Data Integrity: Challenges in Health Information Systems in South Africa

Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

A Continuous Real-Time Analytic for Predicting Instability in Acute Care Rapid Response Team Activations

A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

Decentralised Edge Authentication in the Industrial Enterprise IoT Space

Authentication protocols based on public key infrastructure (PKI) and trusted third party (TTP) are no longer adequate for industrial scale IoT networks thanks to issues such as low compute and power availability, the use of widely distributed and commercial off-the-shelf (COTS) systems, and the increasingly sophisticated attackers and attacks we now have to counter. For example, there is increasing concern about nation-state-based interference and future quantum computing capability. We have examined this space from first principles and have developed several approaches to group and point-to-point authentication for IoT that do not depend on the use of a centralised client-server model. We emphasise the use of quantum resistant primitives such as strong cryptographic hashing and the use multi-factor authentication.

Thermal Analysis of Circular Pin-fin with Rectangular Slot at the Center by Forced Convection

Extended surfaces are commonly used in practice to enhance heat transfer. Most of the engineering problems require high performance heat transfer components with light weight, volumes, accommodating shapes, costs and reliability depending on industrial applications. This paper reports an experimental analysis to investigate heat transfer enhancement by forced convection using different sizes of pin-fin with rectangular slots at the center. The cross sectional area of the oblong duct was 200 mm x 80 mm. The info utilized in performance analysis was obtained experimentally for material, aluminum at 200 Watts heat input varying velocity 1 m/s to 5 m/s. Using the Taguchi experimental design method, optimum design parameters and their levels were analysed. Nusselt number and friction factor were considered as a performance characteristic parameter. An An L9 (33) orthogonal array was designated as an experimental proposal. Optimum results were found by experimenting. It is observed that pin-fins with different slots sizes have a better impact on Nusselt Number.

A Comprehensive Review of Adaptive Building Energy Management Systems Based on Users’ Feedback

Over the past few years, the idea of adaptive buildings and specifically, adaptive building energy management systems (ABEMS) has become popular. Well-performed management in terms of energy is to create a balance between energy consumption and user comfort; therefore, in new energy management models, efficient energy consumption is not the sole factor and the user's comfortability is also considered in the calculations. One of the main ways of measuring this factor is by analyzing user feedback on the conditions to understand whether they are satisfied with conditions or not. This paper provides a comprehensive review of recent approaches towards energy management systems based on users' feedbacks and subsequently performs a comparison between them premised upon their efficiency and accuracy to understand which approaches were more accurate and which ones resulted in a more efficient way of minimizing energy consumption while maintaining users' comfortability. It was concluded that the highest accuracy rate among the presented works was 95% accuracy in determining satisfaction and up to 51.08% energy savings can be achieved without disturbing user’s comfort. Considering the growing interest in designing and developing adaptive buildings, these studies can support diverse inquiries about this subject and can be used as a resource to support studies and researches towards efficient energy consumption while maintaining the comfortability of users.

The Effect on Lead Times When Normalizing a Supply Chain Process

Organizations are living in a very competitive and dynamic environment which is constantly changing. In order to achieve a high level of service, the products and processes of these organizations need to be flexible and evolvable. If the supply chains are not modular and well designed, changes can bring combinatorial effects to most areas of a company from its management, financial, documentation, logistics and its information structure. Applying the normalized system’s concept to segments of the supply chain may help in reducing those ripple effects, but it may also increase lead times. Lead times are important and can become a decisive element in gaining customers. Industries are always under the pressure in providing good quality products, at competitive prices, when and how the customer wants them. Most of the time, the customers want their orders now, if not yesterday. The above concept will be proven by examining lead times in a manufacturing example before and after applying normalized systems concept to that segment of the chain. We will then show that although we can minimize the combinatorial effects when changes occur, the lead times will be increased.

