Impact of Laboratory Value Flowsheet in Electronic Health Record (EHR) Documentation Time

Research on the use of EHR is contradictory since it presents contradicting results regarding the time spent documenting. There is research that supports the use of electronic records as a tool to speed documentation;and research that found that it is time consuming. The purpose of this quantitative retrospective before-after project was to measure the impact of using the laboratory value flowsheet within the EHR on documentation time. The research question was: “Does the use of a laboratory value flowsheet in the EHR impact documentation time by primary care providers (PCPs)?” The theoretical framework utilized in this project was the Donabedian Model. The population in this research was the two PCPs in a small primary care clinic in the northwest of Puerto Rico. The sample was composed of all the encounters during the months of October 2019 and December 2019. The data was obtained through data mining and analyzed using SPSS 27. The evaluative outcome of this project is that there is a decrease in documentation time after implementation of the use of the laboratory value flowsheet in the EHR. However, patients per day increase therefore having an impact on the number of patients seen per day/week/month. The implications for clinical practice include the use of templates to improve workflow and documentation as well as decreasing documentation time while also increasing the number of patients seen per day. .

Smart Client与Office System整合应用研究

Smart Client既可以运用网络和Web Services存取各种外部系统的资源,又能使用本地计算机的所有资源,充分发挥客户端的运算能力,是一种全新软件模式。Office 2003 System中提供了一个Smart Document的功能,使用以文档为基础的方式扩充智能感知的XML标记功能,和用户交互更容易。微软还提出了一套InformationBridge Framework(IBF),来协助开发人员建立方案来连接Microsoft Office应用程序与Web服务。应用Microsoft的Smart Client,结合Office 2003 System以及.NET技术,构建一种部署成本低、维护容易、构架轻小、健壮的应用系统。

An explorative study on document type assignment of review articles in Web of Science,Scopus and journals’websites

Purpose:Accurately assigning the document type of review articles in citation index databases like Web of Science(WoS)and Scopus is important.This study aims to investigate the document type assignation of review articles in Web of Science,Scopus and Publisher’s websites on a large scale.Design/methodology/approach:27,616 papers from 160 journals from 10 review journal series indexed in SCI are analyzed.The document types of these papers labeled on journals’websites,and assigned by WoS and Scopus are retrieved and compared to determine the assigning accuracy and identify the possible reasons for wrongly assigning.For the document type labeled on the website,we further differentiate them into explicit review and implicit review based on whether the website directly indicates it is a review or not.Findings:Overall,WoS and Scopus performed similarly,with an average precision of about 99% and recall of about 80%.However,there were some differences between WoS and Scopus across different journal series and within the same journal series.The assigning accuracy of WoS and Scopus for implicit reviews dropped significantly,especially for Scopus.Research limitations:The document types we used as the gold standard were based on the journal websites’labeling which were not manually validated one by one.We only studied the labeling performance for review articles published during 2017-2018 in review journals.Whether this conclusion can be extended to review articles published in non-review journals and most current situation is not very clear.Practical implications:This study provides a reference for the accuracy of document type assigning of review articles in WoS and Scopus,and the identified pattern for assigning implicit reviews may be helpful to better labeling on websites,WoS and Scopus.Originality/value:This study investigated the assigning accuracy of document type of reviews and identified the some patterns of wrong assignments.

基于本体驱动的航空情报表格信息结构化研究

航空资料汇编是国际民航组织推荐的呈现各国航空信息的主要载体,其中以表格数据形式汇总了大量航空数据与航空运行限制信息。为实现航空汇编资料的智能查询,以及对航空资料汇编中静态数据的挖掘与利用,需要对航空汇编资料中的表格信息予以特征提取与结构化处理。将航空资料汇编中表格信息作为研究对象,提出了一种基于本体驱动的航空情报表格信息结构化抽取方法。首先构建航空情报领域信息的本体框架,实现对领域知识统一规范的描述;其次,利用Document AI对表格文档的布局结构进行研究与预处理,并利用随机森林算法与条件随机场模型进行特征实体提取验证与分析。实验结果表明,所提方法能够有效提取航空情报表格中的特征实体,为航空情报领域静态数据深入挖掘提供参考。

