Construction of armored RNA containing long-size chimeric RNA by increasing the number and affinity of the pac site in exogenous rna and sequence coding coat protein of the MS2 bacteriophage.

PubMed

Wei, Baojun; Wei, Yuxiang; Zhang, Kuo; Yang, Changmei; Wang, Jing; Xu, Ruihuan; Zhan, Sien; Lin, Guigao; Wang, Wei; Liu, Min; Wang, Lunan; Zhang, Rui; Li, Jinming

2008-01-01

To construct a one-plasmid expression system of the armored RNA containing long chimeric RNA by increasing the number and affinity of the pac site. The plasmid pET-MS2-pac was constructed with one C-variant pac site, and then the plasmid pM-CR-2C containing 1,891-bp chimeric sequences and two C-variant pac sites was produced. Meanwhile, three plasmids (pM-CR-C, pM-CR-2W and pM-CR-W) were obtained as parallel controls with a different number and affinity of the pac site. Finally, the armored RNA was expressed and purified. The armored RNA with 1,891 bases target RNA was expressed successfully by the one-plasmid expression system with two C-variant pac sites, while for one pac site, no matter whether the affinity was changed or not, only the 1,200 bases target RNA was packaged. It was also found that the C-variant pac site could increase the expression efficiency of the armored RNA. The armored RNA with 1,891-bp exogenous RNA in our study showed the characterization of ribonuclease resistance and stability at different time points and temperature conditions. The armored RNA with 1,891 bases exogenous RNA was constructed and the expression system can be used as a platform for preparation of the armored RNA containing long RNA sequences. Copyright 2008 S. Karger AG, Basel.

PACS industry in Korea

NASA Astrophysics Data System (ADS)

Kim, Hee-Joung

2002-05-01

PACS industry in Korea has been rapidly growing, since government had supported collaborative PACS project between industry and university hospital. In the beginning, PACS industry had focused on developing peripheral PACS solutions, while the Korea PACS society was being formed. A few companies had started developing and installing domestic large-scale full-PACS system for teaching hospitals. Several years later, many hospitals have installed full-PACS system with national policy of reimbursement for PACS exams in November 1999. Both experiences of full-PACS installation and national policy generated tremendous intellectual and technological expertise about PACS at all levels, clinical, hospital management, education, and industrial sectors. There are now more than 20 domestic PACS companies. They have enough experiences which are capable of installing a truly full-PACS system for large-scale teaching hospitals. As an example, a domestic company had installed more than 40 full-PACS systems within 2-3 years. Enough experiences of full-PACS installation in Korea lead PACS industry to start exporting their full-PACS solutions. However, further understanding and timely implementation of continuously evolving international standard and integrated healthcare enterprise concepts may be necessary for international leading of PACS technologies for the future.

[Definition and specification requirements for PAC-systems (picture archiving and communication system). A performance index with reference to the standard "IEEE Recommended Practice for Software Requirement Specifications"].

PubMed

König, H; Klose, K J

1999-04-01

The formulation of requirements is necessary to control the goals of a PACS project. Furthermore, in this way, the scope of functionality necessary to support radiological working processes becomes clear. Definitions of requirements and specification are formulated independently of systems according to the IEEE standard "Recommended Practice for Software Requirements Specifications". Definitions are given in the Request for Information, specifications in the Request for Proposal. Functional and non-functional requirements are distinguished. The solutions are rated with respect to scope, appropriateness and quality of implementation. A PACS checklist was created according to the methods described above. It is published on the homepage of the "Arbeitsgemeinschaft Informationstechnologie" (AGIT) within the "Deutsche Röntgengesellschaft" (DRG) (http://www.uni-marburg.de/mzr/agit). The checklist provides a discussion forum which should contribute to an agreement on accepted basic PACS functionalities.

Integration of LDSE and LTVS logs with HIPAA compliant auditing system (HCAS)

NASA Astrophysics Data System (ADS)

Zhou, Zheng; Liu, Brent J.; Huang, H. K.; Guo, Bing; Documet, Jorge; King, Nelson

2006-03-01

The deadline of HIPAA (Health Insurance Portability and Accountability Act) Security Rules has passed on February 2005; therefore being HIPAA compliant becomes extremely critical to healthcare providers. HIPAA mandates healthcare providers to protect the privacy and integrity of the health data and have the ability to demonstrate examples of mechanisms that can be used to accomplish this task. It is also required that a healthcare institution must be able to provide audit trails on image data access on demand for a specific patient. For these reasons, we have developed a HIPAA compliant auditing system (HCAS) for image data security in a PACS by auditing every image data access. The HCAS was presented in 2005 SPIE. This year, two new components, LDSE (Lossless Digital Signature Embedding) and LTVS (Patient Location Tracking and Verification System) logs, have been added to the HCAS. The LDSE can assure medical image integrity in a PACS, while the LTVS can provide access control for a PACS by creating a security zone in the clinical environment. By integrating the LDSE and LTVS logs with the HCAS, the privacy and integrity of image data can be audited as well. Thus, a PACS with the HCAS installed can become HIPAA compliant in image data privacy and integrity, access control, and audit control.

Influence of powdered activated carbon addition on water quality, sludge properties, and microbial characteristics in the biological treatment of commingled industrial wastewater.

PubMed

Hu, Qing-Yuan; Li, Meng; Wang, Can; Ji, Min

2015-09-15

A powdered activated carbon-activated sludge (PAC-AS) system, a traditional activated sludge (AS) system, and a powdered activated carbon (PAC) system were operated to examine the insights into the influence of PAC addition on biological treatment. The average COD removal efficiencies of the PAC-AS system (39%) were nearly double that of the AS system (20%). Compared with the average efficiencies of the PAC system (7%), COD removal by biodegradation in the PAC-AS system was remarkably higher than that in the AS system. The analysis of the influence of PAC on water quality and sludge properties showed that PAC facilitated the removal of hydrophobic matter and metabolic acidic products, and also enhanced the biomass accumulation, sludge settleability, and specific oxygen uptake rate inside the biological system. The microbial community structures in the PAC-AS and AS systems were monitored. The results showed that the average well color development in the PAC-AS system was higher than that in the AS system. The utilization of various substrates by microorganisms in the two systems did not differ. The dissimilarity index was far less than one; thus, showing that the microbial community structures of the two systems were the same. Copyright © 2015 Elsevier B.V. All rights reserved.

Biodistribution and Immunogenicity of Allogeneic Mesenchymal Stem Cells in a Rat Model of Intraarticular Chondrocyte Xenotransplantation.

PubMed

Marquina, Maribel; Collado, Javier A; Pérez-Cruz, Magdiel; Fernández-Pernas, Pablo; Fafián-Labora, Juan; Blanco, Francisco J; Máñez, Rafael; Arufe, María C; Costa, Cristina

2017-01-01

Xenogeneic chondrocytes and allogeneic mesenchymal stem cells (MSC) are considered a potential source of cells for articular cartilage repair. We here assessed the immune response triggered by xenogeneic chondrocytes when injected intraarticularly, as well as the immunoregulatory effect of allogeneic bone marrow-derived MSC after systemic administration. To this end, a discordant xenotransplantation model was established by injecting three million porcine articular chondrocytes (PAC) into the femorotibial joint of Lewis rats and monitoring the immune response. First, the fate of MSC injected using various routes was monitored in an in vivo imaging system. The biodistribution revealed a dependency on the injection route with MSC injected intravenously (i.v.) succumbing early after 24 h and MSC injected intraperitoneally (i.p.) lasting locally for at least 5 days. Importantly, no migration of MSC to the joint was detected in rats previously injected with PAC. MSC were then administered either i.v. 1 week before PAC injection or i.p. 3 weeks after to assess their immunomodulatory function on humoral and adaptive immune parameters. Anti-PAC IgM and IgG responses were detected in all PAC-injected rats with a peak at week 2 postinjection and reactivity remaining above baseline levels by week 18. IgG2a and IgG2b were the predominant and long-lasting IgG subtypes. By contrast, no anti-MSC antibody response was detected in the cohort injected with MSC only, but infusion of MSC before PAC injection temporarily augmented the anti-PAC antibody response. Consistent with a cellular immune response to PAC in PAC-injected rats, cytokine/chemokine profiling in serum by antibody array revealed a distinct pattern relative to controls characterized by elevation of multiple markers at week 2, as well as increases in proliferation in draining lymph nodes. Notably, systemic administration of allogeneic MSC under the described conditions did not diminish the immune response. IL-2 measurements in cocultures of rat peripheral blood lymphocytes with PAC indicated that PAC injection induced some T-cell hyporesponsiveness that was not enhanced in the cohorts additionally receiving MSC. Thus, PAC injected intraarticularly in Lewis rats induced a cellular and humoral immune response that was not counteracted by the systemic administration of allogeneic MSC under the described conditions.

Biodistribution and Immunogenicity of Allogeneic Mesenchymal Stem Cells in a Rat Model of Intraarticular Chondrocyte Xenotransplantation

PubMed Central

Marquina, Maribel; Collado, Javier A.; Pérez-Cruz, Magdiel; Fernández-Pernas, Pablo; Fafián-Labora, Juan; Blanco, Francisco J.; Máñez, Rafael; Arufe, María C.; Costa, Cristina

2017-01-01

Xenogeneic chondrocytes and allogeneic mesenchymal stem cells (MSC) are considered a potential source of cells for articular cartilage repair. We here assessed the immune response triggered by xenogeneic chondrocytes when injected intraarticularly, as well as the immunoregulatory effect of allogeneic bone marrow-derived MSC after systemic administration. To this end, a discordant xenotransplantation model was established by injecting three million porcine articular chondrocytes (PAC) into the femorotibial joint of Lewis rats and monitoring the immune response. First, the fate of MSC injected using various routes was monitored in an in vivo imaging system. The biodistribution revealed a dependency on the injection route with MSC injected intravenously (i.v.) succumbing early after 24 h and MSC injected intraperitoneally (i.p.) lasting locally for at least 5 days. Importantly, no migration of MSC to the joint was detected in rats previously injected with PAC. MSC were then administered either i.v. 1 week before PAC injection or i.p. 3 weeks after to assess their immunomodulatory function on humoral and adaptive immune parameters. Anti-PAC IgM and IgG responses were detected in all PAC-injected rats with a peak at week 2 postinjection and reactivity remaining above baseline levels by week 18. IgG2a and IgG2b were the predominant and long-lasting IgG subtypes. By contrast, no anti-MSC antibody response was detected in the cohort injected with MSC only, but infusion of MSC before PAC injection temporarily augmented the anti-PAC antibody response. Consistent with a cellular immune response to PAC in PAC-injected rats, cytokine/chemokine profiling in serum by antibody array revealed a distinct pattern relative to controls characterized by elevation of multiple markers at week 2, as well as increases in proliferation in draining lymph nodes. Notably, systemic administration of allogeneic MSC under the described conditions did not diminish the immune response. IL-2 measurements in cocultures of rat peripheral blood lymphocytes with PAC indicated that PAC injection induced some T-cell hyporesponsiveness that was not enhanced in the cohorts additionally receiving MSC. Thus, PAC injected intraarticularly in Lewis rats induced a cellular and humoral immune response that was not counteracted by the systemic administration of allogeneic MSC under the described conditions. PMID:29163532

DOE Office of Scientific and Technical Information (OSTI.GOV)

Edwin S. Olson; Kurt E. Eylands; Daniel J. Stepan

New federal drinking water regulations have been promulgated to restrict the levels of disinfection by-products (DBPs) in finished public water supplies. DBPs are suspected carcinogens and are formed when organic material is partially oxidized by disinfectants commonly used in the water treatment industry. Additional federal mandates are expected in the near future that will also affect public water suppliers with respect to DBPs. These new federal drinking water regulations may require public water suppliers to adjust treatment practices or incorporate additional treatment operations into their existing treatment trains. Many options have been identified, including membrane processes, granular activated carbon, poweredmore » activated carbon (PAC), enhanced coagulation and/or softening, and alternative disinfectants (e.g., chlorine dioxide, ozone, and chloramines). Of the processes being considered, PAC appears to offer an attractive benefit-to-cost advantage for many water treatment plants, particularly small systems (those serving fewer than 10,000 customers). PAC has traditionally been used by the water treatment industry for the removal of compounds contributing to taste and odor problems. PAC also has the potential to remove naturally occurring organic matter (NOM) from raw waters prior to disinfection, thus controlling the formation of regulated DBPs. Many small water systems are currently using PAC for taste and odor control and have the potential to use PAC for controlling DBPs. Activated carbons can be produced from a variety of raw materials, including wood, peat, coconut husks, and numerous types of coal. The Energy & Environmental Research Center (EERC) has been working on the development of a PAC product to remove NOM from surface water supplies to prevent the formation of carcinogenic DBPs during chlorination. During that study, the sodium and calcium content of the lignites showed a significant effect on the sorption capacity of the activated carbon product. As much as a 130% increase in the humic acid sorption capacity of a PAC produced from a high-sodium-content lignite was observed. We hypothesize that the sodium and calcium content of the coal plays a significant role in the development of pore structures and pore-size distribution, ultimately producing activated carbon products that have greater sorption capacity for specific contaminants, depending on molecular size.« less

Managing healthcare information using short message service (SMS) in wireless broadband networks

NASA Astrophysics Data System (ADS)

Documet, Jorge; Tsao, Sinchai; Documet, Luis; Liu, Brent J.; Zhou, Zheng; Joseph, Anika O.

2007-03-01

Due to the ubiquity of cell phones, SMS (Short Message Service) has become an ideal means to wirelessly manage a Healthcare environment and in particular PACS (Picture Archival and Communications System) data. SMS is a flexible and mobile method for real-time access and control of Healthcare information systems such as HIS (Hospital Information System) or PACS. Unlike conventional wireless access methods, SMS' mobility is not limited by the presence of a WiFi network or any other localized signal. It provides a simple, reliable yet flexible method to communicate with an information system. In addition, SMS services are widely available for low costs from cellular phone service providers and allows for more mobility than other services such as wireless internet. This paper aims to describe a use case of SMS as a means of remotely communicating with a PACS server. Remote access to a PACS server and its Query-Retrieve services allows for a more convenient, flexible and streamlined radiology workflow. Wireless access methods such as SMS will increase dedicated PACS workstation availability for more specialized DICOM (Digital Imaging and Communications in Medicine) workflow management. This implementation will address potential security, performance and cost issues of applying SMS as part of a healthcare information management system. This is in an effort to design a wireless communication system with optimal mobility and flexibility at minimum material and time costs.

PACS in an intensive care unit: results from a randomized controlled trial

NASA Astrophysics Data System (ADS)

Bryan, Stirling; Weatherburn, Gwyneth C.; Watkins, Jessamy; Walker, Samantha; Wright, Carl; Waters, Brian; Evans, Jeff; Buxton, Martin J.

1998-07-01

The objective of this research was to assess the costs and benefits associated with the introduction of a small PACS system into an intensive care unit (ICU) at a district general hospital in north Wales. The research design adopted for this study was a single center randomized controlled trial (RCT). Patients were randomly allocated either to a trial arm where their x-ray imaging was solely film-based or to a trial arm where their x-ray imaging was solely PACS based. Benefit measures included examination-based process measures, such as image turn-round time, radiation dose and image unavailability; and patient-related process measures, which included adverse events and length of stay. The measurement of costs focused on additional 'radiological' costs and the costs of patient management. The study recruited 600 patients. The key findings from this study were that the installation of PACS was associated with important benefits in terms of image availability, and important costs in both monetary and radiation dose terms. PACS-related improvements in terms of more timely 'clinical actions' were not found. However, the qualitative aspect of the research found that clinicians were advocates of the technology and believed that an important benefit of PACS related to improved image availability.

MyFreePACS: a free web-based radiology image storage and viewing tool.

PubMed

de Regt, David; Weinberger, Ed

2004-08-01

We developed an easy-to-use method for central storage and subsequent viewing of radiology images for use on any PC equipped with Internet Explorer. We developed MyFreePACS, a program that uses a DICOM server to receive and store images and transmit them over the Web to the MyFreePACS Web client. The MyFreePACS Web client is a Web page that uses an ActiveX control for viewing and manipulating images. The client contains many of the tools found in modern image viewing stations including 3D localization and multiplanar reformation. The system is built entirely with free components and is freely available for download and installation from the Web at www.myfreepacs.com.

Changes in the use of postacute care during the initial Medicare payment reforms.

