Using a health information exchange network to enhance disease surveillance

first_imgReviewed by James Ives, M.Psych. (Editor)Feb 12 2019How do public health officials know if there is a disease outbreak and where that outbreak has occurred?Surveillance is the cornerstone of public health practice, yet while disease surveillance has shifted toward greater use of electronically transmitted information to decrease the reporting burden on physicians, the challenge of getting the right information to public health officials at the right time has not been completely solved.Brian E. Dixon, Ph.D., of the Regenstrief Institute and Indiana University Richard M. Fairbanks School of Public Health at IUPUI, outlines how using a health exchange network can facilitate electronic disease reporting during the 2019 Healthcare Information and Management Systems Society’s Global Conference and Exhibition in Orlando, February 11-15. HIMSS19 is one of the largest health IT gatherings in the world, with more than 45,000 attendees.Dr. Dixon will present “Enhanced Public Health Reporting Using an HIE,” discussing how electronic health information exchange can be used to improve compliance with public health reporting laws, increase completeness of reports to public health, and make the surveillance work process more efficient while reducing the burden on clinics.”Traditionally, public health agencies wait for laboratories to initiate notifiable disease case reports,” he notes. “However, this passive approach typically yields incomplete and delayed reports, which can hinder assessment of disease in the community and potentially delay recognition of patterns and outbreaks.”In his HIMSS presentation, he will discuss a novel decision support tool — pre-populated electronic reporting forms — that he and Regenstrief colleagues designed, tested and implemented to facilitate awareness and compliance among primary care providers regarding notifiable disease reporting to county public health agencies.Related StoriesSafe sex an elusive target; STIs continue to rise in EnglandResearch sheds light on sun-induced DNA damage and repairOlympus Europe and Cytosurge join hands to accelerate drug development, single cell research”In 2019, many clinics still use fax machines to communicate patient data to public health offices, said Dr. Dixon. “Our objective is to automate the process by which primary care clinics report case information to public health following a laboratory-confirmed diagnosis of one of the many diseases that clinicians are required to report.”In addition to notifiable disease confirmatory test results, the pre-populated fields on the electronic forms include patient demographics and provider information. Seven representative, high priority diseases were included in the Regenstrief test project: chlamydia, gonorrhea, syphilis, salmonella, hepatitis B, hepatitis C and histoplasmosis.In his HIMSS presentation, Dr. Dixon will explore how pre-populated, electronic case reporting may improve disease reporting and barriers that must be overcome to make that possible.Regenstrief Institute is a dynamic people-centered research organization driven by a mission to connect and innovate for better health. We envision a world where better information empowers people to end disease and realize true health, and we pursue this vision through research and development guided by our core values.Committed to advancing the public’s health and well-being through education, innovation and leadership, the IU Richard M. Fairbanks School of Public Health at IUPUI is known for its expertise in biostatistics, epidemiology, cancer research, community health, environmental public health, health policy and health administration. Source:https://www.regenstrief.org/article/do-we-have-an-epidemic/last_img read more

