Electronic Patient Record Security Policy in Saudi Arabia National Health Service

Saudi Arabia is in the process of implementing Electronic Patient Records (EPR) throughout its National Health services. One of the key challenges during the adoption process is the security of EPR. This thesis investigates the current state of EPR security in Saudi Arabia’s National Health Services (SA NHS) both from a policy perspective and with regard to its implementation in SA NHS’s information systems. To facilitate the analysis of EPR security, an EPR model has been developed that captures the information that is stored as part of the electronic record system in conjunction with stated security requirements. This model is used in the analysis of policy consistency and to validate operational reality against stated policies at various levels within the SA NHS. The model is based on a comprehensive literature survey and structured interviews which established the current state of practice with respect to EPRs in a representative Saudi Arabian hospital. The key contribution of this research is the development and evaluation of a structured and model-based analysis approach to EPR security at the early adoption stage in SA, based on types of information present in EPRs and the needs of the users of EPRs. The key findings show that the SA EPR adoption process is currently proceeding without serious consideration for security policy to protect EPR and a lack of awareness amongst hospital staff.Saudi Cultural Burea

Adaptive step-size sign least mean squares

In this paper, we propose a novel structure for adaptive sign least mean squares (ASLMS). A powerful adaptation scheme is used to adapt the step-size of the sign function inside the recursion of the sign algorithm. It is shown how the algorithm can be implemented with no real multiplication. Simulation results show that the performance of the proposed algorithm can be made arbitrarily close to that of the original least means squares algorithm

Power-of-Two Quantization in Decision Feedback Equalization

In this work, we propose and efficient structure for decision feedback equalization (DFE). The proposed structure makes use of the power-of-two quantization concept to completely eliminate the real multiplications in the DFE's update equations. The resulting structure is shown to substantially reduce the complexity of the DFE without any loss of performance. The study includes performance analysis of the proposed method and closed form expressions for the mean square error

Adaptive step-size sign least mean squares

In this paper, we propose a novel structure for adaptive sign least mean squares (ASLMS). A powerful adaptation scheme is used to adapt the step-size of the sign function inside the recursion of the sign algorithm. It is shown how the algorithm can be implemented with no real multiplication. Simulation results show that the performance of the proposed algorithm can be made arbitrarily close to that of the original least means squares algorithm

Flocculation performance of lignin-acrylamide derivatives

Wastewater produced in different industries contains fine suspended particles that raise a number of environmental concerns due to their potential toxicity and physicochemical properties and make their removal from industrial wastewater a challenging process. Synthetic polymers are commonly used as flocculants in colloidal systems due to their effectiveness at low dosages and their inertness to pH changes. However, in addition to their high costs, these synthetic polymers are toxic and nonbiodegradable. These disadvantages of synthetic flocculants can be overcome by using flocculants derived from natural sources. Lignin, after cellulose, is the most abundant biopolymer; it's an inexpensive raw material, and readily available as a by-product of pulping processes. Kraft lignin does not possess suitable properties to be used as a flocculant, however, lignin attributes can be changed by means of chemical modification. In this thesis, kraft lignin-acrylamide polymer was produced and then hydrolyzed to a product with properties that favor its use as a flocculant. The flocculant performance of hydrolyzed kraft lignin-acrylamide polymer was compared with analyzed kraft lignin-acrylamide and polyacrylamide polymers synthesized under the same conditions, in an alumina suspension. Alternatively, kraft lignin was modified via carboxymethylation and oxidation, and subsequently polymerized with acrylamide monomer to produce an effective flocculant for alumina suspension. The properties of the resulting polymers were characterized using different methods including TGA, DSC, elemental analysis, molecular weight analysis, and NMR. All of these methods illustrated remarkable changes in the chemical and physical properties of kraft lignin after modification. The flocculant properties of the produced polymers were investigated in alumina suspension by studying a) the adsorption behavior of polymer on alumina particles, b) the effect of modified lignin on the zeta potential of alumina suspension, c) the affinity of the modified polymers to alter the relative turbidity of alumina colloids. The flocculation of the lignin polymers in alumina suspension was also analyzed by an FBRM. The results obtained demonstrated that modified lignin could indeed act as an effective flocculant in an alumina suspension with its performance being mainly dependent on charge density, molecular weight, and affinity to decrease the zeta potential of the alumina suspension. Modified lignin with a higher charge density showed high adsorption on alumina particles and significantly reduced the relative turbidity of the suspension. This work demonstrates the potential of using renewable and inexpensive material, i.e., kraft lignin, in the production of environmentally friendly flocculants

