Physicians differ in their perceptions of sensitive medical records: Survey and interview study.

Physician categorizations of electronic health record (EHR) data (e.g., depression) into sensitive data categories (e.g., Mental Health) and their perspectives on the adequacy of the categories to classify medical record data were assessed. One thousand data items from patient EHR were classified by 20 physicians (10 psychiatrists paired with ten non-psychiatrist physicians) into data categories via a survey. Cluster-adjusted chi square tests and mixed models were used for analysis. 10 items were selected per each physician pair (100 items in total) for discussion during 20 follow-up interviews. Interviews were thematically analyzed. Survey item categorization yielded 500 (50.0%) agreements, 175 (17.5%) disagreements, 325 (32.5%) partial agreements. Categorization disagreements were associated with physician specialty and implied patient history. Non-psychiatrists selected significantly (p = .016) more data categories than psychiatrists when classifying data items. The endorsement of Mental Health and Substance Use categories were significantly (p = .001) related for both provider types. During thematic analysis, Encounter Diagnosis (100%), Problems (95%), Health Concerns (90%), and Medications (85%) were discussed the most when deciding the sensitivity of medical information. Most (90.0%) interview participants suggested adding additional data categories. Study findings may guide the evolution of digital patient-controlled granular data sharing technology and processes.

Vinylogous Reactivity of Cyclic 2-Enones: Organocatalysed Asymmetric Addition to 2-Enals to Synthesize Fused Carbocycles.

A method for asymmetric and site selective annulations at the γ and γ' positions of cyclic 2-enones with α,ß-unsaturated aldehydes has been developed. The organocatalysed [3+3]-annulations proceed with high levels of regio-, diastereo-, and enantioselectivity, affording a series of high value fused carbocycles. Further elaboration gave key lactones (both bridged and fused).

Effort variation regularization in sound field reproduction.

In this paper, active control is used in order to reproduce a given sound field in an extended spatial region. A method is proposed which minimizes the reproduction error at a number of control positions with the reproduction sources holding a certain relation within their complex strengths. Specifically, it is suggested that the phase differential of the source driving signals should be in agreement with the phase differential of the desired sound pressure field. The performance of the suggested method is compared with that of conventional effort regularization, wave field synthesis (WFS), and adaptive wave field synthesis (AWFS), both under free-field conditions and in reverberant rooms. It is shown that effort variation regularization overcomes the problems associated with small spaces and with a low ratio of direct to reverberant energy, improving thus the reproduction accuracy in the listening room.

Regularization in global sound equalization based on effort variation.

Sound equalization in closed spaces can be significantly improved by generating propagating waves that are naturally associated with the geometry, as, for example, plane waves in rectangular enclosures. This paper presents a control approach termed effort variation regularization based on this idea. Effort variation equalization involves modifying the conventional cost function in sound equalization, which is based on minimizing least-squares reproduction errors, by adding a term that is proportional to the squared deviations between complex source strengths, calculated independently for the sources at each of the two walls perpendicular to the direction of propagation. Simulation results in a two-dimensional room of irregular shape and in a rectangular room with sources randomly distributed on two opposite walls demonstrate that the proposed technique leads to smaller global reproduction errors and better equalization performance at listening positions outside of the control region compared to effort regularization and compared to a simple technique that involves driving groups of sources identically.

Power-output regularization in global sound equalization.

The purpose of equalization in room acoustics is to compensate for the undesired modification that an enclosure introduces to signals such as audio or speech. In this work, equalization in a large part of the volume of a room is addressed. The multiple point method is employed with an acoustic power-output penalty term instead of the traditional quadratic source effort penalty term. Simulation results demonstrate that this technique gives a smoother decline of the reproduction performance away from the control points.