Process Optimization and Automation of Information Technology Services in a Heterogenic Digital Environment

With customers’ ever-increasing expectations for fast services provisioning for all their business needs, information technology (IT) organizations, as business partners, have to cope with this demanding environment and deliver their services in the most effective and efficient way. The purpose of this paper is to identify optimization and automation opportunities for the top requested IT services in a heterogenic digital environment and widely spread customer base. In collaboration with systems, processes, and subject matter experts (SMEs), the processes in scope were approached by analyzing four-year related historical data, identifying and surveying stakeholders, modeling the as-is processes, and studying systems integration/automation capabilities. This effort resulted in identifying several pain areas, including standardization, unnecessary customer and IT involvement, manual steps, systems integration, and performance measurement. These pain areas were addressed by standardizing the top five requested IT services, eliminating/automating 43 steps, and utilizing a single platform for end-to-end process execution. In conclusion, the optimization of IT service request processes in a heterogenic digital environment and widely spread customer base is challenging, yet achievable without compromising the service quality and customers’ added value. Further studies can focus on measuring the value of the eliminated/automated process steps to quantify the enhancement impact. Moreover, a similar approach can be utilized to optimize other IT service requests, with a focus on business criticality.

Fundamental Theory of the Evolution Force: Gene Engineering utilizing Synthetic Evolution Artificial Intelligence

The effects of the evolution force are observable in nature at all structural levels ranging from small molecular systems to conversely enormous biospheric systems. However, the evolution force and work associated with formation of biological structures has yet to be described mathematically or theoretically. In addressing the conundrum, we consider evolution from a unique perspective and in doing so we introduce the “Fundamental Theory of the Evolution Force: FTEF”. We utilized synthetic evolution artificial intelligence (SYN-AI) to identify genomic building blocks and to engineer 14-3-3 ζ docking proteins by transforming gene sequences into time-based DNA codes derived from protein hierarchical structural levels. The aforementioned served as templates for random DNA hybridizations and genetic assembly. The application of hierarchical DNA codes allowed us to fast forward evolution, while dampening the effect of point mutations. Natural selection was performed at each hierarchical structural level and mutations screened using Blosum 80 mutation frequency-based algorithms. Notably, SYN-AI engineered a set of three architecturally conserved docking proteins that retained motion and vibrational dynamics of native Bos taurus 14-3-3 ζ.

A Study of the Trade-off Energy Consumption-Performance-Schedulability for DVFS Multicore Systems

Dynamic Voltage and Frequency Scaling (DVFS) multicore platforms are promising execution platforms that enable high computational performance, less energy consumption and flexibility in scheduling the system processes. However, the resulting interleaving and memory interference together with per-core frequency tuning make real-time guarantees hard to be delivered. Besides, energy consumption represents a strong constraint for the deployment of such systems on energy-limited settings. Identifying the system configurations that would achieve a high performance and consume less energy while guaranteeing the system schedulability is a complex task in the design of modern embedded systems. This work studies the trade-off between energy consumption, cores utilization and memory bottleneck and their impact on the schedulability of DVFS multicore time-critical systems with a hierarchy of shared memories. We build a model-based framework using Parametrized Timed Automata of UPPAAL to analyze the mutual impact of performance, energy consumption and schedulability of DVFS multicore systems, and demonstrate the trade-off on an actual case study.

Einstein’s General Equation of the Gravitational Field

The generalization of relativistic theory of gravity based essentially on the principle of equivalence stipulates that for all bodies, the grave mass is equal to the inert mass which leads us to believe that gravitation is not a property of the bodies themselves, but of space, and the conclusion that the gravitational field must curved space-time what allows the abandonment of Minkowski space (because Minkowski space-time being nonetheless null curvature) to adopt Riemannian geometry as a mathematical framework in order to determine the curvature. Therefore the work presented in this paper begins with the evolution of the concept of gravity then tensor field which manifests by Riemannian geometry to formulate the general equation of the gravitational field.