Studies verify novel method of HIV transmission among injection drug users and

first_imgReviewed by James Ives, M.Psych. (Editor)Apr 26 2019New studies from Lawson Health Research Institute and Western University have found for the first time that HIV can be transmitted through the sharing of equipment used to prepare drugs before injection and that a simple intervention – heating the equipment with a cigarette lighter for 10 seconds – can destroy the HIV virus, preventing that transmission. The findings, used to inform a public health campaign called ‘Cook Your Wash,’ have helped reduce rates of HIV transmission in London, Ontario.The two studies published in Journal of Acquired Immune Deficiency Syndrome (JAIDS) were initiated in 2016 to address a public health emergency in London, Ontario when HIV rates amongst injection drug users more than doubled.”This outbreak occurred despite London having Canada’s largest per capita sterile needle and syringe distribution program, a strong opiate substitution therapy program and a multidisciplinary HIV clinic,” says Dr. Michael Silverman, Lawson Associate Scientist and Chair/Chief of Infectious Diseases at the Schulich School of Medicine & Dentistry, Western University, London Health Sciences Centre and St. Joseph’s Health Care London. “We knew there must be a novel method of HIV transmission at play.”From August 2016 to June 2017, the research team interviewed 119 injection drug users to understand their injection behaviours and risk for HIV. They discovered that those who shared equipment used to prepare drugs for injection were 22 times more likely to contract HIV than those who did not, despite not sharing needles or syringes.The equipment includes a metal ‘cooker’ used to dissolve drugs in water and a filter used to draw the mixture, known as ‘the wash,’ into the syringe. Injection drug users reported reusing the equipment when consuming controlled-release hydromorphone, one of the most commonly injected opioids.”Controlled-release hydromorphone is expensive and difficult to dissolve. After the first wash, large amounts of the drug remain in the equipment which is then saved, shared or sold for future use,” explains Dr. Sharon Koivu, Associate Scientist at Lawson and Associate Professor at Schulich Medicine & Dentistry. “While people know not to share needles, some use their own needle multiple times allowing for contamination of the equipment.”The team took their findings back to the research laboratory. They confirmed that, on average, 45 per cent of the drug remains in the equipment after the first wash. They not only confirmed the HIV virus can be transmitted between needles, cookers and filters, but also discovered that controlled-release hydromorphone has properties that promote survival of the virus.Related StoriesHIV persists in spinal fluid even after long-term treatment and is linked to cognitive deficitsStudy: HIV patients continue treatments if health care providers are compassionateAlcohol reduction associated with improved viral suppression in women living with HIV”The slow release properties in the drug can unfortunately stabilize the HIV virus,” says Eric Arts, PhD, Chair of the Department of Microbiology and Immunology at Schulich Medicine & Dentistry. “For the first time, we were able to demonstrate that sharing equipment could lead to the type of HIV outbreak we observed in the community.”The team discovered that when the cooker is heated with a cigarette lighter for approximately 10 seconds, or until the wash bubbles, the virus is destroyed. They termed the technique ‘cook your wash.’They also confirmed that heating the cooker did not impact drug concentration. “We had to make sure that cooking your wash would not change the amount of drug being drawn into the syringe,” notes Dr. Silverman. “If too much drug was released, it could lead to overdoses. If any drug was burnt off or lost, the intervention would not be accepted by persons who inject drugs.”Partnering with local community organizations like the Middlesex-London Health Unit and Regional HIV/AIDS Connection, ‘Cook Your Wash’ was launched as a public health campaign.”The ‘Cook Your Wash’ campaign is one of the most exciting things to happen in our community,” says Dr. Koivu. “We learned from persons who inject drugs, took that information to the lab to develop a solution and then brought that solution back to the community in record time.”Dr. Silverman adds that local rates of new HIV cases fell dramatically after the introduction of the campaign. “It wasn’t the sole reason for the reduction in HIV rates as other interventions were also introduced, but the timing suggests it was part of the solution.”The studies build on previous research that shows sharing equipment can lead to the transmission of hepatitis C and controlled-release hydromorphone can promote the survival of bacteria that can cause endocarditis, which is an infection of the heart valves.The team hopes this research can be used to inform understanding and interventions in other centers facing HIV epidemics amongst persons who inject drugs. “We hope our findings can be used to reduce the incidence of HIV transmissions even further and that, one day, society will be HIV free,” says Dr. Silverman.Source: https://www.lawsonresearch.ca/researchers-verify-new-method-hiv-transmissionlast_img read more