Hybrid Optimization Algorithm for Handwritten Document Enhancement

The Gannet Optimization Algorithm (GOA) and the Whale Optimization Algorithm (WOA) demonstrate strong performance;however, there remains room for improvement in convergence and practical applications. This study introduces a hybrid optimization algorithm, named the adaptive inertia weight whale optimization algorithm and gannet optimization algorithm (AIWGOA), which addresses challenges in enhancing handwritten documents. The hybrid strategy integrates the strengths of both algorithms, significantly enhancing their capabilities, whereas the adaptive parameter strategy mitigates the need for manual parameter setting. By amalgamating the hybrid strategy and parameter-adaptive approach, the Gannet Optimization Algorithm was refined to yield the AIWGOA. Through a performance analysis of the CEC2013 benchmark, the AIWGOA demonstrates notable advantages across various metrics. Subsequently, an evaluation index was employed to assess the enhanced handwritten documents and images, affirming the superior practical application of the AIWGOA compared with other algorithms.

Multimodal Deep Neural Networks for Digitized Document Classification

As digital technologies have advanced more rapidly,the number of paper documents recently converted into a digital format has exponentially increased.To respond to the urgent need to categorize the growing number of digitized documents,the classification of digitized documents in real time has been identified as the primary goal of our study.A paper classification is the first stage in automating document control and efficient knowledge discovery with no or little human involvement.Artificial intelligence methods such as Deep Learning are now combined with segmentation to study and interpret those traits,which were not conceivable ten years ago.Deep learning aids in comprehending input patterns so that object classes may be predicted.The segmentation process divides the input image into separate segments for a more thorough image study.This study proposes a deep learning-enabled framework for automated document classification,which can be implemented in higher education.To further this goal,a dataset was developed that includes seven categories:Diplomas,Personal documents,Journal of Accounting of higher education diplomas,Service letters,Orders,Production orders,and Student orders.Subsequently,a deep learning model based on Conv2D layers is proposed for the document classification process.In the final part of this research,the proposed model is evaluated and compared with other machine-learning techniques.The results demonstrate that the proposed deep learning model shows high results in document categorization overtaking the other machine learning models by reaching 94.84%,94.79%,94.62%,94.43%,94.07%in accuracy,precision,recall,F-score,and AUC-ROC,respectively.The achieved results prove that the proposed deep model is acceptable to use in practice as an assistant to an office worker.

A Framework Based on the DAO and NFT in Blockchain for Electronic Document Sharing

In the information age,electronic documents(e-documents)have become a popular alternative to paper documents due to their lower costs,higher dissemination rates,and ease of knowledge sharing.However,digital copyright infringements occur frequently due to the ease of copying,which not only infringes on the rights of creators but also weakens their creative enthusiasm.Therefore,it is crucial to establish an e-document sharing system that enforces copyright protection.However,the existing centralized system has outstanding vulnerabilities,and the plagiarism detection algorithm used cannot fully detect the context,semantics,style,and other factors of the text.Digital watermark technology is only used as a means of infringement tracing.This paper proposes a decentralized framework for e-document sharing based on decentralized autonomous organization(DAO)and non-fungible token(NFT)in blockchain.The use of blockchain as a distributed credit base resolves the vulnerabilities inherent in traditional centralized systems.The e-document evaluation and plagiarism detection mechanisms based on the DAO model effectively address challenges in comprehensive text information checks,thereby promoting the enhancement of e-document quality.The mechanism for protecting and circulating e-document copyrights using NFT technology ensures effective safeguarding of users’e-document copyrights and facilitates e-document sharing.Moreover,recognizing the security issues within the DAO governance mechanism,we introduce an innovative optimization solution.Through experimentation,we validate the enhanced security of the optimized governance mechanism,reducing manipulation risks by up to 51%.Additionally,by utilizing evolutionary game analysis to deduce the equilibrium strategies of the framework,we discovered that adjusting the reward and penalty parameters of the incentive mechanism motivates creators to generate superior quality and unique e-documents,while evaluators are more likely to engage in assessments.