Carpal Tunnel Syndrome in Patient on long Term Hemodialysis - a Case Report

Pain in hands is a common complaint in patients of end-stage renal disease on long term hemodialysis. This pain can arise from various different etiological factors. We present one such case of 56 years old lady who suffered from pain in the hand due to carpal tunnel syndrome on the side with angioaccess. Carpal tunnel was released by open surgical technique resulting in symptomatic relief of the patient

A critical analysis of e-commerce use by Jordanian travel agents

While e-commerce has become a significant matter with the advancement of the Internet, there have been inadequate empirical research efforts concerning its acceptance in developing countries, specifically in the Middle East area, and more particularly in Jordan. Previous studies investigated e-commerce acceptance and use extensively, by employing different technology acceptance models in developed countries. However, the application of some technology models successful in developed countries, such as the Technology Acceptance Model (TAM), the Theory of Planned Behaviour (TPB) and the Decomposed Theory of Planned Behaviour (DTPB) have been found to be less predictive when tested in developing countries. This suggests that culture and the empirical setting of the study will have an effect on the technology acceptance and use. Moreover, there are limited studies that investigate the technology acceptance in the tourism sector in both the developing and developed countries. As a result, this study has attempted to fill this research gap by creating a developing country model (using Jordan as a research site) and then comparing this model to traditional models which arc predominantly Western/developed country- in origin. Data was collected from 313 travel agencies 111 the area of Amman through a questionnaire survey, and then the data was analysed through various analytical methods. Data analysis started with the descriptive statistics of the demographic variables, key informants and actual use of the Internet. Then an investigation of the reliability and validity of each construct was conducted using item-to-total correlations and exploratory factor analyses. The results of factor analysis were used as inputs in successive multiple regression analyses. E-commerce use was measured by time and frequency of the Internet use. The research findings indicate that the adapted Unified Theory of Acceptance and Use of Technology model (UTAUT), which was originally tested in the developed countries, can also explain e-commerce acceptance and use of travel agents. In addition, the study indicates the factors that affect e-commerce adoption in the Jordanian travel agencies, namely performance expectancy, effort expectancy, social influence, perceived risk, government support, competition and external pressure, facilitating conditions and compatibility. The key influence drivers that have affected the behaviour intention to use e-commerce were the construct of competition and external pressure followed by the performance expectancy construct, then the effort expectancy and finally the facilitating condition constructs. Furthermore, the results of the analyses revealed that performance expectancy and effort expectancy along with social influence and competition and external pressure and facilitating conditions were significant factors and had a positive influence on the behaviour intention to use e-commerce. In contrast, perceived risk, along with government support and compatibility, were insignificant factors. In addition, the behaviour intention has a significantly positive effect on intended degree of use. Also, the findings of this study clarify the effects of various moderators on the behaviour intention to use e-commerce. Performance expectancy was not moderated by age and gender. Effort expectancy was moderated by gender with a stronger effect for males, but age did not moderate the relationship between effort expectancy and behaviour intention. Finally, age did not moderate the relationship between social influence and behaviour intention. In contrast, gender moderated this relationship, with a markedly stronger effect for women. The study contributes to the body of literature in the area of technology acceptance in developing countries and in the hospitality industry. The findings suggested that the UTAUT explains e-commerce acceptance and use in Jordanian travel agencies. It also provides several managerial and methodological implications. The study provides a useful model for managers of travel agencies to evaluate the factors that influence the use of e-commerce. It also provides suggestions to help managers to formulate organizational policies and marketing strategies prior to the use of the e-commerce. The limitations of the study together with directions for future research are also considered