New study pinpoints better strategies to stem arsenic poisoning in Bangladesh

first_imgReviewed by Alina Shrourou, B.Sc. (Editor)May 8 2019In what has been called “the largest mass poisoning of a population in history,” some 40 million people in Bangladesh are drinking water that contains unsafe levels of arsenic. The naturally occurring element seeps into groundwater reached by shallow wells, and from there it has a huge impact on the health and lives of Bangladeshis; chronic exposure to arsenic is estimated to be responsible for six percent of deaths in the country. It causes cardiovascular disease, cancer, infant mortality, and motor and intellectual problems in children.Bangladesh’s government is taking measures to address the problem, and plans to invest $200 million toward cleaning up water supplies. A new study, published last week in Environmental Science and Technology, could help to inform how that money would be best spent. The analysis compares four methods of dealing with the arsenic contamination, and pinpoints strategies to deliver cleaner water to the greatest number of people at the lowest cost.The study was inspired by a regional pipe water system recently built by the Bangladeshi government, said Lex van Geen, a research professor at Columbia University’s Lamont-Doherty Earth Observatory and a coauthor on the new study. “We saw that the pipe system cost several hundred thousand dollars, and that it was only helping a tiny part of the population.”By comparing the costs and impacts of the different mitigation strategies, the study concludes that the government’s strategies of constructing pipe systems and drilling deeper wells are the most expensive yet least effective options. Instead, the researchers recommend several strategies that could help more people at a much lower cost.Four StrategiesThe study, led by Nadia Jamil at Montclair State University, pulls from van Geen’s decades-long research in Bangladesh. Van Geen’s work has shown that simply testing well water and providing information about the risks of arsenic poisoning can get 60 percent of people, on average, to switch to lower-arsenic water sources. His team’s most recent survey of 48,790 wells in Araihazar province is estimated to have helped 132,000 inhabitants find a cleaner source of water, at a cost of just $1 per person.Because arsenic contamination is more common in shallow wells, another strategy is to drill medium-depth wells. These private wells are a bit more expensive, costing $28 per person whose exposure is reduced.Related StoriesEngineered stem cells offer new treatment for metastatic bone cancerResearchers identify gene mutations linked to leukemia in children with Down’s syndromeTrends in colonoscopy rates not aligned with increase in early onset colorectal cancer”The real shocker was that both of the government approaches were closer to $150 per person,” says van Geen. These included drilling deep tubewells and constructing piped water supply systems. The researchers calculated that these strategies cost $143 and $158 per person, respectively. In addition, the government requires households to pay 10 percent of the cost of each well; as a result, the wells are often installed on private land instead of being a public resource, so they end up helping fewer people.Wider ImplicationsAlthough the study focused on one district, called Araihazar Upazila, the authors think the results have significant implications for arsenic mitigation all over Bangladesh.”It strengthens the importance of widespread testing programs, which would work as a basis for other mitigation options,” said Jamil. “Testing is the cheapest of all mitigation methods.” She added that the study also underlines the potential of intermediate wells, which are quite low in cost, but have been “overlooked for a long period of time for unknown reasons.” The team hopes to share its village-level data on contaminated wells in order to inform where best to place these intermediate wells.Due to the high cost of piped water systems, the study recommends that this approach should be used only as a last resort in areas where not even deep wells can provide low arsenic water.However, van Geen says his conversations with government officials have indicated that they will likely continue investing in deep tubewells and piped water systems, despite the fact that cheaper and more impactful strategies exist.There may be ways to increase the effectiveness of deep wells. The authors mention that by siting the wells in a more strategic way and ensuring they are truly public, just 916 wells could bring 132,000 inhabitants with an unsafe well to within 100-meters of a safe source of water. The researchers are currently exploring strategies to help make these deep well deployments more tactical.”The government is spending the money on deep wells anyway,” he says, “so why not do it better?” Source:https://blogs.ei.columbia.edu/2019/05/05/solutions-arsenic-poisoning-bangladesh/last_img read more

Emerging 5G networks – new opportunities for drone detection

Citation: Emerging 5G networks – new opportunities for drone detection? (2018, January 23) retrieved 18 July 2019 from https://phys.org/news/2018-01-emerging-5g-networks-opportunities-drone.html Researchers from Aalto University and Tampere University of Technology in Finland have addressed new possibilities for efficient detection of drones by relying on future 5G communication systems. There, mmWave base stations may act as multistatic radar system receivers, thus acquiring the reflected signal from nearby flying drones. Credit: Aalto University The contributors have therefore developed novel techniques for effective drone detection in urban environments where 5G networks are expected to be deployed soon. Given that 5G deployments are expected to operate at mmWave frequencies, the feasibility of drone detection improves due to shorter wavelengths, which are comparable with the size of a drone, as well as due to larger available bandwidth of the mmWave system. Governments can accordingly benefit by preventing amateur drones from unauthorized flight over restricted areas, which ultimately increases public safety in cities.”We are hopeful that our work will help protect people’s privacy and safety in urban crowded areas, where drones can pose a serious threat to the masses of people,” the authors claim. Provided by Aalto University This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. More information: Dmitrii Solomitckii et al. Technologies for Efficient Amateur Drone Detection in 5G Millimeter-Wave Cellular Infrastructure, IEEE Communications Magazine (2018). DOI: 10.1109/MCOM.2017.1700450 Credit: Aalto University Study finds drones more damaging than bird strikes to planes Today, unmanned aerial vehicles (UAVs), or simply drones, are becoming more and more popular as they are utilized in various applications. Modern technologies and materials allow for constructing cheaper, smaller, and more functional drones, which can revolutionize many industrial sectors.The flip side of the above is a potential threat posed by drones to humans and urban infrastructure. Recent regulations are unable to fully protect against illegal actions that involve UAVs. For instance, a drone can collect information from non-flight zones or invade people’s privacy. These examples are, however, dwarfed by more offensive violations that some drones can conduct. Far more dangerous situations with devastating consequences may emerge if e.g., a malfunctioning drone is carrying hazardous payload. “To prevent dangerous situations, it is crucial to detect a violating drone as early as possible. For that purpose, integration of multistatic radar techniques with extremely high frequency 5G infrastructure has been proposed, which partly employs radio resources for early drone detection,” the researchers say. Explore further read more