PubMed

Lin, Wen-Chieh; Kane, Robert L; Mehr, David R; Madsen, Richard W; Petroski, Gregory F

2006-08-01

To examine changes in postacute care (PAC) use during the initial Medicare payment reforms enacted by the Balanced Budget Act of 1997. We used claims data from the 5 percent Medicare beneficiary sample in 1996, 1998, and 2000. Linked data from the Denominator file, Provider of Service file, and Area Resource File provided additional patient, hospital, and market-area characteristics. Six disease groups with high PAC use were selected for analysis. We used multinomial logit regression to examine how PAC use differed by year of service, controlling for patient, hospital, and market-area characteristics. There were major changes in PAC use, and a portion of services shifted to settings where reimbursement remained cost-based. During the first reform, the home health agency interim payment system, home health use decreased consistently across disease groups. This decrease was accompanied by increased use in skilled nursing facilities (SNFs). Following the implementation of the prospective payment system for SNFs, the use of inpatient rehabilitation facilities increased. The shift in usage among settings occurred in two stages that corresponded to the timing of payment reforms for home health agencies and SNFs. Evidence strongly suggests the substitutability between PAC settings. Financial incentives, in addition to clinical needs and individual preferences, play a major role in PAC use.

UV254 absorbance as real-time monitoring and control parameter for micropollutant removal in advanced wastewater treatment with powdered activated carbon.

PubMed

Altmann, Johannes; Massa, Lukas; Sperlich, Alexander; Gnirss, Regina; Jekel, Martin

2016-05-01

This study investigates the applicability of UV absorbance measurements at 254 nm (UVA254) to serve as a simple and reliable surrogate parameter to monitor and control the removal of organic micropollutants (OMPs) in advanced wastewater treatment applying powdered activated carbon (PAC). Correlations between OMP removal and corresponding UVA254 reduction were determined in lab-scale adsorption batch tests and successfully applied to a pilot-scale PAC treatment stage to predict OMP removals in aggregate samples with good accuracy. Real-time UVA254 measurements were utilized to evaluate adapted PAC dosing strategies and proved to be effective for online monitoring of OMP removal. Furthermore, active PAC dosing control according to differential UVA254 measurements was implemented and tested. While precise removal predictions based on real-time measurements were not accurate for all OMPs, UVA254-controlled dynamic PAC dosing was capable of achieving stable OMP removals. UVA254 can serve as an effective surrogate parameter for OMP removal in technical PAC applications. Even though the applicability as control parameter to adjust PAC dosing to water quality changes might be limited to applications with fast response between PAC adjustment and adsorptive removal (e.g. direct filtration), UVA254 measurements can also be used to monitor the adsorption efficiency in more complex PAC applications. Copyright © 2016 Elsevier Ltd. All rights reserved.

Frequent premature atrial contractions impair left atrial contractile function and promote adverse left atrial remodeling.

PubMed

John, Anub G; Hirsch, Glenn A; Stoddard, Marcus F

2018-06-10

This study assessed if frequent premature atrial contractions (PACs) were associated with decreased left atrial (LA) strain and adverse remodeling. Left atrial dysfunction and enlargement increases risk of stroke. If frequent PACs cause LA dysfunction and remodeling, PAC suppressive therapy may be beneficial. Inclusion criteria were age ≥18 years and sinus rhythm. Exclusion criteria were atrial fibrillation or any etiology for LA enlargement. Hundred and thirty-two patients with frequent PACs (≥100/24 hours) by Holter were matched to controls. Speckle tracking strain of the left atrium was performed from the 4-chamber view. Strain measurements were LA peak contractile, reservoir and conduit strain and strain rates. In the frequent PAC vs control group, PACs were more frequent (1959 ± 3796 vs 28 ± 25/24 hours, P < .0001). LA peak contractile strain was reduced in the group with frequent PACs vs controls (-7.85 ± 4.12% vs -9.33 ± 4.45%, P = .006). LA peak late negative contractile strain rate was less negative in the frequent PAC vs control group (-0.63 ± 0.27 s -1 vs -0.69 ± 0.32 s -1 , P = .051). LA reservoir and conduit strain and strain rates did not differ. LA volume index (LAVI) was larger in the frequent PAC vs control group (26.6 ± 7.8 vs 24.6 ± 8.8 mL/m 2 , P < .05). Frequent PACs were an independent predictor of reduced LA peak contractile strain and reduced LA peak late negative contractile strain rate. Patients with frequent PACs have reduced LA peak contractile strain and strain rates and larger LAVI compared to controls. Frequent PACs are an independent predictor of reduced LA peak contractile strain and strain rate. These findings support the hypothesis that frequent PACs impair LA contractile function and promote adverse LA remodeling. © 2018 Wiley Periodicals, Inc.

Design and evaluation of web-based image transmission and display with different protocols

NASA Astrophysics Data System (ADS)

Tan, Bin; Chen, Kuangyi; Zheng, Xichuan; Zhang, Jianguo

2011-03-01

There are many Web-based image accessing technologies used in medical imaging area, such as component-based (ActiveX Control) thick client Web display, Zerofootprint thin client Web viewer (or called server side processing Web viewer), Flash Rich Internet Application(RIA) ,or HTML5 based Web display. Different Web display methods have different peformance in different network environment. In this presenation, we give an evaluation on two developed Web based image display systems. The first one is used for thin client Web display. It works between a PACS Web server with WADO interface and thin client. The PACS Web server provides JPEG format images to HTML pages. The second one is for thick client Web display. It works between a PACS Web server with WADO interface and thick client running in browsers containing ActiveX control, Flash RIA program or HTML5 scripts. The PACS Web server provides native DICOM format images or JPIP stream for theses clients.

PacCYP707A2 negatively regulates cherry fruit ripening while PacCYP707A1 mediates drought tolerance.

PubMed

Li, Qian; Chen, Pei; Dai, Shengjie; Sun, Yufei; Yuan, Bing; Kai, Wenbin; Pei, Yuelin; He, Suihuan; Liang, Bin; Zhang, Yushu; Leng, Ping

2015-07-01

Sweet cherry is a non-climacteric fruit and its ripening is regulated by abscisic acid (ABA) during fruit development. In this study, four cDNAs (PacCYP707A1-4) encoding 8'-hydroxylase, a key enzyme in the oxidative catabolism of ABA, were identified in sweet cherry fruits using tobacco rattle virus-induced gene silencing (VIGS) and particle bombardment approaches. Quantitative real-time PCR confirmed significant down-regulation of target gene transcripts in VIGS-treated cherry fruits. In PacCYP707A2-RNAi-treated fruits, ripening and fruit colouring were promoted relative to control fruits, and both ABA accumulation and PacNCED1 transcript levels were up-regulated by 140%. Silencing of PacCYP707A2 by VIGS significantly altered the transcripts of both ABA-responsive and ripening-related genes, including the ABA metabolism-associated genes NCED and CYP707A, the anthocyanin synthesis genes PacCHS, PacCHI, PacF3H, PacDFR, PacANS, and PacUFGT, the ethylene biosynthesis gene PacACO1, and the transcription factor PacMYBA. The promoter of PacMYBA responded more strongly to PacCYP707A2-RNAi-treated fruits than to PacCYP707A1-RNAi-treated fruits. By contrast, silencing of PacCYP707A1 stimulated a slight increase in fruit colouring and enhanced resistance to dehydration stress compared with control fruits. These results suggest that PacCYP707A2 is a key regulator of ABA catabolism that functions as a negative regulator of fruit ripening, while PacCYP707A1 regulates ABA content in response to dehydration during fruit development. © The Author 2015. Published by Oxford University Press on behalf of the Society for Experimental Biology.

PacCYP707A2 negatively regulates cherry fruit ripening while PacCYP707A1 mediates drought tolerance

PubMed Central

Li, Qian; Chen, Pei; Dai, Shengjie; Sun, Yufei; Yuan, Bing; Kai, Wenbin; Pei, Yuelin; He, Suihuan; Liang, Bin; Zhang, Yushu; Leng, Ping

2015-01-01

Sweet cherry is a non-climacteric fruit and its ripening is regulated by abscisic acid (ABA) during fruit development. In this study, four cDNAs (PacCYP707A1–4) encoding 8′-hydroxylase, a key enzyme in the oxidative catabolism of ABA, were identified in sweet cherry fruits using tobacco rattle virus-induced gene silencing (VIGS) and particle bombardment approaches. Quantitative real-time PCR confirmed significant down-regulation of target gene transcripts in VIGS-treated cherry fruits. In PacCYP707A2-RNAi-treated fruits, ripening and fruit colouring were promoted relative to control fruits, and both ABA accumulation and PacNCED1 transcript levels were up-regulated by 140%. Silencing of PacCYP707A2 by VIGS significantly altered the transcripts of both ABA-responsive and ripening-related genes, including the ABA metabolism-associated genes NCED and CYP707A, the anthocyanin synthesis genes PacCHS, PacCHI, PacF3H, PacDFR, PacANS, and PacUFGT, the ethylene biosynthesis gene PacACO1, and the transcription factor PacMYBA. The promoter of PacMYBA responded more strongly to PacCYP707A2-RNAi-treated fruits than to PacCYP707A1-RNAi-treated fruits. By contrast, silencing of PacCYP707A1 stimulated a slight increase in fruit colouring and enhanced resistance to dehydration stress compared with control fruits. These results suggest that PacCYP707A2 is a key regulator of ABA catabolism that functions as a negative regulator of fruit ripening, while PacCYP707A1 regulates ABA content in response to dehydration during fruit development. PMID:25956880

From PACS to Web-based ePR system with image distribution for enterprise-level filmless healthcare delivery.

PubMed

Huang, H K

2011-07-01

The concept of PACS (picture archiving and communication system) was initiated in 1982 during the SPIE medical imaging conference in New Port Beach, CA. Since then PACS has been matured to become an everyday clinical tool for image archiving, communication, display, and review. This paper follows the continuous development of PACS technology including Web-based PACS, PACS and ePR (electronic patient record), enterprise PACS to ePR with image distribution (ID). The concept of large-scale Web-based enterprise PACS and ePR with image distribution is presented along with its implementation, clinical deployment, and operation. The Hong Kong Hospital Authority's (HKHA) integration of its home-grown clinical management system (CMS) with PACS and ePR with image distribution is used as a case study. The current concept and design criteria of the HKHA enterprise integration of the CMS, PACS, and ePR-ID for filmless healthcare delivery are discussed, followed by its work-in-progress and current status.

Operator interface design considerations for a PACS information management system

NASA Astrophysics Data System (ADS)

Steinke, James E.; Nabijee, Kamal H.; Freeman, Rick H.; Prior, Fred W.

1990-08-01

As prototype PACS grow into fully digital departmental and hospital-wide systems, effective information storage and retrieval mechanisms become increasingly important. Thus far, designers of PACS workstations have concentrated on image communication and display functionality. The new challenge is to provide appropriate operator interface environments to facilitate information retrieval. The "Marburg Model" 1 provides a detailed analysis of the functions, control flows and data structures used in Radiology. It identifies a set of "actors" who perform information manipulation functions. Drawing on this model and its associated methodology it is possible to identify four modes of use of information systems in Radiology: Clinical Routine, Research, Consultation, and Administration. Each mode has its own specific access requirements and views of information. An operator interface strategy appropriate for each mode will be proposed. Clinical Routine mode is the principal concern of PACS primary diagnosis workstations. In a full PACS implementation, such workstations must provide a simple and consistent navigational aid for the on-line image database, a local work list of cases to be reviewed, and easy access to information from other hospital information systems. A hierarchical method of information access is preferred because it provides the ability to start at high-level entities and iteratively narrow the scope of information from which to select subsequent operations. An implementation using hierarchical, nested software windows which fulfills such requirements shall be examined.

The biometric study in different stages of primary angle-closure glaucoma

PubMed Central

Chen, Y-Y; Chen, Y-Y; Sheu, S-J; Chou, P

2013-01-01

Purpose This study compared the general and ocular biometric characteristics of normal, primary angle closure (PAC), and primary angle-closure glaucoma (PACG) patients to better understand the possible relationship between differences in ocular parameters that might predict risk for PACG in PAC patients. Methods One hundred normal, 90 PAC, and 90 PACG eyes were retrospectively reviewed. General characteristics such as age, gender, body height, body weight, blood pressure, pulse, systemic diseases, and education level were recorded. Ocular findings included visual acuity, intraocular pressure, refraction, cup to disc ratio, and ocular biometry. Ocular biometry was obtained by A-scan ultrasonography (Digital A/B scan 5500; Sonomed Inc., Lake Success, NY, USA). The parameters recorded were anterior chamber depth (ACD), lens thickness (LT), axial length (AXL), lens/axial length factor (LAF), and relative lens position (RLP). Results Although the controls, PAC group, and PACG group were found to be significantly different in age (62.7±9.8; 65.3±7.5; and 66.0±7.4, respectively), there were no gender differences. With regard to ocular parameters, the ACD tended to decrease and the LT and LAF tended to increase from normal to PAC to PACG. The eyes of the PACG group had significantly shallower ACD (P<0.001) and thicker lens (P<0.001) than those of the PAC group. While PAC had similar lens position to the control group, PACG had more anteriorly positioned lens than the PAC group (P<0.001). Logistic regression analysis found a significant association between a decrease in ACD and increased risk of PACG (odds ratio (OR)=3.59 for 0.2 mm decrease in ACD) as well as a significant association between an increase in LT and increased risk of PACG (OR=1.30). Conclusions In addition to LT, a shallower ACD owing to a change in RLP may have a role in the progression from PAC to PACG. Owing to the differences of certain biometric characteristics between PAC and PACG, A-scan ultrasonography might potentially be used for the early detection of PACG in PAC eyes. PMID:23788204

Detailed description of the Mayo/IBM PACS

NASA Astrophysics Data System (ADS)

Gehring, Dale G.; Persons, Kenneth R.; Rothman, Melvyn L.; Salutz, James R.; Morin, Richard L.

1991-07-01

The Mayo Clinic and IBM/Rochester have jointly developed a picture archiving system (PACS) for use with Mayo's MRI and Neuro-CT imaging modalities. The system was developed to replace the imaging system's vendor-supplied magnetic tape archiving capability. The system consists of seven MR imagers and nine CT scanners, each interfaced to the PACS via IBM Personal System/2(tm) (PS/2) computers, which act as gateways from the imaging modality to the PACS network. The PAC system operates on the token-ring component of Mayo's city-wide local area network. Also on the PACS network are four optical storage subsystems used for image archival, three optical subsystems used for image retrieval, an IBM Application System/400(tm) (AS/400) computer used for database management and multiple PS/2-based image display systems and their image servers.

Using technology assessment as the picture archiving and communication system spreads outside radiology to the enterprise.

PubMed

Maliff, R P; Launders, J

2000-05-01

Picture archiving and communication systems (PACS) are being implemented within radiology departments, and many facilities are entering the next stage of PACS use by deploying PACS to departments outside of radiology and to other facilities located at a distance. Many PACS vendors and department administrators have based cost-justification analyses on the anticipated savings from expanding PACS to these areas. However, many of these cost-savings analyses can be highly suspect in their assumptions and findings. Technology assessment (TA) at the hospital/health system level is an organized, systematic approach to examining the efficacy of a technology in relation to the health system's mission and clinical needs. It can be an organized and unifying approach to aid in the distribution of limited capital resources. As extra-radiology PACS deployment is a costly endeavor, TA may be used to plan for PACS implementation throughout the enterprise. In many organizations, PACS is thought of as a radiology domain as its first uses were centered on this image-producing service. Now, as PACS technology spreads to other service areas, such as cardiology, dermatology, pathology, orthopedics, obstetrics, etc, the need to incorporate other viewpoints in a system-based PACS is necessary to avoid having independent PACS that may duplicate archives and may not communicate with each other. How to meet the diverse PACS needs of clinical services can be a challenging task; a TA program has been demonstrated to effectively handle the clinical needs, demands, and timeframes of PACS planning and support throughout hospitals and health systems. A hospital-based TA program can assist health care organizations to present PACS as a system-wide need and program rather than a radiology-based program gobbling up the capital budget. Submitting PACS to the TA review process can identify essential elements in planning and help avoid many of the pitfalls of PACS implementation and operations. Thorough cost and/or return on investment analyses, phasing decisions, workflow re-engineering, and outcomes assessment programs are a few of the issues that a TA program can address to help in the transition to a complete electronic image environment. The TA process includes clinician selection, evaluation criteria and their selection for technologies under review, a policy for review/authorization/denial, and measurement of expected outcomes.

Reengineering the picture archiving and communication system (PACS) process for digital imaging networks PACS.

