Evaluation of the HIV Case-Based Surveillance System: A Pilot of the Electronic Health Record System in Mutare District, Zimbabwe, 2021

Background: Zimbabwe started HIV case-based surveillance in April 2017. Rapid testing for HIV recent infection was introduced into routine HIV and testing services in 2019 along with the Impilo Electronic Health Record System. For the period January-June 2020, only 1 out of 13 health facilities in Mutare district reported seven newly diagnosed HIV patients through the electronic health record system compared to 483 in the District Health Information System (DHIS-2) recorded from paper-based registers. We evaluated the case-based surveillance system attributes, usefulness and reasons for under-reporting from January-December 2020. Methods: We conducted a descriptive cross-sectional study using updated Centres for Disease Control guidelines for evaluating public health surveillance systems. Questionnaires were administered to 36 health workers involved in HIV testing services. Facility checklists were used to collect data on knowledge, system attributes and usefulness of the system. Completed HIV case-based surveillance forms were assessed for completeness. Epi Info Version 7 was used to generate frequencies, means and proportions. Results: The reasons for under-reporting of patients in the electronic health record system were lack of reporting guidelines 26/36 (72%), limited coordination between technical staff and health facilities 24/36 (67%) and limited competency on the Electronic health record system 22/36 (61%). Timeliness, completeness, and validity were 88%, 82% and 100% respectively. The stability of the system was affected by the lack of standard operating procedures during system interruptions. Overall representativeness was 45% despite increasing from 3/226 (1%) to 224/303 (73%) between Quarter-1 and Quarter-4 of 2020. Acceptability was 100% due to reduced paperwork and the ability to generate simple reports. The information generated was used to identify new infection hotspots 28/36 (78%). Conclusion: The HIV cases based surveillance system was timely, acceptable with good data quality. Representativeness was poor due to limited competency on the electronic health record system. As a result, health workers received further training.

Ensuring Information Security in Electronic Health Record System Using Cryptography and Cuckoo Search Algorithm

In the contemporary era,the abundant availability of health information through internet and mobile technology raises concerns.Safeguarding and maintaining the confidentiality of patients’medical data becomes paramount when sharing such information with authorized healthcare providers.Although electronic patient records and the internet have facilitated the exchange of medical information among healthcare providers,concerns persist regarding the security of the data.The security of Electronic Health Record Systems(EHRS)can be improved by employing the Cuckoo Search Algorithm(CS),the SHA-256 algorithm,and the Elliptic Curve Cryptography(ECC),as proposed in this study.The suggested approach involves usingCS to generate the ECCprivate key,thereby enhancing the security of data storage in EHR.The study evaluates the proposed design by comparing encoding and decoding times with alternative techniques like ECC-GA-SHA-256.The research findings indicate that the proposed design achieves faster encoding and decoding times,completing 125 and 175 iterations,respectively.Furthermore,the proposed design surpasses other encoding techniques by exhibiting encoding and decoding times that are more than 15.17%faster.These results imply that the proposed design can significantly enhance the security and performance of EHRs.Through the utilization of CS,SHA-256,and ECC,this study presents promising methods for addressing the security challenges associated with EHRs.

Impact of Bar-Code Medication Administration and Electronic Medication Administration Record System in Clinical Practice for an Effective Medication Administration Process