Navigating the winding road toward driverless mobility

first_imgCredit: Intel Citation: Navigating the winding road toward driverless mobility (2019, July 10) retrieved 17 July 2019 from https://phys.org/news/2019-07-road-driverless-mobility.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. Explore further Regulation: Regulation is an area that receives too little attention. Companies deep in the making of SDSs know that it is the stickiest issue. Beside the fact that laws for granting a license to drive are geared toward human drivers, there is the serious issue of how to balance safety and usefulness in a manner that is acceptable to society.It will be easier to develop laws and regulations governing a fleet of robotaxis than for privately-owned vehicles. A fleet operator will receive a limited license per use case and per geographic region and will be subject to extensive reporting and back-office remote operation. In contrast, licensing such cars to private citizens will require a complete overhaul of the complex laws and regulations that currently govern vehicles and drivers.The auto industry is gradually realizing that autonomy must wait until regulation and technology reach equilibrium, and the best place to get this done is through the robotaxi phase.Scale: The third factor, geographic scale, is mostly a challenge of creating high-definition maps with great detail and accuracy, and of keeping those maps continuously updated. Geographic scale is crucial for series-production driverless cars because they must necessarily operate “everywhere” to fulfill the promise of the self-driving revolution. Robotaxis can be confined to geo-fenced areas, which makes it possible to postpone the issue of scale until the maturity of the robotaxi industry.When the factors of cost, regulation and scale are taken together, it is understandable why series-production passenger cars will not become possible until after the robotaxi phase.As is increasingly apparent, the auto industry is gravitating towards greater emphasis on their Level 2 offerings. Enhanced ADAS—with drivers still in charge of the vehicle at all times—helps achieve many of the expected safety benefits of AVs without bumping into the regulatory, cost and scale challenges.At the same time, automakers are solving for the regulatory, cost and scale challenges by embracing the emerging robotaxi MaaS industry. Once MaaS via robotaxi achieves traction and maturity, automakers will be ready for the next (and most transformative) phase of passenger car autonomy.The Strategy for AutonomyWith all of this in mind, Intel and Mobileye are focused on the most efficient path to reach passenger car autonomy. It requires long-term planning, and for those who can sustain the large investments ahead, the rewards will be great. Our path forward relies on four focus areas:Continue at the forefront of ADAS development. Beyond the fact that ADAS is the core of life-saving technology, it allows us to validate the technological building blocks of autonomous vehicles via tens of new production programs a year with automakers that submit our technology to the most stringent safety testing. Our ADAS programs—more than 34 million vehicles on roads today—provide the financial “fuel” to sustain autonomous development activity for the long run.Design an SDS with a backbone of a camera-centric configuration. Building a robust system that can drive solely based on cameras allows us to pinpoint the critical safety segments for which we truly need redundancy from radars and lidars. This effort to avoid unnecessary over-engineering or “sensor overload” is key to keeping the cost low.Build on our Road Experience Management (REM) crowdsourced automatic high-definition map-making to address the scale issue. Through existing contracts with automakers, we at Mobileye expect to have more than 25 million cars sending road data by 2022.Tackle the regulatory issue through our Responsibility-Sensitive Safety(RSS) formal model of safe driving, which balances the usefulness and agility of the robotic driver with a safety model that complies with societal norms of careful driving.At Intel and Mobileye, we are all-in on the global robotaxi opportunity. We are developing technology for the entire robotaxi experience—from hailing the ride on your phone, through powering the vehicle and monitoring the fleet. Our hands-on approach with as much of the process as possible enables us to maximize learnings from the robotaxi phase and be ready with the right solutions for automakers when the time is right for series-production passenger cars.On the way, we will help our partners deliver on the life-saving safety revolution of ADAS. We are convinced this will be a powerful and historic example of the greatest value being realized on the journey. Tesla eyes ‘robotaxis’ by 2020 with new self-driving technology (Update) The answers are likely a bit of each, which makes it a timely opportunity to review the big picture and share our view of where Intel and Mobileye stand in this landscape.Three Aspects to Auto-Tech-AIThere are three aspects to automotive-technology-artificial intelligence (auto-tech-AI) that are unfolding:Advanced driver-assistance systems (ADAS)Robotaxi ride hailing as the future of mobility-as-a-service (MaaS)Series-production passenger car autonomyWith ADAS technologies, the driver remains in control while the system intervenes when necessary to prevent accidents. This is especially important as distracted driving grows unabated. Known as Levels 0-2 as defined by the Society of Automotive Engineers (SAE), ADAS promises to reduce the probability of an accident to infinitesimal levels. This critical phase of auto-tech-AI is well underway, with today’s penetration around 22%, a number expected to climb sharply to 75% by 2025.Meanwhile, the autonomous driving aspect of auto-tech-AI is coming in two phases: robotaxi MaaS and series-production passenger car autonomy. What has changed in the mindset of many companies, including much of the auto industry, is the realization that those two phases cannot proceed in parallel.Series-production passenger car autonomy (SAE Levels 4-5) must wait until the robotaxi industry deploys and matures. This is due to three factors: cost, regulation and geographic scale. Getting all factors optimized simultaneously has proven too difficult to achieve in a single leap, and it is why many in the industry are contemplating the best path to achieve volume production. Many industry leaders are realizing it is possible to stagger the challenges if the deployment of fully autonomous vehicles (AVs) aims first at the robotaxi opportunity.Cost: The cost of a self-driving system (SDS) with its cameras, radars, lidars and high-performance computing is in the tens of thousands of dollars and will remain so for the foreseeable future. This cost level is acceptable for a driverless ride-hailing service, but is simply too expensive for series-production passenger cars. The cost of SDS should be no more than a few thousand dollars—an order of magnitude lower than today’s costs—before such capability can find its way to series-production passenger cars. Provided by Intel As we all watch automakers and autonomous tech companies team up in various alliances, it’s natural to wonder about their significance and what the future will bring. Are we realizing that autonomous driving technology and its acceptance by society could take longer than expected? Is the cost of investing in such technology proving more than any single organization can sustain? Are these alliances driven by a need for regulation that will be accepted by governments and the public or for developing standards on which manufacturers can agree?last_img read more