Adaptive predictive power control for the uplink channel in DS-CDMA cellular systems

In this paper, we analyze the conventional closed-loop power-control system. We explain that the system behaves essentially as a companded delta modulator and then derive an expression for the power-control error in terms of the channel fading, which suggests methods for reducing the error variance. This is achieved by using a prediction technique for estimating the channel-power fading profile. The prediction module is combined with several proposed schemes for closed-loop power control. The resulting architectures are shown to result in improved performance in simulations

Adaptive differential pulse-coded modulation with exponential tracking

This paper first investigates a companded differential pulse-coded modulator and. derives an expression for its SNR performance. Analysis and simulations show that, the coder has superior SNR and dynamic range performance over other coders of similar complexity. The companded modulator is then extended to an adaptive differential pulse-coded modulator with high SNR and dynamic range performance, and it is shown to be BIBO stable

Expression and regulation of the immune modulatory enzyme indoleamine 2,3-dioxygenase (IDO) in human epithelial cells

Epithelial cells (ECs) are key players in the modulation of immune responses in addition to its main role as a barrier against external stimuli. Upon stimulation with pathogens/allergens, airway ECs can produce a wide range of innate mediators that recruit and activate immune cells which play a key role in maintaining immune homeostasis in the lungs. One such mediator is indoleamine 2,3- dioxygenase (IDO), which is a rate-limiting enzyme involved in tryptophan (TRP) catabolism. IDO plays a role in the modulation of immune responses to antigenic challenges and also acts as an anti-microbial factor. Therefore, the main aim of this project was investigating IDO expression, immune regulatory function and regulation pattern in human airway ECs in response to clinically relevant toll-like receptor (TLR) ligands and allergen extracts. This was done in 2D cultures and in a 3D model using ECs from healthy and diseased donors. The data clearly demonstrated that ECs constitutively produce IDO which is up-regulated in response to IFN-. However, I have shown for the first time, that IDO production and activity is down-regulated in response to TLR ligands and allergen extracts. Indeed, using gene silencing, I demonstrated that ‘resting’ ECs (i.e. with high IDO expression) can suppress T cell activation in an IDO-dependent manner, but this regulatory function is lost in response to TLR agonists mimicking bacterial or viral infections. These data provide new insight into how ECs, as part of their function in maintaining immune homeostasis in airways, can influence downstream innate and adaptive immune responses through the production of IDO. In this study, I also focused on developing an immunocompetent 3D model of human airway ECs in regards to produce certain in vivo characteristics. In addition, the effect of EC differentiation state and cross-talk with other cells on IDO activity was investigated. My data showed that EC lines and primary human bronchial ECs (pHBECs) could be differentiated at the air-liquid interface (ALI) and form ZO-1 tight junctions. Moreover, ECs had higher TEER values when co-cultured with fibroblasts than when cultured alone which indicates that fibroblasts facilitate EC differentiation, highlighting the importance of paracrine interactions and cross-talk between cells in maintaining EC barrier function. Moreover, the data showed differential regulation of IDO activity on the basis of culture conditions which suggest that differentiation and co-culture status might affect the orientation and expression pattern of TLRs. Furthermore, our data in regards to IDO regulation in physiological and pathophysiological settings demonstrated the differential regulation of IDO and considerably different IDO basal levels in healthy cells compared with diseased cells, emphasizing the immunosuppressive role of IDO. In conclusion, these advances in the understanding of IDO expression and regulation in different tissue/cell types in health and disease could contribute to delineating the potential role of IDO in inflammatory responses in different pathologies and enable the development of novel IDO-targeted therapeutic strategies