Clinical innovations are ideations resulting from collective experiences that enhance the “norm” and embrace an avenue for change with an invention. As such, collective data that were suggestive of increased medication errors that compromised patient safety initiated the exploration of methods that could reduce multifactorial human errors. The pursuit for an appropriate system followed with the discovery of barcode medication administration system (BCMA) and electronic medication administration system (e-MAR). Prior to the adoption of BCMA and e-MAR, it was crucial to assess the impact of the new medication administration system and the rate of medication administration errors recorded, specifically those that resulted in harm. The purpose of the study was to evaluate BCMA and e-MAR usage outcomes, clinical practices, policies, and processes impacting nurses administering medications in the clinical environment using BCMA and e-MAR system. Thus, an annotated literature review was conducted prior to the implementation of the innovation which analyzed various studies that elaborated on their study methods, data collection and analysis that deliberated on the advantages and disadvantages of barcode medication administration system. It is evident in the researched journals that increased compliance was observed with appropriate guidance, processes and policies in place. There was also a significant reduction in reported errors. The incorporation of barcode technology with electronic medication administration record (e-MAR) had greatly improved the efficiency of the BCMA system. BCMAs method was one of the proposed solutions to medication administration errors and to enhance patient safety measures. As such, the innovation could significantly reduce medication error resulting from intrinsic and extrinsic factors. This paper will further elaborate on the advantages and disadvantages of BCMA and e-MAR, the strategies assumed in the development of BCMA and e-MAR system and its implementation process by identifying and overcoming potential challenges that may arise.

Setting up a Customized Electronic Health Record System Fit for Internal Medicine in Dakar, Senegal

Objective: Describe the design and implementation of an electronic medical record—E-INTMED—customized for Internal Medicine in Dakar, Senegal. Methodology: This study was carried out in a public teaching hospital in Dakar Senegal. It entailed collaboration between physicians specialized in various fields in Internal Medicine and Computer Scientists to carry out the compilation of data and their electronic transcription to produce a prototype which met users’ needs. Results: E-INTMED software is structured around several hierarchical tables allowing users to register and store all relevant patients’ information. E-INTMED structures patient’s data to provide a clear overview of their medical history and users’ activity performance. E-INTMED makes medical users’ life so much easier. Users can generate and send letters and prescriptions quickly and efficiently using the customized templates which they can modify or create new ones. In addition to these capabilities, all of the features expected in an Internal Medicine EHR are handled by E-INTMED, such as lab orders and results, mechanisms for continuity of care, embedding and access to images and documents, and so much more. E-INTMED provides medical students with a number of educational, practical and administrative advantages. Conclusion: Computerization of medical records has become a necessity today. Crossing the line to Electronic medical records could help to improve medical practice and medical training.

FAULT LOCATION AND RECORDING SYSTEM OF TRANSMISSION LINES BASED ON COMPUTER NETWORK

In this paper a fault location and recording system based on a computer network is presented. A brief description of the system structure and main features are given. Emphasis is placed on the accurate fault location method for extra high voltage and long distance transmission lines.

Under the narrative medicine theory to establish the evidence-based medical record written by doctors and patients through integrated therapy of traditional Chinese and western on digestive system diseases

Objective:The aim of this article was to discuss the theory of doctor-patient co-operated evidence-based medical record and set up the preliminary frame of the doctor-patient co-operated evidence-based medical record following the concept of narrative evidence-based medicine.Methods:The information was searched from Pubmed,Embase,CBMdisc,CNKI.A preliminary agreement was reached by referring to the principles of narrative medicine and advises given by experts of digestive system and evidence-based medicine in both Traditional Chinese Medicine and Western Medicine.Result:This research is a useful attempt to discuss the establishment of doctor-patient co-operated evidence-based medical record guided by the direction of narrative evidence-based medicine.Reflection and outlook:Doctor-patient co-operated medical record can be a key factor of the curative effect evaluation methodology system of integrated therapy of Tradition Chinese Medicine and Western Medicine on spleen and stomach diseases.

Maturity Assessment of Hospital Information Systems Based on Electronic Medical Record Adoption Model (EMRAM)— Private Hospital Cases in Iran