Centre asks Andhra Pradesh to continue with existing power purchase agreements

first_img COMMENT The Ministry of New and Renewable Energy has written to the Andhra Pradesh government seeking continuity of existing power purchase agreements (PPAs).“Revisiting PPAs shakes the confidence of investors in the sector and adversely affects the future bids and investment in the State and the country. I shall be grateful if you could kindly apprise the Chief Minister of the above facts,” Anand Kumar, Secretary, Ministry of New and Renewable Energy said in a letter to LV Subramanyam, Chief Secretary at the Government of Andhra Pradesh. Kumar said he was writing this letter after reports stating that the AP government is objecting to the price at which solar and wind energy is being procured by the State. CERC norms“Various renewable energy project developers sign PPAs with the State Government either under Section 62 or Section 63 of the Electricity Act. In the first case, the tariff is fixed by the State Electricity Regulatory Commission in line with the Central Electricity Regulatory Commission guidelines and in the second case the tariff is arrived at through transparent open competitive bidding. In both cases, SERCs conduct public hearings before adopting the tariffs and signing the PPAs,” he said.Shortly after taking charge, the YS Jagan Mohan Reddy-led AP government has been reviewing infrastructure projects awarded during former Chief Minister N Chandrababu Naidu’s regime.“Recent projects in both wind and solar power have been awarded through transparent and competitive bids. It seems Jagan wants to take on projects that were offered on a nomination basis,” a representative at a renewable energy power generation association told BusinesssLine. “If corrupt practices are established, there are provisions within the law to scrap projects at any stage. But cancelling projects without any reason is not the way to go about things,” an MNRE official said.AP’s growthKumar spoke about the Centre’s target to achieve a total installed capacity of 175 giga watts from the renewable energy sector by 2022 and felt the move to revisit PPAs would dent confidence. Over the past five years, Andhra Pradesh has seen its renewable energy capacity going up to close to 7.5 GW, with wind power accounting for about 4.2 GW and the rest coming from solar PV installations.With inputs from Our Hyderabad Bureau June 09, 2019 SHARE SHARE EMAIL SHARE Published oncenter_img energy and resource Andhra Pradesh ‘Revisiting PPAs shakes investor confidence and affects future bids and investments’ COMMENTSlast_img read more