Concerted adoption as an emerging strategy for digital transformation of healthcare-lessons from Australia, Canada, and England.

OBJECTIVES: With an increasing focus on the digitalization of health and care settings, there is significant scope to learn from international approaches to promote concerted adoption of electronic health records. MATERIALS AND METHODS: We review three large-scale initiatives from Australia, Canada, and England, and extract common lessons for future health and social care transformation strategy. RESULTS: We discuss how, despite differences in contexts, concerted adoption enables sharing of experience and learning to streamline the digital transformation of health and care. DISCUSSION AND CONCLUSION: Concerted adoption can be accelerated through building communities of expertise and partnerships promoting knowledge transfer and circulation of expertise; commonalities in geographical and cultural contexts; and commonalities in technological systems.

Publicly subsidised smoking cessation medicines in times of COVID-19 in Australia: An interrupted time series analysis.

INTRODUCTION: In Australia, the available published literature demonstrated a spike in dispensed prescription medicines after the onset of the COVID-19 pandemic that subsequently returned to expected levels. Smoking cessation medicines may not follow this pattern because quit attempts are influenced by a range of factors. Knowledge of whether dispensing of these medicines has changed since the pandemic is lacking. We explored the change in dispensing of publicly subsidised smoking cessation medicines since the pandemic. METHODS: Australia's universal health-care system provides access to government-subsidised medicines via the Pharmaceutical Benefits Scheme and records of dispensed medicines are publicly available on a nationally aggregated level. We retrieved Pharmaceutical Benefits Scheme data from January 2016 to January 2021. We used interrupted time series modelling to quantify the impact of COVID-19 on dispensing of nicotine replacement therapy (NRT) patches, varenicline and all smoking cessation treatments combined separately. RESULTS: After an initial spike in medicines at the onset of the pandemic, the monthly rate of prescriptions dispensed for varenicline was predominantly within predicted ranges, while that of NRT patches was predominantly below predicted ranges. DISCUSSION AND CONCLUSIONS: There has been a differential change in the number of subsidised smoking cessation medicines supplied in Australia since the COVID-19 pandemic, with varenicline prescriptions largely within, and NRT patches largely lower than, expected ranges. The reasons for the apparent change in dispensing of subsidised smoking cessation medicines are unclear.

Identifying anomalous nuclear radioactive sources using Poisson kriging and mobile sensor networks.

Nuclear security is a critical concept for public health, counter-terrorism efforts, and national security. Nuclear radioactive materials should be monitored and secured in near real-time to reduce potential danger of malicious usage. However, several challenges have arose to detect the anomalous radioactive source in a large geographical area. Radiation naturally occurs in the environment. Therefore, a non-zero level of radiation will always exist with or without an anomalous radioactive source present. Additionally, radiation data contain high levels of uncertainty, meaning that the measured radiation value is significantly affected by the velocity of the detector and background noise. In this article, we propose an innovative approach to detect anomalous radiation source using mobile sensor networks combined with a Poisson kriging technique. We validate our results using several experiments with simulated radioactive sources. As results, the accuracy of the model is extremely high when the source intensity is high or the anomalous source is close enough to the detector.

Spatial-temporal modeling of background radiation using mobile sensor networks.

Modeling of background radiation for the urban environment plays an important role in homeland security. However, background radiation is difficult to assess due to its spatial-temporal fluctuations caused by the variation in soil composition, building materials, and weather patterns etc. To address the challenge of background radiation modeling, we developed a mobile sensor network to continuously monitor the background radiation; we also proposed a maximum likelihood estimation algorithm to decouple and estimate the background's spatial distribution and temporal fluctuation. Experimental results demonstrated how this background radiation monitoring system accurately recognized high background regions in the experimental area, and successfully captured temporal fluctuation trends of background radiation during rains. Our system provides an efficient solution to model the temporal fluctuation and spatial distribution of background radiation.

Altered clot kinetics in patients with non-alcoholic fatty liver disease.

BACKGROUND: Emerging evidence has linked the presence of non-alcoholic fatty liver disease (NAFLD) with an increased risk for cardiovascular events. We hypothesised that altered clot kinetics and platelet function may contribute to this increased risk. This study compared whole blood clotting kinetics in patients with 1) non-cirrhotic NAFLD (n = 28) and 2) healthy control subjects (n = 22). METHODS: Clotting kinetics were assessed in whole blood using thromboelastography (TEG) and assessed for correlations with cardiovascular risk factors. RESULTS: Clot kinetics in patients with NAFLD showed significantly stronger clot development (maximum amplitude (MA); 58.3 +/- 6.3 mm vs. 52.0 +/- 10.1 mm, p = 0.01) and reduced clot lysis in the presence of thrombin (35 +/- 30% vs. 51 +/- 26% clot lysis 30 minutes after MA, p = 0.03) compared to control subjects. Clot strength was independently positively associated with body mass index in NAFLD, but not in control subjects. There was a greater platelet contribution to clot strength in patients with NAFLD compared to controls despite similar platelet counts. There was no association between clot kinetics and features of the metabolic syndrome or presence of type 2 diabetes. CONCLUSION: Patients with NAFLD have disturbances in ex-vivo clot kinetics including increased clot strength and clots that are more resistant to thrombin-stimulated lysis.