Introduction: Today, information technology is considered as an important national development principle in each country which is applied in different fields. Health care as a whole and the hospitals could be regarded as a field and organizations with most remarkable IT applications respectively. Although different benchmarks and frameworks have been developed to assess different aspects of Hospital Information Systems (HISs) by various researchers, there is not any suitable reference model yet to benchmark HIS in the world. Electronic Medical Record Adoption Model (EMRAM) has been currently presented and is globally well-known to benchmark the rate of HIS utilization in the hospitals. Notwithstanding, this model has not been introduced in Iran so far. Methods: This research was carried out based on an applied descriptive method in three private hospitals of Isfahan—one of the most important provinces of Iran—in the year 2015. The purpose of this study was to investigate IT utilization stage in three selected private hospitals. Conclusion: The findings revealed that HIS is not at the center of concern in studied hospitals and is in the first maturity stage in accordance with EMRAM. However, hospital managers are enforced and under the pressure of different beneficiaries including insurance companies to improve their HIS. Therefore, it could be concluded that these types of hospitals are still far away from desirable conditions and need to enhance their IT utilization stage significantly.

Detection of Turbulence Anomalies Using a Symbolic Classifier Algorithm in Airborne Quick Access Record(QAR)Data Analysis

As the risks associated with air turbulence are intensified by climate change and the growth of the aviation industry,it has become imperative to monitor and mitigate these threats to ensure civil aviation safety.The eddy dissipation rate(EDR)has been established as the standard metric for quantifying turbulence in civil aviation.This study aims to explore a universally applicable symbolic classification approach based on genetic programming to detect turbulence anomalies using quick access recorder(QAR)data.The detection of atmospheric turbulence is approached as an anomaly detection problem.Comparative evaluations demonstrate that this approach performs on par with direct EDR calculation methods in identifying turbulence events.Moreover,comparisons with alternative machine learning techniques indicate that the proposed technique is the optimal methodology currently available.In summary,the use of symbolic classification via genetic programming enables accurate turbulence detection from QAR data,comparable to that with established EDR approaches and surpassing that achieved with machine learning algorithms.This finding highlights the potential of integrating symbolic classifiers into turbulence monitoring systems to enhance civil aviation safety amidst rising environmental and operational hazards.

Data Processing of Fault Recorder in Power System

This article studies the fault recorder in power system and introduces the Comtrade format. Andituses C++ programming to read recorded fault data and adopts Fourier analysis and symmetrical component method to filter and extract fundamental waves. Finally the effectiveness of the data processing method introduced in this paper is verified by CAAP software.

Securing Patient-Centric Personal Health Records Sharing System in Cloud Computing

Personal health record （PHR） enables patients to manage their own electronic medical records （EMR） in a centralized way, and it is oRen outsourced to be stored in a third-party server. In this paper we propose a novel secure and scalable system for sharing PHRs. We focus on the multiple data owner scenario, and divide the users in the system into multiple security domains that greatly reduce the key management complexity for owners and users. A high degree of patient privacy is guaranteed by exploiting hierarchical and multi- authority attribute-sets based encryption （HM- ASBE）. Our system not only supports compound attributes due to flexible attribute sets combinations, but also achieves fine-grained access control. Our scheme supports efficient on-demand user/attribute revocation and break-glass access under emergency scenarios.

An iterative ITI cancellation method for multi-head multi-track bit-patterned magnetic recording systems

Bit-Pattemed Magnetic Recording(BPMR)is one of the emerging data storage technologies,which promises an Areal Density(AD)of about 4 Tb/in2.However,a major problem practically encountered in a BPMR system is Inter-Track Interference(ITI)that can deteriorate the overall system performance,especially at high ADs.This paper proposes an iterative ITI cancellation method for an m-head m-track BPMR system,which uses m heads to read m adjacent tracks and decodes them simultaneously.To cancel the ITI,we subtract the weighted readback signals of adjacent tracks,acting as the ITI signals,from the readback signal of the target track,before passing the refined readback signal to a turbo decoder.Then,the decoded data will be employed to reconstruct the ITI signal for the next turbo iteration.Experimental results indicate that the proposed system performs better than the conventional system that uses one head to read one data track.Furthermore,we also find out that the proposed system is more robust to media noise and track misregistration than the conventional system.