Probabilistic Approach of Dealing with Uncertainties in Distributed Constraint Optimization Problems and Situation Awareness for Multi-agent Systems

In this paper, we describe how Bayesian inferential reasoning will contributes in obtaining a well-satisfied prediction for Distributed Constraint Optimization Problems (DCOPs) with uncertainties. We also demonstrate how DCOPs could be merged to multi-agent knowledge understand and prediction (i.e. Situation Awareness). The DCOPs functions were merged with Bayesian Belief Network (BBN) in the form of situation, awareness, and utility nodes. We describe how the uncertainties can be represented to the BBN and make an effective prediction using the expectation-maximization algorithm or conjugate gradient descent algorithm. The idea of variable prediction using Bayesian inference may reduce the number of variables in agents’ sampling domain and also allow missing variables estimations. Experiment results proved that the BBN perform compelling predictions with samples containing uncertainties than the perfect samples. That is, Bayesian inference can help in handling uncertainties and dynamism of DCOPs, which is the current issue in the DCOPs community. We show how Bayesian inference could be formalized with Distributed Situation Awareness (DSA) using uncertain and missing agents’ data. The whole framework was tested on multi-UAV mission for forest fire searching. Future work focuses on augmenting existing architecture to deal with dynamic DCOPs algorithms and multi-agent information merging.

Impact of Weather Conditions on Generalized Frequency Division Multiplexing over Gamma Gamma Channel

The technique called as Generalized frequency division multiplexing (GFDM) used in the free space optical channel can be a good option for implementation free space optical communication systems. This technique has several strengths e.g. good spectral efficiency, low peak-to-average power ratio (PAPR), adaptability and low co-channel interference. In this paper, the impact of weather conditions such as haze, rain and fog on GFDM over the gamma-gamma channel model is discussed. A Trade off between link distance and system performance under intense weather conditions is also analysed. The symbol error probability (SEP) of GFDM over the gamma-gamma turbulence channel is derived and verified with the computer simulations.

BIM Application Research Based on the Main Entrance and Garden Area Project of Shanghai Disneyland

Based on the main entrance and garden area (ME&G) project of Shanghai Disneyland, this paper introduces the application of BIM technology in this kind of low-rise comprehensive building with complex facade system, electromechanical system and decoration system. BIM technology is applied to the whole process of design, construction and completion of the whole project. With the construction of BIM application framework of the whole project, the key points of BIM modeling methods of different systems and the integration and coordination of BIM models are elaborated in detail. The specific application methods of BIM technology in similar complex low-rise building projects are sorted out. Finally, the paper summarizes the benefits of BIM technology application, and puts forward some suggestions for BIM management mode and practical application of similar projects in the future.

Needs Analysis Survey of Hearing Impaired Students’ Teachers in Elementary Schools for Designing Curriculum Plans and Improving Human Resources

This paper intends to study needs analysis of hearing-impaired students’ teachers in elementary schools all over Iran. The subjects of this study were 275 teachers who were teaching hearing-impaired students in elementary schools. The participants were selected by a quota sampling method. To collect the data, questionnaires of training needs consisting of 41 knowledge items and 31 performance items were used. The collected data were analyzed by using SPSS software in the form of descriptive analyses (frequency and mean) and inferential analyses (one sample t-test, paired t-test, independent t-test, and Pearson correlation coefficient). The findings of the study indicated that teachers generally have considerable needs in knowledge and performance domains. In 32 items out of the total 41 knowledge domain items and in the 27 items out of the total 31 performance domain items, the teachers had considerable needs. From the quantitative point of view, the needs of the performance domain were more than those of the knowledge domain, so they have to be considered as the first priority in training these teachers. There was no difference between the level of the needs of male and female teachers. There was a significant difference between the knowledge and performance domain needs and the teachers’ teaching experience, 0.354 and 0.322 respectively. The teachers who had been trained in working with hearing-impaired students expressed more training needs (both knowledge and performance).