PubMed

Horton, M C; Lewis, T E; Kinsey, T V

1999-05-01

Prior to June 1997, military picture archiving and communications systems (PACS) were planned, procured, and installed with key decisions on the system, equipment, and even funding sources made through a research and development office called Medical Diagnostic Imaging Systems (MDIS). Beginning in June 1997, the Joint Imaging Technology Project Office (JITPO) initiated a collaborative and consultative process for planning and implementing PACS into military treatment facilities through a new Department of Defense (DoD) contract vehicle called digital imaging networks (DIN)-PACS. The JITPO reengineered this process incorporating multiple organizations and politics. The reengineered PACS process administered through the JITPO transformed the decision process and accountability from a single office to a consultative method that increased end-user knowledge, responsibility, and ownership in PACS. The JITPO continues to provide information and services that assist multiple groups and users in rendering PACS planning and implementation decisions. Local site project managers are involved from the outset and this end-user collaboration has made the sometimes difficult transition to PACS an easier and more acceptable process for all involved. Corporately, this process saved DoD sites millions by having PACS plans developed within the government and proposed to vendors second, and then having vendors respond specifically to those plans. The integrity and efficiency of the process have reduced the opportunity for implementing nonstandard systems while sharing resources and reducing wasted government dollars. This presentation will describe the chronology of changes, encountered obstacles, and lessons learned within the reengineering of the PACS process for DIN-PACS.

Factors Affecting Radiologist's PACS Usage.

PubMed

Forsberg, Daniel; Rosipko, Beverly; Sunshine, Jeffrey L

2016-12-01

The purpose of this study was to determine if any of the factors radiologist, examination category, time of week, and week effect PACS usage, with PACS usage defined as the sequential order of computer commands issued by a radiologist in a PACS during interpretation and dictation. We initially hypothesized that only radiologist and examination category would have significant effects on PACS usage. Command logs covering 8 weeks of PACS usage were analyzed. For each command trace (describing performed activities of an attending radiologist interpreting a single examination), the PACS usage variables number of commands, number of command classes, bigram repetitiveness, and time to read were extracted. Generalized linear models were used to determine the significance of the factors on the PACS usage variables. The statistical results confirmed the initial hypothesis that radiologist and examination category affect PACS usage and that the factors week and time of week to a large extent have no significant effect. As such, this work provides direction for continued efforts to analyze system data to better understand PACS utilization, which in turn can provide input to enable optimal utilization and configuration of corresponding systems. These continued efforts were, in this work, exemplified by a more detailed analysis using PACS usage profiles, which revealed insights directly applicable to improve PACS utilization through modified system configuration.

[The changes in renin-angiotensin-aldosterone-system in different subtypes of Cushing's syndrome].

PubMed

Cui, Jia; Dou, Jingtao; Yang, Guoqing; Zang, Li; Jin, Nan; Chen, Kang; Du, Jin; Gu, Weijun; Wang, Xianling; Yang, Lijuan; Lyu, Zhaohui; Ba, Jianming; Mu, Yiming; Lu, Juming; Li, Jiangyuan; Pan, Changyu

2015-07-01

Cushing's syndrome is a clinical condition resulting from chronic exposure to excess glucocorticoid. As a consequence, long-term hypercortisolism contributes significantly to the development of systemic disorders by direct and/or indirect effects. The present study was to analyze the changes of renin-angiotensin-aldosterone-system in different subtypes of Cushing's syndrome on the standard posture test. We retrospectively reviewed 150 patients with histologically confirmed Cushing's syndrome treated at the PLA General Hospital between 2002 and 2014. Among them, 128 patients were diagnosed as adreno-cortico-tropic-hormone (ACTH)-independent Cushing's syndrome, and 22 were ACTH-dependent Cushing's syndrome. All patients were undertaken the posture test. Plasma renin activity (PRA), angiotensin II, plasma aldosterone concertration (PAC) levels were measured before and after the test. Basal plasma PRA [0.5 (0.2,1.3)µg·L(-1)·h(-1), angiotensin II [(48.9±20.1) ng/L] and PAC [(285.0±128.1) pmol/L] levels were within the normal range in supine position. Compared with the subjects with ACTH-independent Cushing's syndrome, the basal PAC levels were higher in subjects with ACTH-dependent Cushing's syndrome [(348.0±130.4) pmol/L vs (274.2±125.0) pmol/L, P<0.05]. However, the PAC response in subjects with ACTH-dependent Cushing's syndrome [(49.7±26.4)%] was significantly lower than that in those with ACTH-independent Cushing's syndrome [(81.2±69.3)%] upon upright posture stimulation (P<0.05). There were no statistical significances in PRA and angiotensin II levels between the two groups. The basal PAC and PRA levels were positively correlated with ACTH, whereas PAC response was negatively correlated with ACTH. The renin-angiotensin-aldosterone-system activity in subjects with Cushing's syndrome was similar to that in normal control. The basal PAC level and its response to upright posture are differently associated with ACTH level in Cushing's syndrome.

Department of Defense picture archiving and communication system acceptance testing: results and identification of problem components.

PubMed

Allison, Scott A; Sweet, Clifford F; Beall, Douglas P; Lewis, Thomas E; Monroe, Thomas

2005-09-01

The PACS implementation process is complicated requiring a tremendous amount of time, resources, and planning. The Department of Defense (DOD) has significant experience in developing and refining PACS acceptance testing (AT) protocols that assure contract compliance, clinical safety, and functionality. The DOD's AT experience under the initial Medical Diagnostic Imaging Support System contract led to the current Digital Imaging Network-Picture Archiving and Communications Systems (DIN-PACS) contract AT protocol. To identify the most common system and component deficiencies under the current DIN-PACS AT protocol, 14 tri-service sites were evaluated during 1998-2000. Sixteen system deficiency citations with 154 separate types of limitations were noted with problems involving the workstation, interfaces, and the Radiology Information System comprising more than 50% of the citations. Larger PACS deployments were associated with a higher number of deficiencies. The most commonly cited systems deficiencies were among the most expensive components of the PACS.

Large-scale PACS implementation.

PubMed

Carrino, J A; Unkel, P J; Miller, I D; Bowser, C L; Freckleton, M W; Johnson, T G

1998-08-01

The transition to filmless radiology is a much more formidable task than making the request for proposal to purchase a (Picture Archiving and Communications System) PACS. The Department of Defense and the Veterans Administration have been pioneers in the transformation of medical diagnostic imaging to the electronic environment. Many civilian sites are expected to implement large-scale PACS in the next five to ten years. This presentation will related the empirical insights gleaned at our institution from a large-scale PACS implementation. Our PACS integration was introduced into a fully operational department (not a new hospital) in which work flow had to continue with minimal impact. Impediments to user acceptance will be addressed. The critical components of this enormous task will be discussed. The topics covered during this session will include issues such as phased implementation, DICOM (digital imaging and communications in medicine) standard-based interaction of devices, hospital information system (HIS)/radiology information system (RIS) interface, user approval, networking, workstation deployment and backup procedures. The presentation will make specific suggestions regarding the implementation team, operating instructions, quality control (QC), training and education. The concept of identifying key functional areas is relevant to transitioning the facility to be entirely on line. Special attention must be paid to specific functional areas such as the operating rooms and trauma rooms where the clinical requirements may not match the PACS capabilities. The printing of films may be necessary for certain circumstances. The integration of teleradiology and remote clinics into a PACS is a salient topic with respect to the overall role of the radiologists providing rapid consultation. A Web-based server allows a clinician to review images and reports on a desk-top (personal) computer and thus reduce the number of dedicated PACS review workstations. This session will focus on effective strategies for a seamless transition. Critical issues involve maintaining a good working relationship with the vendor, cultivating personnel readiness and instituting well-defined support systems. Success depends on the ability to integrate the institutional directives, user expectations and available technologies. A team approach is mandatory for success.

PACS 2000: quality control using the task allocation chart

NASA Astrophysics Data System (ADS)

Norton, Gary S.; Romlein, John R.; Lyche, David K.; Richardson, Ronald R., Jr.

2000-05-01

Medical imaging's technological evolution in the next century will continue to include Picture Archive and Communication Systems (PACS) and teleradiology. It is difficult to predict radiology's future in the new millennium with both computed radiography and direct digital capture competing as the primary image acquisition methods for routine radiography. Changes in Computed Axial Tomography (CT) and Magnetic Resonance Imaging (MRI) continue to amaze the healthcare community. No matter how the acquisition, display, and archive functions change, Quality Control (QC) of the radiographic imaging chain will remain an important step in the imaging process. The Task Allocation Chart (TAC) is a tool that can be used in a medical facility's QC process to indicate the testing responsibilities of the image stakeholders and the medical informatics department. The TAC shows a grid of equipment to be serviced, tasks to be performed, and the organization assigned to perform each task. Additionally, skills, tasks, time, and references for each task can be provided. QC of the PACS must be stressed as a primary element of a PACS' implementation. The TAC can be used to clarify responsibilities during warranty and paid maintenance periods. Establishing a TAC a part of a PACS implementation has a positive affect on patient care and clinical acceptance.

Treatment of coal gasification wastewater by membrane bioreactor hybrid powdered activated carbon (MBR–PAC) system.

PubMed

Jia, Shengyong; Han, Hongjun; Hou, Baolin; Zhuang, Haifeng; Fang, Fang; Zhao, Qian

2014-12-01

A laboratory-scale membrane bioreactor hybrid powdered activated carbon (MBR–PAC) system was developed to treat coal gasification wastewater to enhance the COD, total phenols (TPh), NH4+ removals and migrate the membrane fouling. Since the MBR–PAC system operated with PAC dosage of 4 g L−1, the maximum removal efficiencies of COD, TPh and NH4+ reached 93%, 99% and 63%, respectively with the corresponding influent concentrations of 2.27 g L−1, 497 mg L−1 and 164 mg N L−1; the PAC extraction efficiencies of COD, TPh and NH4+ were 6%, 3% and 13%, respectively; the transmembrane pressure decreased 34% with PAC after 50 d operation. The results demonstrate that PAC played a key role in the enhancement of biodegradability and mitigation of membrane fouling.

[Change in process management by implementing RIS, PACS and flat-panel detectors].

PubMed

Imhof, H; Dirisamer, A; Fischer, H; Grampp, S; Heiner, L; Kaderk, M; Krestan, C; Kainberger, F

2002-05-01

Implementation of radiological information systems (RIS) and picture archiving and communicating systems (PACS) results in significant changes of workflow in a radiological department. Additional connection with flat-panel detectors leads to a shortening of the work process. RIS and PACS implementation alone reduces the complete workflow by 21-80%. With flatpanel technology the image production process is further shortened by 25-30%. The workflow-steps are changed from original 17-12 with the implementation of RIS and PACS and to 5 with the integrated use of flatpanels. This clearly recognizable advantages in the workflow need an according financial investment. Several studies could show that the capitalisation-factor calculated over eight years is positive, with a gain range between 5-25%. Whether the additional implementation of flatpanel detectors results also in a positive capitalisation over the years, cannot be estimated exactly, at the moment, because the experiences are too short. Particularly critical are the interfaces, which needs a constant quality control. Our flatpanel detector-system is fixed, special images--as we have them in about 3-5% of all cases--need still conventional filmscreen or phosphorplate-systems. Full-spine and long-leg examinations cannot be performed with sufficient exactness. Without any questions implementation of integrated RIS, PACS and flatpanel detector-system needs excellent training of the employees, because of the changes in workflow etc. The main profits of such an integrated implementation are an increase in quality in image and report datas, easier handling--there are almost no more cassettes necessary--and excessive shortening of workflow.

History of PACS in Asia.

PubMed

Inamura, Kiyonari; Kim, Jong Hyo

2011-05-01

First, history of PACS (picture archiving and communication system for medical use) in Japan is described in two parts: in part 1, the early stage of PACS development from 1984 to 2002, and in part 2 the matured stage from 2002 to 2010. PACS in Japan has been developed and installed by local manufacturers by their own technology and demand from domestic hospitals. Part 1 mainly focuses on quantitative growth and part 2 on qualitative change. In part 2, integration of PACS into RIS (radiology information system), HIS (hospital information system), EPR (electronic patient record), teleradiology and IHE (integrating healthcare enterprise) is reported. Interaction with other elements of technology such as moving picture network system and three dimensional display is also discussed. Present situation of main 4 large size hospitals is presented. Second, history of PACS in Korea is reported. Very acute climbing up of filmless PACS diffusion was observed from 1997 to 2000. The reasons for such evolution are described and discussed. Also changes of PACS installation and system integration with other systems such as HIS and role of them in radiological diagnoses in Korea since 2002 are described. Third, history in China is investigated by checking international academic journals in English and described as far as events are logically linked and consistently meaningful. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Automating PACS quality control with the Vanderbilt image processing enterprise resource

NASA Astrophysics Data System (ADS)

Esparza, Michael L.; Welch, E. Brian; Landman, Bennett A.

2012-02-01

Precise image acquisition is an integral part of modern patient care and medical imaging research. Periodic quality control using standardized protocols and phantoms ensures that scanners are operating according to specifications, yet such procedures do not ensure that individual datasets are free from corruption; for example due to patient motion, transient interference, or physiological variability. If unacceptable artifacts are noticed during scanning, a technologist can repeat a procedure. Yet, substantial delays may be incurred if a problematic scan is not noticed until a radiologist reads the scans or an automated algorithm fails. Given scores of slices in typical three-dimensional scans and widevariety of potential use cases, a technologist cannot practically be expected inspect all images. In large-scale research, automated pipeline systems have had great success in achieving high throughput. However, clinical and institutional workflows are largely based on DICOM and PACS technologies; these systems are not readily compatible with research systems due to security and privacy restrictions. Hence, quantitative quality control has been relegated to individual investigators and too often neglected. Herein, we propose a scalable system, the Vanderbilt Image Processing Enterprise Resource (VIPER) to integrate modular quality control and image analysis routines with a standard PACS configuration. This server unifies image processing routines across an institutional level and provides a simple interface so that investigators can collaborate to deploy new analysis technologies. VIPER integrates with high performance computing environments has successfully analyzed all standard scans from our institutional research center over the course of the last 18 months.

Characterization of ocular biometrics and aqueous humor dynamics in primary angle closure suspects.

PubMed

Guo, Li; Deng, Yuan; Fang, Li; Liu, Chaoqi; Guo, Tao

2017-02-01

Detailed characterizations of ocular biometrics and parameters of aqueous humor dynamics are lacking in primary angle closure suspect (PACS) patients. This study aims to characterize these parameters and compare them with age-matched healthy volunteers.Elderly healthy volunteers (60.6 ± 7.2 years of age, mean ± SD, n = 28) and PACS patients (64.1 ± 11.6 years, n = 30) completed the study. Parameters investigated were axial length (AXL), anterior chamber depth (ACD), anterior chamber volume (ACV), central cornea thickness (CCT), intraocular pressure (IOP), aqueous flow (Fa), outflow facility (C), episcleral venous pressure (EVP), and uveoscleral outflow (Fu). Comparisons and correlations were made between and within groups.In healthy volunteers, ocular biometric parameters, IOP, and EVP correlated very well between the 2 eyes of each individual, but Fa, C, and Fu were not significantly correlated. Biometric parameters of the PACS group significantly (P < 0.001) differed from those of the healthy controls: AXL (23.31 ± 1.03 mm [PACS] vs 22.39 ± 1.04 mm [Control]; mean ± SD), ACD (2.44 ± 0.33 mm [PACS] vs 1.86 ± 0.25 mm [Control]), ACV (136.0 ± 36.1 μL [PACS] vs 81.4 ± 21.8 μL [Control]), CCT (526.9 ± 37.0 μm [PACS] vs 556.1 ± 28.4 μm [Control]). There was no significant change in IOP, Fa, C, EVP, or Fu between Control and PACS. Furthermore, IOP showed no significant correlations with AXL, ACD, ACV, CCT, or C in both groups.The PACS eyes had a shorter AXL, a shallower ACD, and a smaller ACV, but a thicker CCT. Despite these morphological changes, the PACS eyes did not have any significant changes in IOP, and aqueous humor dynamics parameters. This is consistent with the findings that IOP did not show significant correlations with biometrics, or C.

In-house access to PACS images and related data through World Wide Web

NASA Astrophysics Data System (ADS)

Mascarini, Christian; Ratib, Osman M.; Trayser, Gerhard; Ligier, Yves; Appel, R. D.

1996-05-01

The development of a hospital wide PACS is in progress at the University Hospital of Geneva and several archive modules are operational since 1992. This PACS is intended for wide distribution of images to clinical wards. As the PACS project and the number of archived images grow rapidly in the hospital, it was necessary to provide an easy, more widely accessible and convenient access to the PACS database for the clinicians in the different wards and clinical units of the hospital. An innovative solution has been developed using tools such as Netscape navigator and NCSA World Wide Web server as an alternative to conventional database query and retrieval software. These tools present the advantages of providing an user interface which is the same independently of the platform being used (Mac, Windows, UNIX, ...), and an easy integration of different types of documents (text, images, ...). A strict access control has been added to this interface. It allows user identification and access rights checking, as defined by the in-house hospital information system, before allowing the navigation through patient data records.

