious tube crossmatch incompatibilities. Interpretation of blood crossmatch results is considered subjective. We aimed to determine if the duration of canine donor blood storage impacts compatibility testing using a standard gel column crossmatch and evaluate interobserver variation in the interpretation of crossmatch results. Observational study. Whole blood segments were obtained from 23 canine packed red blood cell (RBC) units for use in crossmatches after storage for 0, 7, 14, 21, 28, and 35 days. Major and minor crossmatches were performed using serum and RBCs, respectively, from two to three healthy "recipient" dogs per unit. All crossmatch results were interpreted by four observers, of whom three were blinded. All major crossmatches (n=61) were compatible on day 0 and remained compatible through day 35 of storage. All minor crossmatches (n=69) were compatible at all time points, except for five donor pairs with 1 to 3+ agglutination. Repeat testing of these five donor pairs confirmed crossmatch incompatibilities on days 0 through 35, with no change in the degree of incompatibility over time. There was substantial agreement among four observers in determining compatibility (κ=0.94) and scoring incompatibility (κ=0.76). The current practice of performing canine crossmatches with whole blood segments stored for up to 35 days is acceptable, with no spurious changes in compatibility expected over time. The substantial interobserver agreement suggests that the gel column is suitable for performing canine crossmatches in a laboratory setting with multiple personnel.

Control strategy of fan filter units based on personnel position in semiconductor fabs

To meet the high environmental requirements of semiconductor manufacturing, fabs operate at a huge air volume that is designed under the most unfavorable condition, resulting in extremely high energy consumption. In this study, a new control strategy of fan filter units (FFUs) based on personnel position was proposed to reduce the operating air volume, i.e., higher air supply velocity around personnel and lower air supply velocity far from the personnel. And then a computational fluid dynamics (CFD) model was established to simulate the particle distribution under different scenarios. The specific supply air velocity of FFUs above the personnel and other areas were determined with the scenario that only one personnel stands in cleanroom. More scenarios with multiple personnel and personnel moving around were used to verify the effectiveness of proposed control strategy. The results show that supply air velocities of 0.35 m/s around personnel and 0.15 m/s and far from the personnel can guarantee the same level of cleanliness as the conventional constant air volume method (i.e., air supply velocity of all FFUs at 0.35 m/s). With the proposed control strategy, the required air volume can be significantly decreased by 42–55.3% under different working conditions. The proposed strategy has the advantage of high energy savings and emission reduction in semiconductor fabs.

A Multi-Disciplinary Approach for the Management of Prosthetic Joint Infections: An Australian Perspective.

Introduction:Prosthetic joint infections (PJI) are a major complication of hip and knee arthroplasty, imposing significant morbidity and mortality. Orthopaedic oncology units have utilised a multi-disciplinary team (MDT) approach for some time. PJI is not only an equally life-threatening condition, it also requires input from multiple healthcare personnel and treatment can vary significantly between individuals given the diversity in microbiological, surgical and host factors. Our arthroplasty service established an MDT meeting to manage this complex patient group. This study describes the philosophy and implementation of an MDT approach to the management of PJIs at a tertiary hospital in Australia.Materials and methods:A retrospective review of all patients that presented to the MDT PJI meeting from October 2017 to April 2020 was performed. Patient characteristics, microbiological profile and management were reviewed.Results:One hundred and one patients were reviewed over 2.5 years with a mean age of 69.2 years (SD 11.9). Patients presenting predominantly had a primary TKR (32%) or primary THR (22%). Results of Microbiology cultures varied, with 42% Gram-positive organisms, 13% Gram-negative organisms, 2% fungus and 1% yeast origin. Management mainly consisted of two-stage revision (28%), debridement-antibiotics-and-implant retention (22%) and antibiotic suppression (14%). A total of 91.5% of patients who underwent surgical management were considered cured at one year.Conclusion:PJIs are complex and require coordinated care by a number of healthcare personnel. The MDT process has allowed collaboration between Orthopaedic, Infectious Disease and Microbiology departments and aims to improve the quality of care provided to patients, potentially reducing morbidity and mortality of patients with PJI.