Fog-Based Secure Framework for Personal Health Records Systems

The rapid development of personal health records(PHR)systems enables an individual to collect,create,store and share his PHR to authorized entities.Health care systems within the smart city environment require a patient to share his PRH data with a multitude of institutions’repositories located in the cloud.The cloud computing paradigm cannot meet such a massive transformative healthcare systems due to drawbacks including network latency,scalability and bandwidth.Fog computing relieves the load of conventional cloud computing by availing intermediate fog nodes between the end users and the remote servers.Assuming a massive demand of PHR data within a ubiquitous smart city,we propose a secure and fog assisted framework for PHR systems to address security,access control and privacy concerns.Built under a fog-based architecture,the proposed framework makes use of efficient key exchange protocol coupled with ciphertext attribute based encryption(CP-ABE)to guarantee confidentiality and fine-grained access control within the system respectively.We also make use of digital signature combined with CP-ABE to ensure the system authentication and users privacy.We provide the analysis of the proposed framework in terms of security and performance.

An Automatic Threshold Selection Using ALO for Healthcare Duplicate Record Detection with Reciprocal Neuro-Fuzzy Inference System

ESystems based on EHRs(Electronic health records)have been in use for many years and their amplified realizations have been felt recently.They still have been pioneering collections of massive volumes of health data.Duplicate detections involve discovering records referring to the same practical components,indicating tasks,which are generally dependent on several input parameters that experts yield.Record linkage specifies the issue of finding identical records across various data sources.The similarity existing between two records is characterized based on domain-based similarity functions over different features.De-duplication of one dataset or the linkage of multiple data sets has become a highly significant operation in the data processing stages of different data mining programmes.The objective is to match all the records associated with the same entity.Various measures have been in use for representing the quality and complexity about data linkage algorithms,and many other novel metrics have been introduced.An outline of the problem existing in themeasurement of data linkage and de-duplication quality and complexity is presented.This article focuses on the reprocessing of health data that is horizontally divided among data custodians,with the purpose of custodians giving similar features to sets of patients.The first step in this technique is about an automatic selection of training examples with superior quality from the compared record pairs and the second step involves training the reciprocal neuro-fuzzy inference system(RANFIS)classifier.Using the Optimal Threshold classifier,it is presumed that there is information about the original match status for all compared record pairs(i.e.,Ant Lion Optimization),and therefore an optimal threshold can be computed based on the respective RANFIS.Febrl,Clinical Decision(CD),and Cork Open Research Archive(CORA)data repository help analyze the proposed method with evaluated benchmarks with current techniques.

Nursing decision support system:application in electronic health records

The clinical decision support system makes electronic health records(EHRs)structured,intelligent,and knowledgeable.The nursing decision support system(NDSS)is based on clinical nursing guidelines and nursing process to provide intelligent suggestions and reminders.The impact on nurses’work is mainly in shortening the recording time,improving the quality of nursing diagnosis,reducing the incidence of nursing risk events,and so on.However,there is no authoritative standard for the NDSS at home and abroad.This review introduces development and challenges of EHRs and recommends the application of the NDSS in EHRs,namely the nursing assessment decision support system,the nursing diagnostic decision support system,and the nursing care planning decision support system(including nursing intervene),hoping to provide a new thought and method to structure impeccable EHRs.

A Novel System for Recognizing Recording Devices from Recorded Speech Signals

The field of digital audio forensics aims to detect threats and fraud in audio signals.Contemporary audio forensic techniques use digital signal processing to detect the authenticity of recorded speech,recognize speakers,and recognize recording devices.User-generated audio recordings from mobile phones are very helpful in a number of forensic applications.This article proposed a novel method for recognizing recording devices based on recorded audio signals.First,a database of the features of various recording devices was constructed using 32 recording devices(20 mobile phones of different brands and 12 kinds of recording pens)in various environments.Second,the audio features of each recording device,such as the Mel-frequency cepstral coefficients(MFCC),were extracted from the audio signals and used as model inputs.Finally,support vector machines(SVM)with fractional Gaussian kernel were used to recognize the recording devices from their audio features.Experiments demonstrated that the proposed method had a 93.4%accuracy in recognizing recording devices.