Limited Component Evaluation of the Effect of Regular Cavities on the Sheet Metal Element of the Steel Plate Shear Wall

Steel Metal Shear Wall is one of the most common and widely used energy dissipation systems in structures, which is used today as a damping system due to the increase in the construction of metal structures. In the present study, the shear wall of the steel plate with dimensions of 5×3 m and thickness of 0.024 m was modeled with 2 floors of total height from the base level with finite element method in Abaqus software. The loading is done as a concentrated load at the upper point of the shear wall on the second floor based on step type buckle. The mesh in the model is applied in two directions of length and width of the shear wall, equal to 0.02 and 0.033, respectively, and the mesh in the models is of sweep type. Finally, it was found that the steel plate shear wall with cavity (CSPSW) compared to the SPSW model, S (Mises), Smax (In-Plane Principal), Smax (In-Plane Principal-ABS), Smax (Min Principal) increased by 53%, 70%, 68% and 43%, respectively. The presence of cavities has led to an increase in the estimated stresses, but their presence has caused critical stresses and critical deformations created to be removed from the inner surface of the shear wall and transferred to the desired sections (regular cavities) which can be suggested as a solution in seismic design and improvement of the structure to transfer possible damage during the earthquake and storm to the desired and pre-designed location in the structure.

Micromechanics of Stress Transfer across the Interface Fiber-Matrix Bonding

The study and application of composite materials are a truly interdisciplinary endeavor that has been enriched by contributions from chemistry, physics, materials science, mechanics and manufacturing engineering. The understanding of the interface (or interphase) in composites is the central point of this interdisciplinary effort. From the early development of composite materials of various nature, the optimization of the interface has been of major importance. Even more important, the ideas linking the properties of composites to the interface structure are still emerging. In our study, we need a direct characterization of the interface; the micromechanical tests we are addressing seem to meet this objective and we chose to use two complementary tests simultaneously. The microindentation test that can be applied to real composites and the drop test, preferred to the pull-out because of the theoretical possibility of studying systems with high adhesion (which is a priori the case with our systems). These two tests are complementary because of the principle of the model specimen used for both the first "compression indentation" and the second whose fiber is subjected to tensile stress called the drop test. Comparing the results obtained by the two methods can therefore be rewarding.

SNR Classification Using Multiple CNNs

Noise estimation is essential in today wireless systems for power control, adaptive modulation, interference suppression and quality of service. Deep learning (DL) has already been applied in the physical layer for modulation and signal classifications. Unacceptably low accuracy of less than 50% is found to undermine traditional application of DL classification for SNR prediction. In this paper, we use divide-and-conquer algorithm and classifier fusion method to simplify SNR classification and therefore enhances DL learning and prediction. Specifically, multiple CNNs are used for classification rather than a single CNN. Each CNN performs a binary classification of a single SNR with two labels: less than, greater than or equal. Together, multiple CNNs are combined to effectively classify over a range of SNR values from −20 ≤ SNR ≤ 32 dB.We use pre-trained CNNs to predict SNR over a wide range of joint channel parameters including multiple Doppler shifts (0, 60, 120 Hz), power-delay profiles, and signal-modulation types (QPSK,16QAM,64-QAM). The approach achieves individual SNR prediction accuracy of 92%, composite accuracy of 70% and prediction convergence one order of magnitude faster than that of traditional estimation.