Treatment patterns, social determinants of health, and functional outcomes for older adults in supportive oncology.

e18575 Background: Research suggests that disparities in all-cause cancer survival times include a dynamic interplay of social determinants of health (SDOH) and treatment decisions. The social environment and associated vulnerability to interpersonal factors, access to social resources and supports, socialization and socioecological experiences affect health outcomes. The purpose of this study was to examine the nexus of SDOH, treatment decisions, and functional outcomes for older adults in supportive oncology at a large academic medical center. Methods: After obtaining IRB approval, we conducted a retrospective chart review of supportive oncology older adults from 2014-2017 (n = 4495) using data restricted to ICD10 codes for solid tumors. We conducted a retrospective analysis to investigate SDOH and treatment decisions for the older adult cancer cohort. Demographic variables included patient age, race, sex, medical insurance, primary diagnosis, attending physician specialty, and comorbidities. Survival time was defined as time from admission to event of death or discharge. We used zip code median income as a surrogate for individual level social gradients. The data were analyzed using the Statistical Analysis Software (SAS) application version 9.4. We used logistics regression and Cox proportional hazards models to answer research questions. Results: The sample (n = 4495) of adult cancer patients was 50% female, 51% white, and mostly (81%) high SES position. The mean age was 66.24 years (SD = 15.23). Treatment patterns included 596 (14%) chemotherapy, 402 (9%) radiation, 415 (9%) both chemotherapy and radiation; and 3015 (68%) reported not having any treatment. Median survival time was 12.88 days. Over 95% of sample reported multiple comorbidities while 76% reported enrollment in government insurance. The crude association between treatment decisions and social position was 1.64 (CI 1.38,1.95) compared to the bias adjusted association which ranged from 2.60 to 4.54. However, the hazard of mortality between those with no cancer treatment was HR = 1.03 (0.96, 1.11) times the corresponding hazard among those receiving treatment. Conclusions: Although supportive oncology clinics may decrease symptom-burden, they may add to fragmentation of care if multiple personnel are involved. Our findings provided evidence that high socially positioned older adults were 4.54 times more likely to receive treatment compared to low socially positioned older adults although there was no meaningful difference in survival times. Clinicians need to create interventions to reduce treatment disparities. Further research is warranted to foster policy models to improve health equity and promote positive functional outcomes for older adults with cancer.

Access, Engagement, and Experiences with Critical Incident Response Resources in Athletic Training

Purpose: Experiencing an event that involves actual or threatened death or serious injury is a critical incident and produces serious emotional responses. Athletic trainers (ATs) experience critical incidents in their day-to-day work. The purpose of this study was to explore how ATs experience a critical incident during the course of clinical practice. Methods: We used one-on-one, web-based, semi-structured interviewing with a criterion sample of ATs who experienced a critical incident and used any critical incident response resources in the last year (n=17; age=32±8; years of experience=9±7; years in current position=4±5). We used a 3-person team with a multi-phase process to identify the emerging domains and categories. Results: Two emergent domains were identified from the study. External support referenced multiple personnel resources available after a critical incident occurred, specifically, trained mental health professionals, untrained personnel, and trusted colleagues/coworkers. Coping with the emotional response included debriefing, spirituality, and complementary mental health strategies. Conclusion: In preparation for critical incidents, emergency action planning and after-action planning for healthcare delivery and the emotional response are both essential. Many ATs do not have the formal training, but continuing education courses, community-based mental health resources, and the promotion of professional organization resources can assist ATs in critical incident management.

Clinical Research on Gastrointestinal Surgery Based on Smart Medicine.

Smart medical technology uses the medical information platform, with the help of current technical means, so that the information between medical staff and medical equipment can be shared. The combination of current technology and the medical field has become the norm. In the future, more artificial intelligence technologies will be incorporated in the medical field to promote the development of medical undertakings. At present, the information on the Internet is very large and complex, and general search engines often do not have knowledge in certain professional fields and can only perform shallow keyword searches, so it is difficult to meet people's medical diagnostic needs. Smart medical technology can solve the problem of these needs. Surgery, commonly known as operation, refers to the process of entering the body to change the condition of the disease through technical means and under the guidance of professionals. Earlier operations only performed cutting on the body surface. With the continuous maturity of surgical operations, operations can now be performed on any part, but manual operations are still the main one. In addition to manual surgery, there are many machine surgeries, such as laser surgeries. Clinical research takes the diagnosis and treatment of diseases as the main content, takes patients as the research object, and is a scientific research activity involving multiple personnel. This article aimed to study the clinical research of gastrointestinal surgery based on smart medicine and hoped to use smart medical technology to improve the clinical research level of gastrointestinal surgery and provide technical support for surgery. This study proposes to apply natural language processing technology to the medical field, build an intelligent diagnostic auxiliary system, and use the existing medical record data to realize the corresponding medical auxiliary function. The research measures and analyzes the basic information of medical students, the incidence of functional gastrointestinal disease, the incidence of common symptoms of functional gastrointestinal disease, and the differential distribution of various symptoms in different professions, genders, and ages. The experimental results of this article show that there are 27 cases of gastrointestinal bleeding, accounting for 18%; 10 cases of dysphagia, accounting for 7%; 78 cases of abdominal pain and bloating, accounting for 53%; and 19 cases of melena, accounting for 13%. Abdominal pain and bloating are the most common clinical manifestations of the gastrointestinal tract and require more attention.