Assessing adequacy of emergency provider documentation among interhospital transferred patients with acute aortic dissection

BACKGROUND: Acute aortic dissection(AoD) is a hypertensive emergency often requiring the transfer of patients to higher care hospitals; thus, clinical care documentation and compliance with the Emergency Medical Treatment and Active Labor Act(EMTALA) is crucial. The study assessed emergency providers(EP) documentation of clinical care and EMTALA compliance among interhospital transferred AoD patients.METHODS: This retrospective study examined adult patients transferred directly from a referring emergency department(ED) to a quaternary academic center between January 1, 2011 and September 30, 2015. The primary outcome was the percentage of records with adequate documentation of clinical care(ADoCC). The secondary outcome was the percentage of records with adequate documentation of EMTALA compliance(ADoEMTALA). RESULTS: There were 563 electronically identified patients with 287 included in the final analysis. One hundred and five(36.6%) patients had ADoCC while 166(57.8%) patients had ADoEMTALA. Patients with inadequate documentation of EMTALA(IDoEMTALA) were associated with a higher likelihood of not meeting the American Heart Association(AHA) ED Departure SBP guideline(OR 1.8, 95% CI 1.03–3.2, P=0.04). Male gender, handwritten type of documentation, and transport by air were associated with an increased risk of inadequate documentation of clinical care(IDoCC), while receiving continuous infusion was associated with higher risk of IDoEMTALA.CONCLUSION: Documentation of clinical care and EMTALA compliance by Emergency Providers is poor. Inadequate EMTALA documentation was associated with a higher likelihood of patients not meeting the AHA ED Departure SBP guideline. Therefore, Emergency Providers should thoroughly document clinical care and EMTALA compliance among this critically ill group before transfer.

On the study of ecosystem health:state of the art

Ecosystem health is a newly proposed concept that sets new goals for environmental management. Its definition, assessment indicators, and assessment methods are reviewed in this paper. Literature shows that the definitions and the assessment indicators cover a wide range of ecosystem health, and they differ in terms of researchers different scientific background. It is concluded that the concept of ecosystem health cannot be defined or understood simply in biological or ethical or aesthetic or historical terms and the assessment should be based on applying several indicators simultaneously to get overall picture of the health or integrity state of an ecosystem.

Evaluation of a Mobile Station Electronic Health Record on Documentation Compliance and Nurses’ Attitudes

Electronic Health Record (EHR) Systems have been adopted by healthcare organizations for documentation of patient care. Often these information systems are embedded in mobile nurse stations. As part of assessing the impact of this technology it is important to determine the effect it has on charting compliance and user acceptance. Data were collected at a medical center in Taiwan in two stages. The first stage involved use of a 28-item medical review tool to measure charting compliance in 99 charts before and after implementation of the EHR system. In stage two, a survey was conducted with 709 nurse users to determine their level of mobile EHR acceptance 3 months after this documentation technology was initiated. Results demonstrated that EHR significantly improved documentation compliance in standardized data entry format (name, date, time), abbreviation, content correction/revision, patient care needs, and care goals. Analysis of data from the five categories of a user acceptance survey revealed the following results (based on a 4-point Likert scale): patient care (2.92), nursing efficiency (2.78), education and training (2.98), usability (2.61), and usage benefits (2.87). The study concluded that use of mobile nurse stations with EHR can improve documentation compliance and that although frequent system downtime needs improvement, nurses generally have positive attitudes toward this technology application.