Improved Thermal Comfort and Sensation with Occupant Control of Ceiling Personalized Ventilation System: A Lab Study

This study aims at determining the extent to which occupant control of microenvironment influences, improves thermal sensation and comfort, and saves energy in spaces equipped with ceiling personalized ventilation (CPV) system assisted by chair fans (CF) and desk fans (DF) in 2 experiments in a climatic chamber equipped with two-station CPV systems, one that allows control of fan flow rate and the other is set to the fan speed of the selected participant in control. Each experiment included two participants each entering the cooled space from transitional environment at a conventional mixed ventilation (MV) at 24 °C. For CPV diffuser, fresh air was delivered at a rate of 20 Cubic feet per minute (CFM) and a temperature of 16 °C while the recirculated air was delivered at the same temperature but at a flow rate 150 CFM. The macroclimate air of the space was at 26 °C. The full speed flow rates for both the CFs and DFs were at 5 CFM and 20 CFM, respectively. Occupant 1 was allowed to operate the CFs or the DFs at (1/3 of the full speed, 2/3 of the full speed, and the full speed) while occupant 2 had no control on the fan speed and their fan speed was selected by occupant 1. Furthermore, a parametric study was conducted to study the effect of increasing the fresh air flow rate on the occupants’ thermal comfort and whole body sensations. The results showed that most occupants in the CPV+CFs, who did not control the CF flow rate, felt comfortable 6 minutes. The participants, who controlled the CF speeds, felt comfortable in around 24 minutes because they were preoccupied with the CFs. For the DF speed control experiments, most participants who did not control the DFs felt comfortable within the first 8 minutes. Similarly to the CPV+CFs, the participants who controlled the DF flow rates felt comfortable at around 26 minutes. When the CPV system was either supported by CFs or DFs, 93% of participants in both cases reached thermal comfort. Participants in the parametric study felt more comfortable when the fresh air flow rate was low, and felt cold when as the flow rate increased.

Fast Approximate Bayesian Contextual Cold Start Learning (FAB-COST)

Cold-start is a notoriously difficult problem which can occur in recommendation systems, and arises when there is insufficient information to draw inferences for users or items. To address this challenge, a contextual bandit algorithm – the Fast Approximate Bayesian Contextual Cold Start Learning algorithm (FAB-COST) – is proposed, which is designed to provide improved accuracy compared to the traditionally used Laplace approximation in the logistic contextual bandit, while controlling both algorithmic complexity and computational cost. To this end, FAB-COST uses a combination of two moment projection variational methods: Expectation Propagation (EP), which performs well at the cold start, but becomes slow as the amount of data increases; and Assumed Density Filtering (ADF), which has slower growth of computational cost with data size but requires more data to obtain an acceptable level of accuracy. By switching from EP to ADF when the dataset becomes large, it is able to exploit their complementary strengths. The empirical justification for FAB-COST is presented, and systematically compared to other approaches on simulated data. In a benchmark against the Laplace approximation on real data consisting of over 670, 000 impressions from autotrader.co.uk, FAB-COST demonstrates at one point increase of over 16% in user clicks. On the basis of these results, it is argued that FAB-COST is likely to be an attractive approach to cold-start recommendation systems in a variety of contexts.

Design and Simulation of Heartbeat Measurement System Using Arduino Microcontroller in Proteus

If a person can monitor his/her heart rate regularly then he/she can detect heart disease early and thus he/she can enjoy longer life span. Therefore, this disease should be taken seriously. Hence, many health care devices and monitoring systems are being designed to keep track of the heart disease. This work reports a design and simulation processes of an Arduino microcontroller based heart rate measurement and monitoring system in Proteus environment. Clipping sensors were utilized to sense the heart rate of an individual from the finger tips. It is a digital device and uses mainly infrared (IR) transmitter (mainly IR LED) and receiver (mainly IR photo-transistor or IR photo-detector). When the heart pumps the blood and circulates it among the blood vessels of the body, the changed blood pressure is detected by the transmitter and then reflected back to the receiver accordingly. The reflected signals are then processed inside the microcontroller through a software written assembly language and appropriate heart rate (HR) is determined by it in beats per minute (bpm) from the detected signal for a duration of 10 seconds and display the same in bpm on the LCD screen in digital format. The designed system was simulated on several persons with varying ages, for example, infants, adult persons and active athletes. Simulation results were found very satisfactory.