Picture Archiving And Communication Systems (PACS): Introductory Systems Analysis Considerations

NASA Astrophysics Data System (ADS)

Hughes, Simon H. C.

1983-05-01

Two fundamental problems face any hospital or radiology department that is thinking about installing a Picture Archiving and Communications System (PACS). First, though the need for PACS already exists, much of the relevant technology is just beginning to be developed. Second, the requirements of each hospital are different, so that any attempts to market a single PACS design for use in large numbers of hospitals are likely to meet with the same problems as were experienced with general-purpose Hospital Information Systems. This paper outlines some of the decision processes involved in arriving at specifications for each module of a PACS and indicates design principles which should be followed in order to meet individual hospital requirements, while avoiding the danger of short-term systems obsolescence.

Product Related Advantages of a Structured PACS Architecture

PubMed Central

Greinacher, C.F.C.; Fuchs, D.; Perry, J.

1986-01-01

Most of the previously described PACS solutions are either developed and evaluated by the users themselves or they are pilot projects evaluated in close cooperation between a user and one or several manufacturers. Many of the prerequisites that will have to be met by future PACS are of minor interest in these pilot projects; e.g. minimization of costs, compatibility between different manufacturers' equipment, feasibility of systems engineering and customizing of a standard product, serviceability of different manufacturers' subsystems, stepwise introduction of the system into the daily routine and failsafety of the system. The paper shows a structured PACS architecture as a prerequisite to make PACS a high quality system from the user's point of view.

Current developments in departmental PACS for ultrasound.

PubMed

Grenier, L E; Eng, P

1995-01-01

1. INTRODUCTION TO DEPARTMENTAL PACS. Full or partial Departmental PACS is generally taken to mean an image management system focused on serving the needs of a specific modality or modality application. It will provide a modality specific means of image acquisition, specialized redisplay of images, distribution, and local long term storage of images. A Departmental PACS can be considered in isolation or as a component in a distributed Radiology PACS which consists of one or more departmental work groups on a back bone, potentially with shared resources. 2. DEPARTMENTAL PACS Issues Implementation of a Departmental PACS requires an in-depth knowledge of departmental clinical practice and work flow in all affected areas in the department, including patient intake, image collection, data routing, retrieval of previous image data, reporting, and long term data management and storage. Optimization of modality specific image display systems requires significant involvement from representative physician users. System architectures and user interfaces must be flexible enough to support the span of variation in clinical practice encountered in the site. A departmental PACS should offer a variety of "open" communications interfaces, both local and wide area, recognizing that outreach efforts are often driven by specific imaging departments. Interfaces to other departmental PAC systems and other information systems must be considered in order to facilitate institutions developing "Best of Breed" PACS systems. As hospitals move toward the integrated electronic medical record, means need to exist for a client process launched from a physician desktop to acquire images and/or reports from a departmental system. At minimum, HIS/RIS interfaces need to be considered to minimize re-keying of data and reduce data entry errors. 3. DESIGN OBJECTIVES FOR ALI ULTRAPACS. The key objectives were to design a product which could function either as a free standing PACS or as a departmental subnet on a larger PACS backbone, one which could function in a local or mixed local and wide area environment and one which could provide a cost effective implementation based on currently available technologies. 4. IMPLEMENTATION STRATEGIES. In order to attain the product design objectives, ALI made the following critical implementation decisions: 1) to build the UltraPACS application as a suite of separable UNIX processes based on a message passing client server model; 2) to host the application and operating system on a Digital Equipment Corporation PC using an Intel microprocessor because of the competition and broad variety of suppliers in the PC arena; and 3) to use NEXTSTEP as the UNIX variant of choice because of NEXTSTEPUs strong object orientation, superb development tools, and the excellent integration between the Graphical User Interface level and the underlying operating system layers. 5. CONCLUSION. ALI is convinced that a departmental approach to PACS offers significant advantages over monolithic PACS in several key areas including: optimization for modality specific clinical practice and workflow, cost effectiveness, the potential for an institution to implement PACS in a stepwise fashion, starting with the department with the potential for the greatest savings, and the capability for an institution to build a "best of breed" solution for large scale PACS.

Picture archiving and communication systems (PACS).

PubMed

Gamsu, Gordon; Perez, Enrico

2003-07-01

Over the past 2 decades, groups of computer scientists, electronic design engineers, and physicians, in universities and industry, have worked to achieve an electronic environment for the practice of medicine and radiology. The radiology component of this revolution is often called PACS (picture archiving and communication systems). More recently it has become evident that the efficiencies and cost savings of PACS are realized when they are part of an enterprise-wide electronic medical record. The installation of PACS requires careful planning by all the various stakeholds over many months prior to installation. All of the users must be aware of the initial disruption that will occur as they become familiar with the systems. Modern fourth generation PACS is linked to radiology and hospital information systems. The PACS consist of electronic acquisition sites-a robust network intelligently managed by a server, multiple viewing sites, and an archive. The details of how these are linked and their workflow analysis determines the success of PACS. PACS evolves over time, components are frequently replaced, and so the users must expect continuous learning about new updates and improved functionality. The digital medical revolution is rapidly being adopted in many medical centers, improving patient care and the success of the institution.

Natural Organic Matter Removal and Fouling in a Low Pressure Hybrid Membrane Systems

PubMed Central

Uyak, Vedat; Akdagli, Muge; Cakmakci, Mehmet; Koyuncu, Ismail

2014-01-01

The objective of this study was to investigate powdered activated carbon (PAC) contribution to natural organic matter (NOM) removal by a submerged MF and UF hybrid systems. It was found that filtration of surface waters by a bare MF and UF membranes removed negligible TOC; by contrast, significant amounts of TOC were removed when daily added PAC particles were predeposited on the membrane surfaces. These results support the assumption that the membranes surface properties and PAC layer structure might have considerably influential factor on NOM removal. Moreover, it was concluded that the dominant removal mechanism of hybrid membrane system is adsorption of NOM within PAC layer rather than size exclusion of NOM by both of membrane pores. Transmembrane pressure (TMP) increases with PAC membrane systems support the view that PAC adsorption pretreatment will not prevent the development of membrane pressure; on the contrary, PAC particles themselves caused membrane fouling by blocking the entrance of pores of MF and UF membranes. Although all three source waters have similar HPI content, it appears that the PAC interaction with the entrance of membrane pores was responsible for offsetting the NOM fractional effects on membrane fouling for these source waters. PMID:24523651

Overview of PACS

NASA Astrophysics Data System (ADS)

Vanden Brink, John A.

1995-08-01

Development of the DICOM standard and incremental developments in workstation, network, compression, archiving, and digital x-ray technology have produced cost effective image communication possibilities for selected medical applications. The emerging markets include modality PACS, mini PACS, and teleradiology. Military and VA programs lead the way in the move to adopt PACS technology. Commercial markets for PACS components and PAC systems are at LR400 million growing to LR500 million in 1996.

Future trends in picture archiving and communication system (PACS)

NASA Astrophysics Data System (ADS)

Al-Hajeri, Mona; Clarke, Malcolm

2015-03-01

Objective: This research investigates the needs and opinions of radiologists on the use of enhanced information technologies and approaches to improve the functionality of Picture Archiving and Communication Systems (PACS). Method: Six interviews were conducted in the main governmental hospital in Kuwait (AL-Sabah Hospital) with radiologists, including two senior radiologists, two junior radiologists, and two trainee radiologists undertaking the Irish radiology board. Results: The radiologists identified a number of limitations that exist in current PACS and requirements to enhance usability and functionality. However, it was the case that some of the radiologists had little knowledge about the advanced trends in PACS. Four themes emerged from the thematic analysis of the data: (1) limitations of traditional PACS; (2) Features and requirements that can increase PACS functionality; (3) web based solutions of PACS; (4) PACS in mobile phones. Conclusion: It is widely recognized that PACS has limitations. This research has identified themes that, when incorporated, will enhance the functionality of PACS and provide better quality clinical practice. This research has determined the important future trends of PACS. Primarily web based solutions and use in mobile phones. The findings from this research can be used as recommendations to vendors, for product development and medical institutes to consider when undertaking implementation of PACS and training future radiologists.

ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT, C. LEE COOK DIVISION, DOVER CORPORATION, STATIC PAC (TM) SYSTEM, PHASE II REPORT

EPA Science Inventory

The Environmental Technology Verification report discusses the technology and performance of the Static Pac System, Phase II, natural gas reciprocating compressor rod packing manufactured by the C. Lee Cook Division, Dover Corporation. The Static Pac System is designed to seal th...

Siemens experience in PACS

NASA Astrophysics Data System (ADS)

Hall, Charles L.; Perry, John H.

1990-08-01

Experience from ten years in Picture Archiving and Communication Systems has led to a clearer understanding of the user, system, and component requirements for PACS, and the evolving market. This paper reports on one manufacturer's considerations and experiences as a PACS supplier.

Picture Archiving and Communication System (PACS) implementation, integration & benefits in an integrated health system.

PubMed

Mansoori, Bahar; Erhard, Karen K; Sunshine, Jeffrey L

2012-02-01

The availability of the Picture Archiving and Communication System (PACS) has revolutionized the practice of radiology in the past two decades and has shown to eventually increase productivity in radiology and medicine. PACS implementation and integration may bring along numerous unexpected issues, particularly in a large-scale enterprise. To achieve a successful PACS implementation, identifying the critical success and failure factors is essential. This article provides an overview of the process of implementing and integrating PACS in a comprehensive health system comprising an academic core hospital and numerous community hospitals. Important issues are addressed, touching all stages from planning to operation and training. The impact of an enterprise-wide radiology information system and PACS at the academic medical center (four specialty hospitals), in six additional community hospitals, and in all associated outpatient clinics as well as the implications on the productivity and efficiency of the entire enterprise are presented. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

Business Model for the Security of a Large-Scale PACS, Compliance with ISO/27002:2013 Standard.

PubMed

Gutiérrez-Martínez, Josefina; Núñez-Gaona, Marco Antonio; Aguirre-Meneses, Heriberto

2015-08-01

Data security is a critical issue in an organization; a proper information security management (ISM) is an ongoing process that seeks to build and maintain programs, policies, and controls for protecting information. A hospital is one of the most complex organizations, where patient information has not only legal and economic implications but, more importantly, an impact on the patient's health. Imaging studies include medical images, patient identification data, and proprietary information of the study; these data are contained in the storage device of a PACS. This system must preserve the confidentiality, integrity, and availability of patient information. There are techniques such as firewalls, encryption, and data encapsulation that contribute to the protection of information. In addition, the Digital Imaging and Communications in Medicine (DICOM) standard and the requirements of the Health Insurance Portability and Accountability Act (HIPAA) regulations are also used to protect the patient clinical data. However, these techniques are not systematically applied to the picture and archiving and communication system (PACS) in most cases and are not sufficient to ensure the integrity of the images and associated data during transmission. The ISO/IEC 27001:2013 standard has been developed to improve the ISM. Currently, health institutions lack effective ISM processes that enable reliable interorganizational activities. In this paper, we present a business model that accomplishes the controls of ISO/IEC 27002:2013 standard and criteria of security and privacy from DICOM and HIPAA to improve the ISM of a large-scale PACS. The methodology associated with the model can monitor the flow of data in a PACS, facilitating the detection of unauthorized access to images and other abnormal activities.

Towards a theory of PACS deployment: an integrative PACS maturity framework.

PubMed

van de Wetering, Rogier; Batenburg, Ronald

2014-06-01

Owing to large financial investments that go along with the picture archiving and communication system (PACS) deployments and inconsistent PACS performance evaluations, there is a pressing need for a better understanding of the implications of PACS deployment in hospitals. We claim that there is a gap in the research field, both theoretically and empirically, to explain the success of the PACS deployment and maturity in hospitals. Theoretical principles are relevant to the PACS performance; maturity and alignment are reviewed from a system and complexity perspective. A conceptual model to explain the PACS performance and a set of testable hypotheses are then developed. Then, structural equation modeling (SEM), i.e. causal modeling, is applied to validate the model and hypotheses based on a research sample of 64 hospitals that use PACS, i.e. 70 % of all hospitals in the Netherlands. Outcomes of the SEM analyses substantiate that the measurements of all constructs are reliable and valid. The PACS alignment-modeled as a higher-order construct of five complementary organizational dimensions and maturity levels-has a significant positive impact on the PACS performance. This result is robust and stable for various sub-samples and segments. This paper presents a conceptual model that explains how alignment in deploying PACS in hospitals is positively related to the perceived performance of PACS. The conceptual model is extended with tools as checklists to systematically identify the improvement areas for hospitals in the PACS domain. The holistic approach towards PACS alignment and maturity provides a framework for clinical practice.

A Socio-technical assessment of the success of picture archiving and communication systems: the radiology technologist’s perspective

PubMed Central

2013-01-01

Background With the increasing prevalence of Picture Archiving and Communication Systems (PACS) in healthcare institutions, there is a growing need to measure their success. However, there is a lack of published literature emphasizing the technical and social factors underlying a successful PACS. Methods An updated Information Systems Success Model was utilized by radiology technologists (RTs) to evaluate the success of PACS at a large medical center in Taiwan. A survey, consisting of 109 questionnaires, was analyzed by Structural Equation Modeling. Results Socio-technical factors (including system quality, information quality, service quality, perceived usefulness, user satisfaction, and PACS dependence) were proven to be effective measures of PACS success. Although the relationship between service quality and perceived usefulness was not significant, other proposed relationships amongst the six measurement parameters of success were all confirmed. Conclusions Managers have an obligation to improve the attributes of PACS. At the onset of its deployment, RTs will have formed their own subjective opinions with regards to its quality (system quality, information quality, and service quality). As these personal concepts are either refuted or reinforced based on personal experiences, RTs will become either satisfied or dissatisfied with PACS, based on their perception of its usefulness or lack of usefulness. A satisfied RT may play a pivotal role in the implementation of PACS in the future. PMID:24053458

Picture archiving and communication system developments expected in the 1990s

NASA Astrophysics Data System (ADS)

Drew, Philip G.; Lorah, Lawrence D.; Lydon, Michael J.; Novak, Elliott D.

1993-01-01

Among the applications for high-bandwidth systems are medical picture archiving and communication systems (PACS). Viewed in the light of developments anticipated ten years ago when these systems were first discussed, progress has been disappointingly slow. However, with the recognition that teleradiology, digital archives, and computed radiography can be regarded as PAC subsystems, and that systems confined to a single modality can be regarded as mini-PACS, it becomes clear that development of PAC systems has made remarkable progress. Growing from modest size today, the markets for PAC systems and subsystems in the U.S. is likely to exceed $600 million by the end of the decade, a market of the same magnitude as those for CT, MRI, and catheterization lab equipment. This paper discusses the forces that have stimulated growth of PAC systems - among them, the opportunity to provide better service to patients and referring physicians, a chance to expand effective service area, and a possible solution to the ubiquitous problems of lost films - as well as the impediments that have retarded growth - among them, technical limitations, especially of the radiologists' workstations, and cost. A review of these forces allows prediction of likely developments in the 1990s.

Clinical experience with PACS at Northwestern: year two

NASA Astrophysics Data System (ADS)

Channin, David S.; Hawkins, Rodney C.; Enzmann, Dieter R.

2001-08-01

We have previously described the PACS configuration at Northwestern Memorial Hospital (NMH). As opposed to an imaging modality, PACS is an evolving system that continuously grows and changes to meet the needs of the institution. The NMH PACS has grown significantly in the past year and has undergone significant architectural enhancements. This growth and evolutionary change will be described and discussed. The system now contains over 339,000 studies consisting of over 13 million images. There are now two short-term RAID storage units that provide for twice as much fast storage. There are also two magneto-optical disk jukeboxes providing long-term archive. We have deployed a redundant database to improve reliability of the system in the event of database failure. The number of modalities connected to the system has increased and will be summarized. Statistics describing utilization of the PACS will be shown. Lastly, we will discuss our plans for exploiting the application service provider model in our PACS environment.

Electronic integrated disease surveillance system and pathogen asset control system.