Measuring sex and gender in U.S. Alzheimer's disease and related dementias (ADRD) research.

Differences between men and women are common in Alzheimer's disease and related dementias (ADRD) research. What do they mean? To answer this, rigorous measurement is needed. We investigated current methods being used in ADRD research to measure sex/gender. An online survey was sent to 38 federally-funded Alzheimer's Disease Research Centers (ADRCs), which are required to maintain research cohorts, and 38 federally-funded cohort studies on aging and cognition in the U.S. The response rate was 65.8% (n=50). The survey assessed whether studies enrolled men and women and study protocols for all measures of sex and gender. One or more personnel from 25 ADRCs/ADCs and 25 cohort studies completed the survey from October to December 2020. Of the 50 ADRCs/ADCs and cohort studies, all enrolled men and all but two cohort studies enrolled women. The majority indicated no documented definitions of "man" or "woman": 23/25 (92%) ADRCs/ADCs and 20/25 (80%) cohort studies. Of the seven reporting study definitions, sex/gender definitions included the following: male vs. female (n=2), biologic sex (n=1), defined by another data source ("NACC form" n=1), or only noted that sex/gender was self-reported (n=3). sIn 4/5 instances where multiple personnel reported on a ADRC/ADC or cohort study, reports were inconsistent [e.g., "sex" vs "gender" (n=1) or named "sex" vs unlisted (n=3)]. Most studies (20/25 ADRCs/ADCs, 17/25 cohort studies) had only one measure of sex/gender. In total, 52 measures of sex/gender were described: self-report (n=43), direct observation (n=5), obtained from secondary source (n=3), and biologic specimen (n=1). Self-report measures asked participants to report whether they identified as "male or female" or "man or woman." ADRD research efforts in the U.S. appear to consistently enroll men and women. However, there is a need to define these terms in ways that ensure inclusivity, representation, and consistency in data collection. It is essential to expand measures of sex/gender in ADRD research beyond self-report data to social, behavioral, and biologic markers in order to aid discovery of specific pathways that affect ADRD outcomes.

Delegated Authorization Framework for EHR Services Using Attribute-Based Encryption

Medical organizations find it challenging to adopt cloud-based Electronic Health Records (EHR) services due to the risk of data breaches and the resulting compromise of patient data. Existing authorization models follow a patient-centric approach for EHR management, where the responsibility of authorizing data access is handled at the patients end. This creates a significant overhead for the patient who must authorize every access of their health record. This is not practical given that multiple personnel are typically involved in providing care and that the patient may not always be in a state to provide this authorization. Hence there is a need to develop a proper authorization delegation mechanism for safe, secure and easy to use cloud-based EHR Service management. We present a novel, centralized, attribute-based authorization mechanism that uses Attribute Based Encryption (ABE) and allows for delegated secure access of patient records. This mechanism transfers the service management overhead from the patient to the medical organization and allows easy delegation of cloud-based EHRs access authority to medical providers.

Research on Non-Contact and Non-Fixed Cable Force Measurement Based on Smartphone

Stay cable is the major load-carrying element in cable-stayed bridges. The process of monitoring cable forces would be beneficial to ensure the safety of bridges. The conventional sensor-based approaches to measure stay cable forces is complicated in operation, time-consuming and relatively expensive. In order to confront these disadvantages, a lightweight measurement method using smartphone imagery was proposed in this paper. The video data acquisition process was first standardized by using a pre-designed target. Then, a novel algorithm to extract the vibration displacement of stay cables under complex condition was developed. An automatic correction algorithm was provided to further improve the displacement results. On top of that, a smartphone-based software for determining cable forces was developed and tested on a real-life bridge. The results showed a maximum error of 1.99% compared with the cable force obtained by using a dynamic tester. The developed software is proven to be feasible in real-life projects and can achieve high accuracy in cable force determination. At the same time, the proposed method does not require a fixed camera for measurement and is not limited by personnel experience and measurement time, facilitating real-time monitoring of multiple projects, multiple cable surfaces and multiple personnel in a visual vibration environment.