Integrating Electronic Systems for Requesting Clinical Laboratory Test into Digital Clinical Records: Design and Implementation

Clinical laboratory tests are basic elements that support healthcare tasks such as disease detection, diagnosis and monitoring of response to treatments. Current laboratory information systems focus on the patient database, tests and results, with multiple modules available, connecting with the various analytical systems or work areas. However laboratory information systems functioned as “islands of information”, because their design was fundamentally inward-looking and disconnected from other healthcare computer applications. Actually, the Electronic Health Register (EHR) is considered by clinicians as a tool with great potential healthcare benefits. The EHR, in the sense of a unique and complete record of a patient’s healthcare and state of health, regardless of the healthcare level used, is a real attempt to eliminate these “islands of information” and need modules to act as “bridges” with the laboratory information systems. This type of module, which in generic terms may be referred to as a laboratory test request module, has become an essential feature of the EHR. These modules need to use a laboratory coding system as a common language for exchanging information, ensuring that tests and results are unequivocally identified. The development of the laboratory test request module requires the commitment of professionals and political authorities, being necessary time for their design and an adequate pilot phase. The laboratory professionals have to assume a leadership role in the whole process of design, development and implementation of these modules, integrating in the equipment of information technologies of healthcare providers. In our manuscript we review the elements that may prove electronic systems for requesting clinical laboratory test into digital clinical records and the key elements to move from theory to practice.

Medi-Block Record Secure Data Sharing in Healthcare System:Issues,Solutions and Challenges

With the advancements in the era of artificial intelligence,blockchain,cloud computing,and big data,there is a need for secure,decentralized medical record storage and retrieval systems.While cloud storage solves storage issues,it is challenging to realize secure sharing of records over the network.Medi-block record in the healthcare system has brought a new digitalization method for patients’medical records.This centralized technology provides a symmetrical process between the hospital and doctors when patients urgently need to go to a different or nearby hospital.It enables electronic medical records to be available with the correct authentication and restricts access to medical data retrieval.Medi-block record is the consumer-centered healthcare data system that brings reliable and transparent datasets for the medical record.This study presents an extensive review of proposed solutions aiming to protect the privacy and integrity of medical data by securing data sharing for Medi-block records.It also aims to propose a comprehensive investigation of the recent advances in different methods of securing data sharing,such as using Blockchain technology,Access Control,Privacy-Preserving,Proxy Re-Encryption,and Service-On-Chain approach.Finally,we highlight the open issues and identify the challenges regarding secure data sharing for Medi-block records in the healthcare systems.

Algorithm for Extracting All Relative-Attribute Reducts in Decision System of Large-Scale Records

A new algorithm based on rough core was proposed to extract all relative-attribute reducts in decision information systems of large-scale records. In the algorithm, the rough core of the decision-making information system is first calculated. Then, an approach based on a top-down strategy is adopted to select the non-core condition attributes and generate candidate relative-attribute reducts. Finally, the set of all relative-attribute reducts is obtained by pruning the candidate relative-attribute reducts. Experimental results show that the proposed algorithm is superior to the other methods such as the algorithm without computing core, the exhaustive method and the discernibility matrix method in extracting all relative-attribute reducts for large-scale data sets.

THE SYSTEM OF REGISTERING AT THE CUSTOMS FOR THE RECORD BUILT UP IN FREE TRADE ZONES

With a view to accelerating the construction and development of the free trade zones and the foreign trade business of enterprises within the said zones, and making entering or leaving the zones convenient for those enterprises; the Customs shall in accordance with the newly promulgated regulations as stipulated in Supervising Measures of the Customs in Free Trade Zones require that consigness, consignors or their agents register for the record their car.

Systematic Recording of Chinese Storytelling Art

Chinese Storytelling; Gem of theWorld Oral HeritageAccording to historical records, storytelling,or "Shuoshu", had already become a professionsince the Song Dynasty (960-1279). In theprocess of the increasing urbanization ever since,the storyteller was regarded as an integral