PubMed

Wahl, Tom G; Burdakov, Aleksey V; Oukharov, Andrey O; Zhilokov, Azamat K

2012-06-20

Electronic Integrated Disease Surveillance System (EIDSS) has been used to strengthen and support monitoring and prevention of dangerous diseases within One Health concept by integrating veterinary and human surveillance, passive and active approaches, case-based records including disease-specific clinical data based on standardised case definitions and aggregated data, laboratory data including sample tracking linked to each case and event with test results and epidemiological investigations. Information was collected and shared in secure way by different means: through the distributed nodes which are continuously synchronised amongst each other, through the web service, through the handheld devices. Electronic Integrated Disease Surveillance System provided near real time information flow that has been then disseminated to the appropriate organisations in a timely manner. It has been used for comprehensive analysis and visualisation capabilities including real time mapping of case events as these unfold enhancing decision making. Electronic Integrated Disease Surveillance System facilitated countries to comply with the IHR 2005 requirements through a data transfer module reporting diseases electronically to the World Health Organisation (WHO) data center as well as establish authorised data exchange with other electronic system using Open Architecture approach. Pathogen Asset Control System (PACS) has been used for accounting, management and control of biological agent stocks. Information on samples and strains of any kind throughout their entire lifecycle has been tracked in a comprehensive and flexible solution PACS.Both systems have been used in a combination and individually. Electronic Integrated Disease Surveillance System and PACS are currently deployed in the Republics of Kazakhstan, Georgia and Azerbaijan as a part of the Cooperative Biological Engagement Program (CBEP) sponsored by the US Defense Threat Reduction Agency (DTRA).

Diagnostic report acquisition unit for the Mayo/IBM PACS project

NASA Astrophysics Data System (ADS)

Brooks, Everett G.; Rothman, Melvyn L.

1991-07-01

The Mayo Clinic and IBM Rochester have jointly developed a picture archive and control system (PACS) for use with Mayo's MRI and Neuro-CT imaging modalities. One of the challenges of developing a useful PACS involves integrating the diagnostic reports with the electronic images so they can be displayed simultaneously. By the time a diagnostic report is generated for a particular case, its images have already been captured and archived by the PACS. To integrate the report with the images, the authors have developed an IBM Personal System/2 computer (PS/2) based diagnostic report acquisition unit (RAU). A typed copy of the report is transmitted via facsimile to the RAU where it is stacked electronically with other reports that have been sent previously but not yet processed. By processing these reports at the RAU, the information they contain is integrated with the image database and a copy of the report is archived electronically on an IBM Application System/400 computer (AS/400). When a user requests a set of images for viewing, the report is automatically integrated with the image data. By using a hot key, the user can toggle on/off the report on the display screen. This report describes process, hardware, and software employed to integrate the diagnostic report information into the PACS, including how the report images are captured, transmitted, and entered into the AS/400 database. Also described is how the archived reports and their associated medical images are located and merged for retrieval and display. The methods used to detect and process error conditions are also discussed.

Surgical PACS for the digital operating room. Systems engineering and specification of user requirements.

PubMed

Korb, Werner; Bohn, Stefan; Burgert, Oliver; Dietz, Andreas; Jacobs, Stephan; Falk, Volkmar; Meixensberger, Jürgen; Strauss, Gero; Trantakis, Christos; Lemke, Heinz U

2006-01-01

For better integration of surgical assist systems into the operating room, a common communication and processing plattform that is based on the users needs is needed. The development of such a system, a Surgical Picture Aquisition and Communication System (S-PACS), according the systems engineering cycle is oulined in this paper. The first two steps (concept and specification) for the engineering of the S-PACS are discussed.A method for the systematic integration of the users needs', the Quality Function Deployment (QFD), is presented. The properties of QFD for the underlying problem and first results are discussed. Finally, this leads to a first definition of an S-PACS system.

Mercury control in 2009

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sjostrom, S.; Durham, M.; Bustard, J.

2009-07-15

Although activated carbon injection (ACI) has been proven to be effective for many configurations and is a preferred option at many plants sufficient quantities of powdered activated coking (PAC) must be available to meet future needs. The authors estimate that upcoming federal and state regulations will result in tripling the annual US demand for activated carbon to nearly 1.5 billion lb from approximately 450 million lb. Rapid expansion of US production capacity is required. Many PAC manufacturers are discussing expansion of their existing production capabilities. One company, ADA Carbon Solutions, is in the process of constructing the largest activated carbonmore » facility in North America to meet the future demand for PAC as a sorbent for mercury control. Emission control technology development and commercialization is driven by regulation and legislation. Although ACI will not achieve > 90% mercury control at every plant, the expected required MACT legislation level, it offers promise as a low-cost primary mercury control technology option for many configurations and an important trim technology for others. ACI has emerged as the clear mercury-specific control option of choice, representing over 98% of the commercial mercury control system orders to date. As state regulations are implemented and the potential for a federal rule becomes more imminent, suppliers are continuing to develop technologies to improve the cost effectiveness and limit the balance of plant impacts associated with ACI and are developing additional PAC production capabilities to ensure that the industry's needs are met. The commercialisation of ACI is a clear example of industry, through the dedication of many individuals and companies with support from the DOE and EPRI, meeting the challenge of developing cost-effectively reducing emissions from coal-fired power plants. 7 refs., 1 fig.« less

User Acceptance of Picture Archiving and Communication System in the Emergency Department.

PubMed

Goodarzi, Hassan; Khatami, Seyed-Masoud; Javadzadeh, Hammidreza; Mahmoudi, Sadrollah; Khajehpour, Hojjatollah; Heidari, Soleiman; Khodaparast, Morteza; Ebrahimi, Ali; Rasouli, Hamidreza; Ghane, Mohammadreza; Faraji, Mehrdad; Hassanpour, Kasra

2016-04-01

Picture archiving and communication system (PACS) has allowed the medical images to be transmitted, stored, retrieved, and displayed in different locations of a hospital or health system. Using PACS in the emergency department will eventually result in improved efficiency and patient care. In spite of the abundant benefits of employing PACS, there are some challenges in implementing this technology like users' resistance to accept the technology, which has a critical role in PACS success. In this study, we will assess and compare user acceptance of PACS in the emergency departments of three different hospitals and investigate the effect of socio-demographic factors on this acceptance. A variant of technology acceptance model (TAM) has been used in order to measure the acceptance level of PACS in the emergency department of three educational hospitals in Iran. A previously used questionnaire was validated and utilized to collect the study data. A stepwise multiple regression model was used to predict factors influencing acceptance score as the dependent variable. Mean age of participants was 32.9 years (standard deviation [SD] = 6.08). Participants with the specialty degree got a higher acceptance score than the three other groups (Mean ± SD = 4.17 ± 0.20). Age, gender, degree of PACS usage and participant's occupation (profession) did not influence the acceptance score. In our multiple regression model, all three variables of perceived usefulness (PU), perceived ease of use (PEU) and the effect of PACS (change) had a significant effect in the prediction of acceptance. The most influencing factor was change with the beta of 0.22 (P value < 0.001). PACS is highly accepted in all three emergency departments especially among specialists. PU, PEU and change are factors influencing PACS acceptance. Our study can be used as an evidence of PACS acceptance in emergency wards.

Autoantibodies against Modified Histone Peptides in SLE Patients Are Associated with Disease Activity and Lupus Nephritis

PubMed Central

Dieker, Jürgen; Berden, Jo H.; Bakker, Marinka; Briand, Jean-Paul; Muller, Sylviane; Voll, Reinhard; Sjöwall, Christopher; Herrmann, Martin; Hilbrands, Luuk B.; van der Vlag, Johan

2016-01-01

Persistent exposure of the immune system to death cell debris leads to autoantibodies against chromatin in patients with systemic lupus erythematosus (SLE). Deposition of anti-chromatin/chromatin complexes can instigate inflammation in multiple organs including the kidney. Previously we identified specific cell death-associated histone modifications as targets of autoantibodies in SLE. In this study we addressed, in a large cohort of SLE patients and controls, the question whether plasma reactivities with specific histone peptides associated with serology and clinical features. Plasma from SLE patients with and without lupus nephritis, disease controls, and healthy controls, were tested in ELISA with histone H4 peptide acetylated at lysines 8, 12 and 16 (H4pac), H2B peptide acetylated at lysine 12 (H2Bpac), H3 peptide trimethylated at lysine 27 (H3pme), and their unmodified equivalents. SLE patients displayed a higher reactivity with the modified equivalent of each peptide. Reactivity with H4pac showed both a high sensitivity (89%) and specificity (91%) for SLE, while H2Bpac exhibited a high specificity (96%) but lower sensitivity (69%). Reactivity with H3pme appeared not specific for SLE. Anti-H4pac and anti-H2Bpac reactivity demonstrated a high correlation with disease activity. Moreover, patients reacting with multiple modified histone peptides exhibited higher SLEDAI and lower C3 levels. SLE patients with renal involvement showed higher reactivity with H2B/H2Bpac and a more pronounced reactivity with the modified equivalent of H3pme and H2Bpac. In conclusion, reactivity with H4pac and H2Bpac is specific for SLE patients and correlates with disease activity, whereas reactivity with H2Bpac is in particular associated with lupus nephritis. PMID:27780265

Plasma renin activity to plasma aldosterone concentration ratio correlates with night-time and pulse pressures in essential hypertensive patients treated with angiotensin-converting enzyme inhibitors/AT1 blockers.

PubMed

Spannella, Francesco; Giulietti, Federico; Balietti, Paolo; Borioni, Elisabetta; Lombardi, Francesca E; Ricci, Maddalena; Cocci, Guido; Landi, Laura; Sarzani, Riccardo

2017-11-01

Angiotensin-converting enzyme inhibitors (ACE-I) and AT1 blockers (ARB) are commonly used antihypertensive drugs, but several factors may affect their effectiveness. We evaluated the associations between ambulatory blood pressure (BP) monitoring (ABPM) parameters and plasma renin activity (PRA)-to-plasma aldosterone concentration (PAC) ratio (RAR) to test renin-angiotensin-aldosterone system inhibition in essential hypertensive patients treated with ACE-I or ARB for at least 12 months. We evaluated 194 consecutive patients referred to our Hypertension Centre. ABPM, PRA and PAC tests were performed without any changes in drug therapy. RAR, PRA and PAC tertiles were considered for the analyses. Mean age: 57.4 ± 12.0 years; male prevalence: 63.9%. No differences between RAR tertiles regarding the use of ACE-I or ARB (P = 0.385), as well as the other antihypertensive drug classes, were found. A reduction of all ABPM values considered (24-h BP, daytime BP and night-time BP and 24-h pulse pressure (PP), daytime PP and night-time PP) and a better BP control were observed at increasing RAR tertiles, with an odds ratio = 0.12 to be not controlled during night-time period for patients in the third tertile compared with patients in the first tertile (P < 0.001). This association remained significant even after adjusting for 24-h BP control. All the associations were also confirmed for PRA tertiles, but not for PAC tertiles. Higher RAR values indicate effective renin-angiotensin-aldosterone system inhibition and lower night-time and pulse pressures in real-life clinical practice. It could be a useful biomarker in the management of essential hypertensive patients treated with ACE-I or ARB.

Factors causing PAC cake fouling in PAC-MF (powdered activated carbon-microfiltration) water treatment systems.

PubMed

Zhao, P; Takizawa, S; Katayama, H; Ohgaki, S

2005-01-01

Two pilot-scale powdered activated carbon-microfiltration (PAC-MF) reactors were operated using river water pretreated by a biofilter. A high permeate flux (4 m/d) was maintained in two reactors with different particle sizes of PAC. High concentration (20 g/L) in the PAC adsorption zone demonstrated 60-80% of organic removal rates. Analysis on the PAC cake fouling demonstrated that attached metal ions play more important role than organic matter attached on PAC to the increase of PAC cake resistance. Effects of factors which may cause PAC cake fouling in PAC-MF process were investigated and evaluated by batch experiments, further revealing that small particulates and metal ions in raw water impose prominent influence on the PAC cake layer formation. Fe (II) precipitates after being oxidized to Fe (III) during PAC adsorption and thus Fe(ll) colloids display more significant effect than other metal ions. At a high flux, PAC cake layer demonstrated a higher resistance with larger PAC due to association among colloids, metals and PAC particles, and easy migration of small particles in raw water into the void space in the PAC cake layer. Larger PAC possesses much more non-uniform particle size distribution and larger void space, making it easier for small colloids to migrate into the voids and for metal ions to associate with PAC particles by bridge effect, hence speeding up and intensifying the of PAC cake fouling on membrane surface.

Informatics in radiology (infoRAD): A complete continuous-availability PACS archive server.

PubMed

Liu, Brent J; Huang, H K; Cao, Fei; Zhou, Michael Z; Zhang, Jianguo; Mogel, Greg

2004-01-01

The operational reliability of the picture archiving and communication system (PACS) server in a filmless hospital environment is always a major concern because server failure could cripple the entire PACS operation. A simple, low-cost, continuous-availability (CA) PACS archive server was designed and developed. The server makes use of a triple modular redundancy (TMR) system with a simple majority voting logic that automatically identifies a faulty module and removes it from service. The remaining two modules continue normal operation with no adverse effects on data flow or system performance. In addition, the server is integrated with two external mass storage devices for short- and long-term storage. Evaluation and testing of the server were conducted with laboratory experiments in which hardware failures were simulated to observe recovery time and the resumption of normal data flow. The server provides maximum uptime (99.999%) for end users while ensuring the transactional integrity of all clinical PACS data. Hardware failure has only minimal impact on performance, with no interruption of clinical data flow or loss of data. As hospital PACS become more widespread, the need for CA PACS solutions will increase. A TMR CA PACS archive server can reliably help achieve CA in this setting. Copyright RSNA, 2004

Prostate cancer: from Gleason scoring to prognostic grade grouping.

PubMed

Montironi, Rodolfo; Santoni, Matteo; Mazzucchelli, Roberta; Burattini, Luciano; Berardi, Rossana; Galosi, Andrea B; Cheng, Liang; Lopez-Beltran, Antonio; Briganti, Alberto; Montorsi, Francesco; Scarpelli, Marina

2016-01-01

The Gleason grading system was developed in the late 1960s by Dr. Donald F. Gleason. Due to changes in prostatic adenocarcinoma (PAC) detection and treatment, newer technologies to better characterize prostatic pathology, subsequently described variants of PAC and further data relating various morphologic patterns to prognosis, the application of the Gleason grading system changed substantially in surgical pathology. First in 2005 and more recently in 2014, consensus conferences were held to update PAC grading. Here, we review of the successive changes in the grading of PAC from the original system, with emphasis on the newest prognostic grade grouping.

Interpretation of digital breast tomosynthesis: preliminary study on comparison with picture archiving and communication system (PACS) and dedicated workstation.

PubMed

Kim, Young Seon; Chang, Jung Min; Yi, Ann; Shin, Sung Ui; Lee, Myung Eun; Kim, Won Hwa; Cho, Nariya; Moon, Woo Kyung

2017-08-01

To compare the diagnostic accuracy and efficiency in the interpretation of digital breast tomosynthesis (DBT) images using a picture archiving and communication system (PACS) and a dedicated workstation. 97 DBT images obtained for screening or diagnostic purposes were stored in both a workstation and a PACS and evaluated in combination with digital mammography by three independent radiologists retrospectively. Breast Imaging-Reporting and Data System final assessments and likelihood of malignancy (%) were assigned and the interpretation time when using the workstation and PACS was recorded. Receiver operating characteristic curve analysis, sensitivities and specificities were compared with histopathological examination and follow-up data as a reference standard. Area under the receiver operating characteristic curve values for cancer detection (0.839 vs 0.815, p = 0.6375) and sensitivity (81.8% vs 75.8%, p = 0.2188) showed no statistically significant differences between the workstation and PACS. However, specificity was significantly higher when analysing on the workstation than when using PACS (83.7% vs 76.9%, p = 0.009). When evaluating DBT images using PACS, only one case was deemed necessary to be reanalysed using the workstation. The mean time to interpret DBT images on PACS (1.68 min/case) was significantly longer than that to interpret on the workstation (1.35 min/case) (p < 0.0001). Interpretation of DBT images using PACS showed comparable diagnostic performance to a dedicated workstation, even though it required a longer reading time. Advances in knowledge: Interpretation of DBT images using PACS is an alternative to evaluate the images when a dedicated workstation is not available.

With great control comes great responsibility: the relationship between perceived academic control, student responsibility, and self-regulation.

PubMed

Fishman, Evan J

2014-12-01

Students' perceived control over academic outcomes has been linked to their use of self-regulated strategies. However, students' sense of responsibility, or internal commitment to produce such outcomes, has not often been considered in this relationship. The purpose of this study was to examine the relationships between perceived academic control (PAC), student responsibility (SR), and knowledge building (KB). Participants were 152 undergraduate students enrolled in an educational technology course. An exploratory factor analysis was conducted to demonstrate the distinction between the PAC and SR constructs. A series of regression analyses were conducted to address the research hypotheses, and a bootstrap test was used to assess the mediating role of SR in the relationship between the PAC variables and KB. Initial evidence regarding the uniqueness of the PAC and SR constructs was provided. PAC (both primary control and secondary control [SC]) were positively and significantly related to SR. KB was positively and significantly related to SR, as was SC. Additionally, SR partially mediated the relationship between the PAC variables and KB. The findings showed that those who perceived the capability to achieve academic outcomes were more likely to feel internally obligated to produce such outcomes. The same was true for students who perceived the capability to psychologically adjust to academic situations. The results also demonstrated that students' sense of responsibility for academic outcomes played a partially mediating role in the relationship between their perceptions of control and reported use of self-regulated behaviour. © 2014 The British Psychological Society.