Assessing an Educational Program to Improve Documentation and Reduce Pain in Hospitalized Patients

Few experimental studies have evaluated the efficacy of continuing educational programs aimed at the improvement of nurses’ pain-management skills. This study assessed whether a standardized educational program aimed at nurses could increase the use of the Numeric Rating Scale-11 in both documenting and reducing postoperative pain-intensity levels in hospitalized surgical patients. The study had a quasi-experimental pre- and post-intervention design. Data were collected from records of surgical patients prior to and after the standardized educational program was completed. There were no significant differences between pre- and post-intervention groups in terms of either pain-documentation frequency or pain-intensity level. The study showed no increase in the frequency of postoperative pain documentation and no reduction of surgical patients’ postoperative pain-intensity level. This finding indicates that the standardized educational program on postoperative pain management was insufficient to bring about changes in clinical practice.

Hadoop-Based Similarity Computation System for Composed Documents

There exist a large number of composed documents in universities in the teaching process. Most of them are required to check the similarity for validation. A kind of similarity computation system is constructed for composed documents with images and text information. Firstly, each document is split and outputs two parts as images and text information. Then, these documents are compared by computing the similarities of images and text contents independently. Through Hadoop system, the text contents are easily and quickly separated. Experimental results show that the proposed system is efficient and practical.

EDCMS:A Content Management System for Engineering Documents

Engineers often need to look for the right pieces of information by sifting through long engineering documents, It is a very tiring and time-consuming job. To address this issue, researchers are increasingly devoting their attention to new ways to help information users, including engineers, to access and retrieve document content. The research reported in this paper explores how to use the key technologies of document decomposition （study of document structure）, document mark-up （with EXtensible Mark- up Language （XML）, HyperText Mark-up Language （HTML）, and Scalable Vector Graphics （SVG））, and a facetted classification mechanism. Document content extraction is implemented via computer programming （with Java）. An Engineering Document Content Management System （EDCMS） developed in this research demonstrates that as information providers we can make document content in a more accessible manner for information users including engineers.The main features of the EDCMS system are： 1） EDCMS is a system that enables users, especially engineers, to access and retrieve information at content rather than document level. In other words, it provides the right pieces of information that answer specific questions so that engineers don＇t need to waste time sifting through the whole document to obtain the required piece of information. 2） Users can use the EDCMS via both the data and metadata of a document to access engineering document content. 3） Users can use the EDCMS to access and retrieve content objects, i.e. text, images and graphics （including engineering drawings） via multiple views and at different granularities based on decomposition schemes. Experiments with the EDCMS have been conducted on semi-structured documents, a textbook of CADCAM, and a set of project posters in the Engineering Design domain. Experimental results show that the system provides information users with a powerful solution to access document content.

A Novel CAPP System Based on SML for Variant Design of Process Planning

The production model of“multi-specification and low-quantity”is becoming the main trend of manufacturing industry.As a key activity in the manufacturing chain,traditional computer aided process planning(CAPP)system fails to adapt to the production model of customization.Therefore,a novel method for variant design of process planning was proposed to develop CAPP system based on Tabular Layouts of Article Characteristics(Sach-Merk Leisten in German and SML for short). With the support of standard database of master process planning documents which are developed by parameterization technique, and instance process planning for special product(instance product)can be generated automatically by the sub-system of variant de- sign of process planning.Finally,a CAPP system was developed for process design of rotor of steam turbine to validate the feasibil- ity and applicability of the method.

Information Network Systems and Information Sharing on Administrative Websites

In Japanese 'e-government' policy, called 'e-Japan', the 'administrative document management system' is functioning as information searching systems. On the other hand, this system has also generated the problem that it is not fully functioning as a means for the information sharing in a governmental agency. So, the purpose of this research is to find how the administrative document management system can function as information sharing in administrative organization. For this purpose, this paper considers the current status and some problems firstly. And secondary, this paper proposes the idea and constructs some information systems using administrative official Website. This is the method and approach of this research. As a conclusion, this proposal information system junctions as information sharing support systems.