Long term operation of high concentration powdered activated carbon membrane bio-reactor for advanced water treatment.

PubMed

Seo, G T; Moon, C D; Chang, S W; Lee, S H

2004-01-01

A pilot scale experiment was conducted to evaluate the performance of a membrane bioreactor filled with high concentration powdered activated carbon. This hybrid system has great potential to substitute for existing GAC or O3/BAC processes in the drinking water treatment train. The system was installed at a water treatment plant located downstream of the Nakdong river basin, Korea. Effluent of rapid sand filter was used as influent of the system which consists of PAC bio-reactor, submerged MF membrane module and air supply facility. PAC concentration of 20 g/L was maintained at the beginning of the experiment and it was increased to 40 g/L. The PAC has not been changed during the operational periods. The membrane was a hollow fiber type with pore sizes of 0.1 and 0.4 microm. It was apparent that the high PAC concentration could prevent membrane fouling. 40 g/L PAC was more effective to reduce the filtration resistance than 20 g/L. At the flux of 0.36 m/d, TMP was maintained less than 40 kPa for about 3 months by intermittent suction type operation (12 min suction/3 min idling). Adsorption was the dominant role to remove DOC at the initial operational period. However the biological effect was gradually increased after around 3 months operation. Constant DOC removal could be maintained at about 40% without any trouble and then a tremendous reduction of DBPs (HAA5 and THM) higher than 85% was achieved. Full nitrification was observed at the controlled influent ammonia nitrogen concentration of 3 and 7 mg/L. pH was an important parameter to keep stable ammonia oxidation. From almost two years of operation, it is clear that the PAC membrane bioreactor is highly applicable for advanced water treatment under the recent situation of more stringent DBPs regulation in Korea.

Transforming medical imaging applications into collaborative PACS-based telemedical systems

NASA Astrophysics Data System (ADS)

Maani, Rouzbeh; Camorlinga, Sergio; Arnason, Neil

2011-03-01

Telemedical systems are not practical for use in a clinical workflow unless they are able to communicate with the Picture Archiving and Communications System (PACS). On the other hand, there are many medical imaging applications that are not developed as telemedical systems. Some medical imaging applications do not support collaboration and some do not communicate with the PACS and therefore limit their usability in clinical workflows. This paper presents a general architecture based on a three-tier architecture model. The architecture and the components developed within it, transform medical imaging applications into collaborative PACS-based telemedical systems. As a result, current medical imaging applications that are not telemedical, not supporting collaboration, and not communicating with PACS, can be enhanced to support collaboration among a group of physicians, be accessed remotely, and be clinically useful. The main advantage of the proposed architecture is that it does not impose any modification to the current medical imaging applications and does not make any assumptions about the underlying architecture or operating system.

How to satisfy both clinical and information technology goals in designing a successful picture archiving and communication system.

PubMed

Beird, L C

2000-05-01

Designing and operating a PACS system requires an integrated focus to maintain peak performance of the system from an information technology (IT) perspective and to ensure that all clinical and financial requirements are met. An IT-based picture archiving and communication system (PACS) manager is in the best position to satisfy these sometime conflicting audiences. This report will describe how an institution moving towards PACS can unite radiologists, hospital administrators, and information systems (IS)/IT specialists into one cohesive team to ensure the highest levels of success with their future PACS. There are several keys to success: (1) Designing and selecting PACS requires a dedicated team, with representatives from radiology, as well as IS/IT and administration. (2) Each group needs to thoroughly outline their specific needs, so that the final PACS solution is relevant from all perspectives. This needs assessment needs to be made before issuing a request for proposal (RFP) and interviewing vendors. (3) The team needs to be small to be effective. Each group should have one or at most two representatives that collect input from, and report to, a group of his or her peers. (4) Plans need to be made to determine how to integrate current and future hospital information systems (HIS), in order to ensure a smooth pathway to the electronic medical record. (5) All team members should agree on the overall objectives for PACS and participate in its design and installation. (6) Each team member is charged with motivating, and helping to educate, his or her peers. (7) Training should be tailored to the needs of each audience. Explain how each staff member benefits from the PACS. Training should be ongoing to accommodate the addition of new system features and new users. This report will describe the importance of recognizing PACS as being an IT system with a clinical focus. The importance of designing goals of the PACS system from various perspectives, including clinical, technical, and financial, will be addressed. More importantly, this presentation will highlight the benefits a medical institution will receive if the various groups can work together, while at the same time outlining some pitfalls they can expect to encounter if the groups take an adversarial approach.

Evolution of filmless PACS in Korea

NASA Astrophysics Data System (ADS)

Choi, Hyung-Sik

2002-05-01

The growth of PACS (Picture Archiving and Communications System) market in Korea over the past 10 years is a brilliant development. In order to reach these brilliant achievements, the efforts of the Korean Society of PACS, the supports of the government on the information technology industry and the efforts of PACS companies in market expansion were all served as vital manures of the sowing time. By the end of 2001, 21% of the total Korean hospitals were under the clinical operation using filmless full PACS and it is believed to be the first incident in the world. The purpose of this paper is to look back upon the growing process of filmless PACS in Korea and analyze the cause of this tremendous growth. I believe that the Korean PACS experience would be helpful to many PACS experts who pray for a proliferation of PACS distribution.

Ergonomic design in the operating room: information technologies

NASA Astrophysics Data System (ADS)

Morita, Mark M.; Ratib, Osman

2005-04-01

The ergonomic design in the Surgical OR of information technology systems has been and continues to be a large problem. Numerous disparate information systems with unique hardware and display configurations create an environment similar to the chaotic environments of air traffic control. Patient information systems tend to show all available statistics making it difficult to isolate the key, relevant vitals for the patient. Interactions in this sterile environment are still being done with the traditional keyboard and mouse designed for cubicle office workflows. This presentation will address the shortcomings of the current design paradigm in the Surgical OR that relate to Information Technology systems. It will offer a perspective that addresses the ergonomic deficiencies and predicts how future technological innovations will integrate into this vision. Part of this vision includes a Surgical OR PACS prototype, developed by GE Healthcare Technologies, that addresses ergonomic challenges of PACS in the OR that include lack of portability, sterile field integrity, and UI targeted for diagnostic radiologists. GWindows (gesture control) developed by Microsoft Research and Voice command will allow for the surgeons to navigate and review diagnostic imagery without using the conventional keyboard and mouse that disrupt the integrity of the sterile field. This prototype also demonstrates how a wireless, battery powered, self contained mobile PACS workstation can be optimally positioned for a surgeon to reference images during an intervention as opposed to the current pre-operative review. Lessons learned from the creation of the Surgical OR PACS Prototype have demonstrated that PACS alone is not the end all solution in the OR. Integration of other disparate information systems and presentation of this information in simple, easy to navigate information packets will enable smoother interactions for the surgeons and other healthcare professionals in the OR. More intuitive IT system interaction is required for all the key players in the OR not just the surgeons. To improve interactions, there are a number of emerging technologies that have the potential to revolutionize the way healthcare professionals interact with computer-based applications in the Surgical OR. A number of these technologies will enable surgeons to interact with vital data without interrupting the sterile field or maneuvering their bodies to view relevant information - information will automatically display for healthcare individuals in a just-in-time manner without navigational challenges.

Refining the pH response in A spergillus nidulans: a modulatory triad involving PacX, a novel zinc binuclear cluster protein

PubMed Central

Bussink, Henk‐Jan; Bignell, Elaine M.; Múnera‐Huertas, Tatiana; Lucena‐Agell, Daniel; Scazzocchio, Claudio; Espeso, Eduardo A.; Bertuzzi, Margherita; Rudnicka, Joanna; Negrete‐Urtasun, Susana; Peñas‐Parilla, Maria M.; Rainbow, Lynne; Peñalva, Miguel Á.; Arst, Herbert N.

2015-01-01

Summary The A spergillus nidulans PacC transcription factor mediates gene regulation in response to alkaline ambient pH which, signalled by the Pal pathway, results in the processing of PacC72 to PacC27 via PacC53. Here we investigate two levels at which the pH regulatory system is transcriptionally moderated by pH and identify and characterise a new component of the pH regulatory machinery, PacX. Transcript level analysis and overexpression studies demonstrate that repression of acid‐expressed pal F, specifying the Pal pathway arrestin, probably by PacC27 and/or PacC53, prevents an escalating alkaline pH response. Transcript analyses using a reporter and constitutively expressed pac C  trans‐alleles show that pac C preferential alkaline‐expression results from derepression by depletion of the acid‐prevalent PacC72 form. We additionally show that pac C repression requires PacX. pac X mutations suppress PacC processing recalcitrant mutations, in part, through derepressed PacC levels resulting in traces of PacC27 formed by pH‐independent proteolysis. pac X was cloned by impala transposon mutagenesis. PacX, with homologues within the Leotiomyceta, has an unusual structure with an amino‐terminal coiled‐coil and a carboxy‐terminal zinc binuclear cluster. pacX mutations indicate the importance of these regions. One mutation, an unprecedented finding in A . nidulans genetics, resulted from an insertion of an endogenous Fot1‐like transposon. PMID:26303777

Financing a large-scale picture archival and communication system.

PubMed

Goldszal, Alberto F; Bleshman, Michael H; Bryan, R Nick

2004-01-01

An attempt to finance a large-scale multi-hospital picture archival and communication system (PACS) solely based on cost savings from current film operations is reported. A modified Request for Proposal described the technical requirements, PACS architecture, and performance targets. The Request for Proposal was complemented by a set of desired financial goals-the main one being the ability to use film savings to pay for the implementation and operation of the PACS. Financing of the enterprise-wide PACS was completed through an operating lease agreement including all PACS equipment, implementation, service, and support for an 8-year term, much like a complete outsourcing. Equipment refreshes, both hardware and software, are included. Our agreement also linked the management of the digital imaging operation (PACS) and the traditional film printing, shifting the operational risks of continued printing and costs related to implementation delays to the PACS vendor. An additional optimization step provided the elimination of the negative film budget variances in the beginning of the project when PACS costs tend to be higher than film and film-related expenses. An enterprise-wide PACS has been adopted to achieve clinical workflow improvements and cost savings. PACS financing was solely based on film savings, which included the entire digital solution (PACS) and any residual film printing. These goals were achieved with simultaneous elimination of any over-budget scenarios providing a non-negative cash flow in each year of an 8-year term.

Design and Implementation of PACS at Georgetown University Hospital

NASA Astrophysics Data System (ADS)

Mun, S. K.; Benson, H.. R.; Choyke, P.; Fahey, F. H.; Wang, P. C.; Zeman, R. K...; Elliott, L. P.

1985-09-01

During the preparation and planning phase of the PACS project at Georgetown University Hospital it was realized that PACS requires truly the state of the art technology in data communication, image processing and man machine interfacing. It was also realized that un-like many other technology intensive devices used in radiology, PACS cannot be seen as an independent system that will provide well defined services. PACS will be the backbone of the department operation in clinical, educational and managerial functions. It will indeed be the nerve center of the radiologic services affecting every aspect of the department. PACS will have to be designed to perform in a cost-effective manner to widely varying needs within the radiology departments. The integration of ever changing complex technology that will impact every aspect of a radiology service is not a trivial matter. This transition period going from current manual film based PACS to Digital PACS can be long, expansive and disruptive unless careful planning preceeds the implementation. PACS is still an emerging technology at its infancy. Performance monitoring and evaluation of diversified functions have to be also established so that improvement to the system can be efficiently implemented. Thus the evaluation criteria should be also established as early as possible.

Interfacing the PACS and the HIS: results of a 5-year implementation.

PubMed

Kinsey, T V; Horton, M C; Lewis, T E

2000-01-01

An interface was created between the Department of Defense's hospital information system (HIS) and its two picture archiving and communication system (PACS)-based radiology information systems (RISs). The HIS is called the Composite Healthcare Computer System (CHCS), and the RISs are called the Medical Diagnostic Imaging System (MDIS) and the Digital Imaging Network (DIN)-PACS. Extensive mapping between dissimilar data protocols was required to translate data from the HIS into both RISs. The CHCS uses a Health Level 7 (HL7) protocol, whereas the MDIS uses the American College of Radiology-National Electrical Manufacturers Association 2.0 protocol and the DIN-PACS uses the Digital Imaging and Communications in Medicine (DICOM) 3.0 protocol. An interface engine was required to change some data formats, as well as to address some nonstandard HL7 data being output from the CHCS. In addition, there are differences in terminology between fields and segments in all three protocols. This interface is in use at 20 military facilities throughout the world. The interface reduces the amount of manual entry into more than one automated system to the smallest level possible. Data mapping during installation saved time, improved productivity, and increased user acceptance during PACS implementation. It also resulted in more standardized database entries in both the HIS (CHCS) and the RIS (PACS).

PACS in the Utrecht University Hospital: final conclusions of the clinical evaluation

NASA Astrophysics Data System (ADS)

Wilmink, J. B.; ter Haar Romeny, Bart M.; Barneveld Binkhuysen, Frits H.; Achterberg, A. J.; Zuiderveld, Karel J.; Calkoen, P.; Kouwenberg, Jef M.

1990-08-01

In the past three years, a clinical evaluation of a PACS has been performed in the Utrecht University Hospital as part of the Dutch PACS project. The clinical evaluation focussed on the following aspects: technical evaluation of the prototype PACS equipment coupled to the HIS; diagnostic accuracy studies; studies concerning the impact on the organization of the radiology-department and the referring wards; and cost-savings analysis. Some of the results of these subprojects have already been presented at previous SPIE conferences. In this paper the general condusions are presented about the usefulness of the evaluated PAC-System in the daily routine of radiology department and clinic. By making available the images of radiological examinations fast, complete, reliable and continously on the ward, concrete improvements with regard to the current process could be realized. The possibilities of PACS caused an increasing enthousiasm among the clinicians. By the easier access to all images of their patients during 24 hours/day, they saw more images on the day of the examination and images could be more easily used at consultations of other specialists. The overall conclusion is positive, but a lot of work has to be done to transform PACS from an experimental setup into a routine production system on which a flimless hospital can be based. A complete PACS needs an inteffigent Image Management System, which indudes prefetching algorithms based on data from the Hospital Information System and automated procedures for removing obsolete images from the local buffers in the workstations. As yet PACS is very expensive, and the direct savings in the hospital cannot compensate for the high costs of investment. Possibly PACS can contribute to a shorter stay of patients in the hospital. This will lead to savings for government and health insurance companies and they can be expected to contribute to PAS implementation studies.

Continuing quality improvement procedures for a clinical PACS.

PubMed

Andriole, K P; Gould, R G; Avrin, D E; Bazzill, T M; Yin, L; Arenson, R L

1998-08-01

The University of California at San Francisco (USCF) Department of Radiology currently has a clinically operational picture archiving and communication system (PACS) that is thirty-five percent filmless, with the goal of becoming seventy-five percent filmless within the year. The design and implementation of the clinical PACS has been a collaborative effort between an academic research laboratory and a commercial vendor partner. Images are digitally acquired from three computed radiography (CR) scanners, five computed tomography (CT) scanners, five magnetic resonance (MR) imagers, three digital fluoroscopic rooms, an ultrasound mini-PACS and a nuclear medicine mini-PACS. The DICOM (Digital Imaging and Communications in Medicine) standard communications protocol and image format is adhered to throughout the PACS. Images are archived in hierarchical staged fashion, on a RAID (redundant array of inexpensive disks) and on magneto-optical disk jukeboxes. The clinical PACS uses an object-oriented Oracle SQL (systems query language) database, and interfaces to the Radiology Information System using the HL7 (Health Languages 7) standard. Components are networked using a combination of switched and fast ethernet, and ATM (asynchronous transfer mode), all over fiber optics. The wide area network links six UCSF sites in San Francisco. A combination of high and medium resolution dual-monitor display stations have been placed throughout the Department of Radiology, the Emergency Department (ED) and Intensive Care Units (ICU). A continuing quality improvement (CQI) committee has been formed to facilitate the PACS installation and training, workflow modifications, quality assurance and clinical acceptance. This committee includes radiologists at all levels (resident, fellow, attending), radiology technologists, film library personnel, ED and ICU clinician end-users, and PACS team members. The CQI committee has proved vital in the creation of new management procedures, providing a means for user feedback and education, and contributing to the overall acceptance of, and user satisfaction with the system. Well developed CQI procedures have been essential to the successful clinical operation of the PACS as UCSF Radiology moves toward a filmless department.

A centralized platform for geo-distributed PACS management.

PubMed

Silva, Luís A Bastião; Pinho, Renato; Ribeiro, Luís S; Costa, Carlos; Oliveira, José Luís

2014-04-01

Picture Archive and Communication System (PACS) is a globally adopted concept and plays a fundamental role in patient care flow within healthcare institutions. However, the deployment of medical imaging repositories over multiple sites still brings several practical challenges namely related to operation and management (O&M). This paper describes a Web-based centralized console that provides remote monitoring, testing, and management over multiple geo-distributed PACS. The system allows the PACS administrator to define any kind of service or operation, reducing the need for local technicians and providing a 24/7 monitoring solution.

Crystal Structure of the PAC1R Extracellular Domain Unifies a Consensus Fold for Hormone Recognition by Class B G-Protein Coupled Receptors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kumar, Shiva; Pioszak, Augen; Zhang, Chenghai

2012-02-21

Pituitary adenylate cyclase activating polypeptide (PACAP) is a member of the PACAP/glucagon family of peptide hormones, which controls many physiological functions in the immune, nervous, endocrine, and muscular systems. It activates adenylate cyclase by binding to its receptor, PAC1R, a member of class B G-protein coupled receptors (GPCR). Crystal structures of a number of Class B GPCR extracellular domains (ECD) bound to their respective peptide hormones have revealed a consensus mechanism of hormone binding. However, the mechanism of how PACAP binds to its receptor remains controversial as an NMR structure of the PAC1R ECD/PACAP complex reveals a different topology ofmore » the ECD and a distinct mode of ligand recognition. Here we report a 1.9 {angstrom} crystal structure of the PAC1R ECD, which adopts the same fold as commonly observed for other members of Class B GPCR. Binding studies and cell-based assays with alanine-scanned peptides and mutated receptor support a model that PAC1R uses the same conserved fold of Class B GPCR ECD for PACAP binding, thus unifying the consensus mechanism of hormone binding for this family of receptors.« less

HIS-PACS coupling in perspective

NASA Astrophysics Data System (ADS)

Lodder, Herman; van Poppel, Bas M.; Wilmink, J. B.; Bakker, Albert R.

1990-08-01

Within the framework of the Dutch PACS project (a cooperation in the PACS field of BAZIS, the Utrecht University Hospital and Philips Medical Systems) a coupling between a HIS and a prototype PACS was realized and evaluated during clinical practice. This one-way coupling is a first step towards a so-called Image Information System, which can be seen as (logically) one system instead of two (a HIS for storage and retrieval of administrative and medical data, and a PACS for the images). The BAZIS/HIS is an integrated HIS, containing about 70 subsystems including a RIS, which is now used in about 40 hospitals in the Netherlands. The main reasons for coupling/integrating a HIS and a PACS can be summerized as: a) the user need for both functional and information integration and b) the need to have access to HIS data for optimizing image database and network management in order to get acceptable response times. As follow-up to the paper presented in the 1989 conference this paper will focus on the experiences gained with this one-way coupling. The event-driven communication took place by sending messages from HIS to PACS in ACRNEMA format. From these experiences recommendations for a next phase: a two-way link between a HIS and a PACS will be given. The necessity for bidirectional datatransfer will be discussed. Directions for future research e.g. on prefetching strategies will be pointed out.

A Recurrent De Novo PACS2 Heterozygous Missense Variant Causes Neonatal-Onset Developmental Epileptic Encephalopathy, Facial Dysmorphism, and Cerebellar Dysgenesis.

PubMed

Olson, Heather E; Jean-Marçais, Nolwenn; Yang, Edward; Heron, Delphine; Tatton-Brown, Katrina; van der Zwaag, Paul A; Bijlsma, Emilia K; Krock, Bryan L; Backer, E; Kamsteeg, Erik-Jan; Sinnema, Margje; Reijnders, Margot R F; Bearden, David; Begtrup, Amber; Telegrafi, Aida; Lunsing, Roelineke J; Burglen, Lydie; Lesca, Gaetan; Cho, Megan T; Smith, Lacey A; Sheidley, Beth R; Moufawad El Achkar, Christelle; Pearl, Phillip L; Poduri, Annapurna; Skraban, Cara M; Tarpinian, Jennifer; Nesbitt, Addie I; Fransen van de Putte, Dietje E; Ruivenkamp, Claudia A L; Rump, Patrick; Chatron, Nicolas; Sabatier, Isabelle; De Bellescize, Julitta; Guibaud, Laurent; Sweetser, David A; Waxler, Jessica L; Wierenga, Klaas J; Donadieu, Jean; Narayanan, Vinodh; Ramsey, Keri M; Nava, Caroline; Rivière, Jean-Baptiste; Vitobello, Antonio; Tran Mau-Them, Frédéric; Philippe, Christophe; Bruel, Ange-Line; Duffourd, Yannis; Thomas, Laurel; Lelieveld, Stefan H; Schuurs-Hoeijmakers, Janneke; Brunner, Han G; Keren, Boris; Thevenon, Julien; Faivre, Laurence; Thomas, Gary; Thauvin-Robinet, Christel

2018-05-03

Developmental and epileptic encephalopathies (DEEs) represent a large clinical and genetic heterogeneous group of neurodevelopmental diseases. The identification of pathogenic genetic variants in DEEs remains crucial for deciphering this complex group and for accurately caring for affected individuals (clinical diagnosis, genetic counseling, impacting medical, precision therapy, clinical trials, etc.). Whole-exome sequencing and intensive data sharing identified a recurrent de novo PACS2 heterozygous missense variant in 14 unrelated individuals. Their phenotype was characterized by epilepsy, global developmental delay with or without autism, common cerebellar dysgenesis, and facial dysmorphism. Mixed focal and generalized epilepsy occurred in the neonatal period, controlled with difficulty in the first year, but many improved in early childhood. PACS2 is an important PACS1 paralog and encodes a multifunctional sorting protein involved in nuclear gene expression and pathway traffic regulation. Both proteins harbor cargo(furin)-binding regions (FBRs) that bind cargo proteins, sorting adaptors, and cellular kinase. Compared to the defined PACS1 recurrent variant series, individuals with PACS2 variant have more consistently neonatal/early-infantile-onset epilepsy that can be challenging to control. Cerebellar abnormalities may be similar but PACS2 individuals exhibit a pattern of clear dysgenesis ranging from mild to severe. Functional studies demonstrated that the PACS2 recurrent variant reduces the ability of the predicted autoregulatory domain to modulate the interaction between the PACS2 FBR and client proteins, which may disturb cellular function. These findings support the causality of this recurrent de novo PACS2 heterozygous missense in DEEs with facial dysmorphim and cerebellar dysgenesis. Copyright © 2018 American Society of Human Genetics. All rights reserved.

PERFORMANCE AND COST OF MERCURY AND MULTIPOLLUTANT EMISSION CONTROL TECHNOLOGY APPLICATIONS ON ELECTRIC UTILITY BOILERS

EPA Science Inventory

The report presents estimates of the performance and cost of both powdered activated carbon (PAC) and multipollutant control technologies that may be useful in controlling mercury emissions. Based on currently available data, cost estimates for PAC injection range are 0.03-3.096 ...

Controlling fertilization and cAMP signaling in sperm by optogenetics.

PubMed

Jansen, Vera; Alvarez, Luis; Balbach, Melanie; Strünker, Timo; Hegemann, Peter; Kaupp, U Benjamin; Wachten, Dagmar

2015-01-20

Optogenetics is a powerful technique to control cellular activity by light. The light-gated Channelrhodopsin has been widely used to study and manipulate neuronal activity in vivo, whereas optogenetic control of second messengers in vivo has not been examined in depth. In this study, we present a transgenic mouse model expressing a photoactivated adenylyl cyclase (bPAC) in sperm. In transgenic sperm, bPAC mimics the action of the endogenous soluble adenylyl cyclase (SACY) that is required for motility and fertilization: light-stimulation rapidly elevates cAMP, accelerates the flagellar beat, and, thereby, changes swimming behavior of sperm. Furthermore, bPAC replaces endogenous adenylyl cyclase activity. In mutant sperm lacking the bicarbonate-stimulated SACY activity, bPAC restored motility after light-stimulation and, thereby, enabled sperm to fertilize oocytes in vitro. We show that optogenetic control of cAMP in vivo allows to non-invasively study cAMP signaling, to control behaviors of single cells, and to restore a fundamental biological process such as fertilization.

Fault tolerance techniques to assure data integrity in high-volume PACS image archives

NASA Astrophysics Data System (ADS)

He, Yutao; Huang, Lu J.; Valentino, Daniel J.; Wingate, W. Keith; Avizienis, Algirdas

1995-05-01

Picture archiving and communication systems (PACS) perform the systematic acquisition, archiving, and presentation of large quantities of radiological image and text data. In the UCLA Radiology PACS, for example, the volume of image data archived currently exceeds 2500 gigabytes. Furthermore, the distributed heterogeneous PACS is expected to have near real-time response, be continuously available, and assure the integrity and privacy of patient data. The off-the-shelf subsystems that compose the current PACS cannot meet these expectations; therefore fault tolerance techniques had to be incorporated into the system. This paper is to report our first-step efforts towards the goal and is organized as follows: First we discuss data integrity and identify fault classes under the PACS operational environment, then we describe auditing and accounting schemes developed for error-detection and analyze operational data collected. Finally, we outline plans for future research.

Novel combination of photoactive species: photoresists formed from selectively esterified novolacs and polyfunctional photoactive compounds

NASA Astrophysics Data System (ADS)

Jeffries, Alfred T., III; Brzozowy, David J.; Naiini, Ahmad A.; Gallagher-Wetmore, Paula M.

1997-07-01

The addition of selected PACs to resists comprised of selectively esterified DNQ novolacs improves their performance in terms of side wall angle and resolution compared to resists whose photoactive component is composed of entirely selectively esterified DNQ novolacs. The performance gain is particularly evident for the resists with two selectively esterified fractions. A conventional 60/40 m-cresol/p-cresol novolac was synthesized and fractionated into five nearly equal weight fractions using supercritical fluids (SCF) fractionation technique. Resists were made from either a single esterified fraction [fraction Two, esterification level (EL), 42%] or dual esterified fractions (fractions Two and Four, EL 21% each), a selection of PACs and the remaining unesterified fractions. They were compared to a control containing only the corresponding esterified fraction(s). The PACs A and B were effective at increasing the resist profile angle for 0.50 (mu) features in the singly esterified novalacs in comparison to the control material and exhibited flat tops. The resolution and profiles of dual esterified fraction resists improved significantly when low levels of PACs were added to dual esterified fraction control resist. The comparison was made from 0.40 (mu) features. The resist made using PAC C is the best candidate for photospeed although its profile angle is less in comparison to PACs A and B.

Prototype development and implementation of picture archiving and communications systems based on ISO-OSI standard

NASA Astrophysics Data System (ADS)

Martinez, Ralph; Nam, Jiseung

1992-07-01

Picture Archiving and Communication Systems (PACS) is an integration of digital image formation in a hospital, which encompasses various imaging equipment, image viewing workstations, image databases, and a high speed network. The integration requires a standardization of communication protocols to connect devices from different vendors. The American College of Radiology and the National Electrical Manufacturers Association (ACR- NEMA) standard Version 2.0 provides a point-to-point hardware interface, a set of software commands, and a consistent set of data formats for PACS. But, it is inadequate for PACS networking environments, because of its point-to-point nature and its inflexibility to allow other services and protocols in the future. Based on previous experience of PACS developments in The University of Arizona, a new communication protocol for PACS networks and an approach were proposed to ACR-NEMA Working Group VI. The defined PACS protocol is intended to facilitate the development of PACS''s capable of interfacing with other hospital information systems. Also, it is intended to allow the creation of diagnostic information data bases which can be interrogated by a variety of distributed devices. A particularly important goal is to support communications in a multivendor environment. The new protocol specifications are defined primarily as a combination of the International Organization for Standardization/Open Systems Interconnection (ISO/OSI), TCP/IP protocols, and the data format portion of ACR-NEMA standard. This paper addresses the specification and implementation of the ISO-based protocol into a PACS prototype. The protocol specification, which covers Presentation, Session, Transport, and Network layers, is summarized briefly. The protocol implementation is discussed based on our implementation efforts in the UNIX Operating System Environment. At the same time, results of performance comparison between the ISO and TCP/IP implementations are presented to demonstrate the implementation of defined protocol. The testing of performance analysis is done by prototyping PACS on available platforms, which are Micro VAX II, DECstation and SUN Workstation.

Evolutionistic or revolutionary paths? A PACS maturity model for strategic situational planning.

PubMed

van de Wetering, Rogier; Batenburg, Ronald; Lederman, Reeva

2010-07-01

While many hospitals are re-evaluating their current Picture Archiving and Communication System (PACS), few have a mature strategy for PACS deployment. Furthermore, strategies for implementation, strategic and situational planning methods for the evolution of PACS maturity are scarce in the scientific literature. Consequently, in this paper we propose a strategic planning method for PACS deployment. This method builds upon a PACS maturity model (PMM), based on the elaboration of the strategic alignment concept and the maturity growth path concept previously developed in the PACS domain. First, we review the literature on strategic planning for information systems and information technology and PACS maturity. Secondly, the PMM is extended by applying four different strategic perspectives of the Strategic Alignment Framework whereupon two types of growth paths (evolutionistic and revolutionary) are applied that focus on a roadmap for PMM. This roadmap builds a path to get from one level of maturity and evolve to the next. An extended method for PACS strategic planning is developed. This method defines eight distinctive strategies for PACS strategic situational planning that allow decision-makers in hospitals to decide which approach best suits their hospitals' current situation and future ambition and what in principle is needed to evolve through the different maturity levels. The proposed method allows hospitals to strategically plan for PACS maturation. It is situational in that the required investments and activities depend on the alignment between the hospital strategy and the selected growth path. The inclusion of both strategic alignment and maturity growth path concepts make the planning method rigorous, and provide a framework for further empirical research and clinical practice.

Improving the Quality of Postabortion Care Services in Togo Increased Uptake of Contraception

PubMed Central

Mugore, Stembile; Kassouta, Ntapi Tchiguiri K; Sebikali, Boniface; Lundstrom, Laurel; Saad, Abdulmumin

2016-01-01

ABSTRACT High-quality postabortion care (PAC) services that include family planning counseling and a full range of contraceptives at point of treatment for abortion complications have great potential to break the cycle of repeat unintended pregnancies and demand for abortions. We describe the first application of a systematic approach to quality improvement of PAC services in a West African country. This approach—IntraHealth International’s Optimizing Performance and Quality (OPQ) approach—was applied at 5 health care facilities in Togo starting in November 2014. A baseline assessment identified the following needs: reorganizing services to ensure that contraceptives are provided at point of treatment for abortion complications, before PAC clients are discharged; improving provider competencies in family planning services, including in providing long-acting reversible contraceptive implants and intrauterine devices; ensuring that contraceptive methods are available to all PAC clients free of charge; standardizing PAC registers and enhancing data collection and reporting systems; enhancing internal supervision systems at facilities and teamwork among PAC providers; and engaging PAC providers in community talks. Solutions devised and applied at the facilities during OPQ resulted in significant increases in contraceptive counseling and uptake among PAC clients: During the 5-month baseline period, 31% of PAC clients were counseled, while during the 13-month intervention period, 91% were counseled. Of all PAC clients counseled during the baseline period, 37% accepted a contraceptive, compared with 60% of those counseled during the intervention period. Oral contraceptive pills remained the most popular method during both periods, yet uptake of implants increased significantly during the intervention period—from 4% to 27% of those accepting contraceptives. This result demonstrates that the solutions applied maintained method choice while expanding access to underused long-acting reversible contraceptives. OPQ shows great potential for sustainability and scale in Togo and for application in similar contexts where the health system struggles to offer safe, high-quality, accessible PAC services. PMID:27688719

User Acceptance of Picture Archiving and Communication System in the Emergency Department

PubMed Central

Goodarzi, Hassan; Khatami, Seyed-Masoud; Javadzadeh, Hammidreza; Mahmoudi, Sadrollah; Khajehpour, Hojjatollah; Heidari, Soleiman; Khodaparast, Morteza; Ebrahimi, Ali; Rasouli, Hamidreza; Ghane, Mohammadreza; Faraji, Mehrdad; Hassanpour, Kasra