Impact of an educational intervention on medical records documentation

BACKGROUND: Inaccurate and incomplete documentation can lead to poor treatment and medicolegal consequences. Studies indicate that teaching programs in this field can improve the documentation of medical records. The study aimed to evaluate the effect of an educational workshop on medical record documentation by emergency medicine residents in the emergency department.METHODS: An interventional study was performed on 30 residents in their first year of training emergency medicine(PGY1), in three tertiary referral hospitals of Tehran University of Medical Sciences. The essential information that should be documented in a medical record was taught in a 3-day-workshop. The medical records completed by these residents before the training workshop were randomly selected and scored(300 records), as was a random selection of the records they completed one(300 records) and six months(300 records) after the workshop.RESULTS: Documentation of the majority of the essential items of information was improved significantly after the workshop. In particular documentation of the patients' date and time of admission, past medical and social history. Documentation of patient identity, requests for consultations by other specialties, first and final diagnoses were 100% complete and accurate up to 6 months of the workshop.CONCLUSION: This study confirms that an educational workshop improves medical record documentation by physicians in training.

UNCERTAIN KNOWLEDGE MANAGEMENT IN EXPERT SYSTEMS USING FUZZY METAGRAPHS

This paper presented a new graph theoretic construct——fuzzy metagraphs and discussed their applications in constructing fuzzy knowledge base. Fuzzy metagraphs describe the relationships between sets of fuzzy elements but not single fuzzy element and offer some distinct advantages both for visualization of systems, as well as for formal analysis of system structure. In rule based system, a fuzzy metagraph is a unity of the knowledge base and the reasoning engine. Based on the closure of the adjacency matrix of fuzzy metagraphs, this paper presented an optimized inferential mechanism working mainly by an off line approach. It can greatly increase the efficiency of inference. Finally, it was applied in a daignostic expert system and satisfactory results were obtained.

STUDY ON CONFLICT MANAGEMENT FOR COLLABORATIVE DESIGN SYSTEM

Modern day products are usually designed cooperatively by groups of experts, each with his own areas of expertise. Because of different viewpoint, evaluation standard and domain knowledge of these design groups in collaborative design system, conflict is unavoidable. In this paper, an integration conflict management system (ICMS) was presented from the aspect of all life cycle. A hierarchical constraint network was introduced to detect the conflicts. Three conflict types were classified in ICMS and different type of conflict was submitted to different resolution strategy, constraint relaxation to data conflict and knowlegdge based reasoning to knowledge conflict or schema conflict. To those conflicts hard to be resolved with the above two strategies, an arbitration was used for the conflict resolution. ICMS also provided interface with other collaborative systems such as CAE, CAD to improve the efficiency of collaborative design system.

Decolorization and kinetics of photo oxidizing cationic blue X-GRL by UV/H_2O_2 system

Azo dye cationic blue X GRL, which is non biodegradable toxic organic compound, is decolorized and subsequently mineralized by UV/H 2O 2/N 2 or UV/H 2O 2/air (O 2) system. The effects of initial solution concentration, initial solution pH, and some ions produced during the degradation on the rate of decolorization of cationic blue X GRL were investigated. The photodegradation of cationic blue X GRL approximately follows first order kinetics. The regression curve of the natural logarithm of concentration verus reaction time becomes less linear with initial concentration increasing. Oxygen and appropriate OH\+· generator can accelerate reaction rate. The effect of reaction atmosphere, initial concentration, light intensity on the optimal dosage of H 2O 2 were studied. It was found that the optimal H 2O 2 dosage was determined by UV light intensity. These intermediates of cationic blue X GRL decolorization are biodegradable.

RSOFCPN:CONTROL SYSTEM STRUCTURE ANDALGORITHM DESIGN

A stable control scheme for a class of unknown nonlinear systems was presented. The control architecture is composed of two parts, the fuzzy sliding mode controller (FSMC) is applied to drive the state to a designed switching hyperplane, and a reinforcement self organizing fuzzy CPN (RSOFCPN) as a feedforward compensator is used to reduce the influence of system uncertainties. The simulation results demonstrate the effectiveness of the proposed control scheme.