2016-01-01

Background Picture archiving and communication system (PACS) has allowed the medical images to be transmitted, stored, retrieved, and displayed in different locations of a hospital or health system. Using PACS in the emergency department will eventually result in improved efficiency and patient care. In spite of the abundant benefits of employing PACS, there are some challenges in implementing this technology like users’ resistance to accept the technology, which has a critical role in PACS success. Objectives In this study, we will assess and compare user acceptance of PACS in the emergency departments of three different hospitals and investigate the effect of socio-demographic factors on this acceptance. Materials and Methods A variant of technology acceptance model (TAM) has been used in order to measure the acceptance level of PACS in the emergency department of three educational hospitals in Iran. A previously used questionnaire was validated and utilized to collect the study data. A stepwise multiple regression model was used to predict factors influencing acceptance score as the dependent variable. Results Mean age of participants was 32.9 years (standard deviation [SD] = 6.08). Participants with the specialty degree got a higher acceptance score than the three other groups (Mean ± SD = 4.17 ± 0.20). Age, gender, degree of PACS usage and participant’s occupation (profession) did not influence the acceptance score. In our multiple regression model, all three variables of perceived usefulness (PU), perceived ease of use (PEU) and the effect of PACS (change) had a significant effect in the prediction of acceptance. The most influencing factor was change with the beta of 0.22 (P value < 0.001). Conclusion PACS is highly accepted in all three emergency departments especially among specialists. PU, PEU and change are factors influencing PACS acceptance. Our study can be used as an evidence of PACS acceptance in emergency wards. PMID:27679692

Using Field-Metered Data to Quantify Annual Energy Use of Portable Air Conditioners

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burke, Thomas; Willem, Henry; Ni, Chun Chun

2014-12-12

As many regions of the United States experience rising temperatures, consumers have come to rely increasingly on cooling appliances (including portable air conditioners) to provide a comfortable indoor temperature. Home occupants sometimes use a portable air conditioner (PAC) to maintain a desired indoor temperature in a single room or enclosed space. Although PACs in residential use are few compared to centrally installed and room air conditioning (AC) units, the past few years have witnessed an increase of PACs use throughout the United States. There is, however, little information and few research projects focused on the energy consumption and performance ofmore » PACs, particularly studies that collect information from field applications of PACs. The operation and energy consumption of PACs may differ among geographic locations and households, because of variations in cooling load, frequency, duration of use, and other user-selected settings. In addition, the performance of building envelope (thermal mass and air leakage) as well as inter-zonal mixing within the building would substantially influence the ability to control and maintain desirable indoor thermal conditions. Lawrence Berkeley National Laboratory (LBNL) conducted an initial field-metering study aimed at increasing the knowledge and data related to PAC operation and energy consumption in the United States. LBNL performed its field-metering study from mid-April to late October 2014. The study, which monitored 19 sites in the Northeastern United States (4 in upstate New York and 15 near Philadelphia), collected real-time data on PAC energy consumption along with information regarding housing characteristics, consumer behavior, and environmental conditions that were expected to affect PAC performance. Given the limited number of test sites, this study was not intended to be statistically representative of PAC users in the United States but rather to understand the system response to the cooling demand and to some extent, the operating hours of the studied units. Specifically, the primary objectives of the field-metering study were to (1) expand knowledge of the installation, energy consumption profiles, consumer patterns of use, and environmental parameters related to PAC use; (2) develop distributions of hours of PAC operation for three operating modes: standby, 1 fan-only, and cooling; and (3) describe how individual consumers’ selection of PAC capacity, the area of the space to be cooled, the temperature set point, and environmental conditions affect energy use. Beginning to understand the energy consumption of PACs operating in American homes and commercial settings will help develop a more accurate energy use profile that characterizes relevant variables. This report on LBNL’s field-metering study of PAC energy use describes: a general definition of a PAC and how it operates (section 2); current practices and sources of data for estimating PAC energy use (section 3); the process LBNL used to select field-metering sites, along with characteristics of the sites and the PACs studied (section 4); data collection methods and instrumentation (section 5); analysis methods (section 6); results and discussion (section 7); and conclusions (section 8).« less

PACS administrators' and radiologists' perspective on the importance of features for PACS selection.

PubMed

Joshi, Vivek; Narra, Vamsi R; Joshi, Kailash; Lee, Kyootai; Melson, David

2014-08-01

Picture archiving and communication systems (PACS) play a critical role in radiology. This paper presents the criteria important to PACS administrators for selecting a PACS. A set of criteria are identified and organized into an integrative hierarchical framework. Survey responses from 48 administrators are used to identify the relative weights of these criteria through an analytical hierarchy process. The five main dimensions for PACS selection in order of importance are system continuity and functionality, system performance and architecture, user interface for workflow management, user interface for image manipulation, and display quality. Among the subdimensions, the highest weights were assessed for security, backup, and continuity; tools for continuous performance monitoring; support for multispecialty images; and voice recognition/transcription. PACS administrators' preferences were generally in line with that of previously reported results for radiologists. Both groups assigned the highest priority to ensuring business continuity and preventing loss of data through features such as security, backup, downtime prevention, and tools for continuous PACS performance monitoring. PACS administrators' next high priorities were support for multispecialty images, image retrieval speeds from short-term and long-term storage, real-time monitoring, and architectural issues of compatibility and integration with other products. Thus, next to ensuring business continuity, administrators' focus was on issues that impact their ability to deliver services and support. On the other hand, radiologists gave high priorities to voice recognition, transcription, and reporting; structured reporting; and convenience and responsiveness in manipulation of images. Thus, radiologists' focus appears to be on issues that may impact their productivity, effort, and accuracy.

Novel in vitro protein fragment complementation assay applicable to high-throughput screening in a 1536-well format.

PubMed

Hashimoto, Junko; Watanabe, Taku; Seki, Tatsuya; Karasawa, Satoshi; Izumikawa, Miho; Seki, Tomoe; Iemura, Shun-Ichiro; Natsume, Tohru; Nomura, Nobuo; Goshima, Naoki; Miyawaki, Atsushi; Takagi, Motoki; Shin-Ya, Kazuo

2009-09-01

Protein-protein interactions (PPIs) play key roles in all cellular processes and hence are useful as potential targets for new drug development. To facilitate the screening of PPI inhibitors as anticancer drugs, the authors have developed a high-throughput screening (HTS) system using an in vitro protein fragment complementation assay (PCA) with monomeric Kusabira-Green fluorescent protein (mKG). The in vitro PCA system was established by the topological formation of a functional complex between 2 split inactive mKG fragments fused to target proteins, which fluoresces when 2 target proteins interact to allow complementation of the mKG fragments. Using this assay system, the authors screened inhibitors for TCF7/beta-catenin, PAC1/PAC2, and PAC3 homodimer PPIs from 123,599 samples in their natural product library. Compound TB1 was identified as a specific inhibitor for PPI of PAC3 homodimer. TB1 strongly inhibited the PPI of PAC3 homodimer with an IC(50) value of 0.020 microM and did not inhibit PPI between TCF7/beta-catenin and PAC1/PAC2 even at a concentration of 250 microM. The authors thus demonstrated that this in vitro PCA system applicable to HTS in a 1536-well format is capable of screening for PPI inhibitors from a huge natural product library.

Cost justification of filmless PACS and national policy

NASA Astrophysics Data System (ADS)

Lim, Jae H.

2002-05-01

The expense of installing PACS is high so most Korean hospitals cannot afford to purchase the system easily. We can justify the cost of PACS by considering the visible and invisible benefits. As a visible benefit we can save the cost of films and equipments for film processing. Invisible benefits of PACS is the cost of film handling. Generally, doctors spend some 25 minutes in handling X-ray films everyday and they spend 10 days (84 hours) throughout a year. Radiology technicians, nurses, orderlies and clerks also handle films and the total salary for handling films by doctors and paramedics will be considerable. Considering the visible and invisible benefits, cost of PACS is justified and PACS can be installed in every hospital, whatever their size. The Korean Society of PACS tried to make reimbursement of the cost of PACS and persuaded the government officers and eventually the Ministry of Health and Welfare decided to reimburse the use of PACS in hospitals. Based on the money reimbursed, general hospitals or university hospitals will earn enough money to purchase a PACS in 3 - 5 years. After the Korean government started to reimburse the cost of PACS, many hospitals wanted to install PACS and the number of hospitals installing PACS is soaring.

Medical image informatics infrastructure design and applications.

PubMed

Huang, H K; Wong, S T; Pietka, E

1997-01-01

Picture archiving and communication systems (PACS) is a system integration of multimodality images and health information systems designed for improving the operation of a radiology department. As it evolves, PACS becomes a hospital image document management system with a voluminous image and related data file repository. A medical image informatics infrastructure can be designed to take advantage of existing data, providing PACS with add-on value for health care service, research, and education. A medical image informatics infrastructure (MIII) consists of the following components: medical images and associated data (including PACS database), image processing, data/knowledge base management, visualization, graphic user interface, communication networking, and application oriented software. This paper describes these components and their logical connection, and illustrates some applications based on the concept of the MIII.

Enterprise PACS and image distribution.

PubMed

Huang, H K

2003-01-01

Around the world now, because of the need to improve operation efficiency and better cost effective healthcare, many large-scale healthcare enterprises have been formed. Each of these enterprises groups hospitals, medical centers, and clinics together as one enterprise healthcare network. The management of these enterprises recognizes the importance of using PACS and image distribution as a key technology in cost-effective healthcare delivery in the enterprise level. As a result, many large-scale enterprise level PACS/image distribution pilot studies, full design and implementation, are underway. The purpose of this paper is to provide readers an overall view of the current status of enterprise PACS and image distribution. reviews three large-scale enterprise PACS/image distribution systems in USA, Germany, and South Korean. The concept of enterprise level PACS/image distribution, its characteristics and ingredients are then discussed. Business models for enterprise level implementation available by the private medical imaging and system integration industry are highlighted. One current system under development in designing a healthcare enterprise level chest tuberculosis (TB) screening in Hong Kong is described in detail. Copyright 2002 Elsevier Science Ltd.

Engineering and clinical-oriented solution to cost-effective PACS for developing areas in China

NASA Astrophysics Data System (ADS)

Hu, Dake; Zhang, Hong; Zhou, Shengmin; Shao, Lin

1997-05-01

Although PACS has been studied in industrial countries for more than sixteen years, few effort has been made so far to apply PACS technology to such developing areas as most rural regions in CHina. Engineering and clinical problems raised from installing PACS in undeveloped areas has brought many challenges to our system design. In this study, we try to analyze the clinical need of the Chinese hospitals and find out a solution to meet most hospitals' requirements from engineering and clinical points of view, such as system cost, ease of deployment, user interface, maintenance difficulty, etc., thus provide patients with better medical serve at affordable cost. First of all, we analyzed data collected from Zhejiang Cancer Hospital (ZCH) and take hospitals' financial situation into consideration. then according to the analysis, we made our choices for hardware and software platform, digitizer and storage device. The development of mini PACS is interacted by clinicians and radiologists from ZCH. They showed great interest in the downsizing PACS that does not risk much of the system performance. It is promising that our solution will be accepted in developing areas.

Developing policies and procedures for a picture archiving and communication system.

PubMed

Gaytos, B

2001-06-01

Policies and procedures (P&P) constitute the mechanism for planning, standardizing, and documenting the provision of clinical services. Upon approval by hospital management, the P&P is an official statement of hospital rules and regulations. Each P&P establishes organizational responsibility for providing services. P&P are a mechanism for communicating standard operating procedures to hospital and medical staff. P&P serve as a reference document for unusual events, as well as routine procedures. P&P are often reviewed by inspection teams from the Joint Commission on Accreditation of Hospital Organizations (JCAHO) to determine whether the hospital has documented systematic practices. A picture archival and communications system (PACS) provides a new vehicle for providing radiology services. P&P that were designed for conventional film-based imaging are often not appropriate for electronic imaging. Because PACS is new and not yet widespread, good examples of PACS P&P are not yet available. JCAHO has no official requirements for PACS: PACS is viewed only as a means for the hospital to accomplish its work. Successful P&P development is a team effort, drafted by personnel responsible for executing the procedure, assisted by staff proficient in PACS technology, and tested in the field. The P&P should be reviewed and approved by management personnel knowledgeable about hospital and imaging operations. P&P should be written in clear and concise language. Successful P&P development is an ongoing effort. P&P must be periodically reviewed and updated to reflect changes in PACS technology and changes in clinical operations. New P&P must be developed when a deficit is noted. PACS security is a good example of a topic worthy of P&P development, especially in the face of the Health Insurance Portability and Accountability Act (HIPAA) legislation of 1996. What are the provisions for access control? Does the system include a feature for automatic shut-off of the software? Are there "generic" passwords and log-ins shared by a community of users? How are passwords assigned and how frequently are they changed? What security measures are in place to assure passwords are given to the appropriate user? Who grants and denies access? Service calls are another topic for P&P. Who initiates a service call? What is the process for escalating a service call from the operator level to the vendor? What immediate actions are expected by the operator in order to restore PACS services? How are service events documented? Who is responsible for determining when "downtime" procedures should be initiated or suspended? When our hospital's total electrical system had to be shut down for an extended period, we found that a P&P was lacking for a task as mundane as shutting down and restarting our PACS components. What is the sequence for the shutdown? Who is responsible for shutting down and restarting? How long can the devices operate on uninteruptible power supplies (UPS)? What components are on emergency power? Should we expect the components to survive the switchover to generator power? Developing this P&P was worth the effort: it made the PACS more fault-tolerant and served as a reference document 3 years later when expansion of our physical plant required two more power outages.

MODELING MERCURY CONTROL WITH POWDERED ACTIVATED CARBON

EPA Science Inventory

The paper presents a mathematical model of total mercury removed from the flue gas at coal-fired plants equipped with powdered activated carbon (PAC) injection for Mercury control. The developed algorithms account for mercury removal by both existing equipment and an added PAC in...

XDS-I Gateway Development for HIE Connectivity with Legacy PACS at Gil Hospital.

PubMed

Simalango, Mikael Fernandus; Kim, Youngchul; Seo, Young Tae; Choi, Young Hwan; Cho, Yong Kyun

2013-12-01

The ability to support healthcare document sharing is imperative in a health information exchange (HIE). Sharing imaging documents or images, however, can be challenging, especially when they are stored in a picture archiving and communication system (PACS) archive that does not support document sharing via standard HIE protocols. This research proposes a standard-compliant imaging gateway that enables connectivity between a legacy PACS and the entire HIE. Investigation of the PACS solutions used at Gil Hospital was conducted. An imaging gateway application was then developed using a Java technology stack. Imaging document sharing capability enabled by the gateway was tested by integrating it into Gil Hospital's order communication system and its HIE infrastructure. The gateway can acquire radiology images from a PACS storage system, provide and register the images to Gil Hospital's HIE for document sharing purposes, and make the images retrievable by a cross-enterprise document sharing document viewer. Development of an imaging gateway that mediates communication between a PACS and an HIE can be considered a viable option when the PACS does not support the standard protocol for cross-enterprise document sharing for imaging. Furthermore, the availability of common HIE standards expedites the development and integration of the imaging gateway with an HIE.

XDS-I Gateway Development for HIE Connectivity with Legacy PACS at Gil Hospital

PubMed Central

Simalango, Mikael Fernandus; Kim, Youngchul; Seo, Young Tae; Cho, Yong Kyun

2013-01-01

Objectives The ability to support healthcare document sharing is imperative in a health information exchange (HIE). Sharing imaging documents or images, however, can be challenging, especially when they are stored in a picture archiving and communication system (PACS) archive that does not support document sharing via standard HIE protocols. This research proposes a standard-compliant imaging gateway that enables connectivity between a legacy PACS and the entire HIE. Methods Investigation of the PACS solutions used at Gil Hospital was conducted. An imaging gateway application was then developed using a Java technology stack. Imaging document sharing capability enabled by the gateway was tested by integrating it into Gil Hospital's order communication system and its HIE infrastructure. Results The gateway can acquire radiology images from a PACS storage system, provide and register the images to Gil Hospital's HIE for document sharing purposes, and make the images retrievable by a cross-enterprise document sharing document viewer. Conclusions Development of an imaging gateway that mediates communication between a PACS and an HIE can be considered a viable option when the PACS does not support the standard protocol for cross-enterprise document sharing for imaging. Furthermore, the availability of common HIE standards expedites the development and integration of the imaging gateway with an HIE. PMID:24523994

Implementation, reliability, and feasibility test of an Open-Source PACS.

PubMed

Valeri, Gianluca; Zuccaccia, Matteo; Badaloni, Andrea; Ciriaci, Damiano; La Riccia, Luigi; Mazzoni, Giovanni; Maggi, Stefania; Giovagnoni, Andrea

2015-12-01

To implement a hardware and software system able to perform the major functions of an Open-Source PACS, and to analyze it in a simulated real-world environment. A small home network was implemented, and the Open-Source operating system Ubuntu 11.10 was installed in a laptop containing the Dcm4chee suite with the software devices needed. The Open-Source PACS implemented is compatible with Linux OS, Microsoft OS, and Mac OS X; furthermore, it was used with operating systems that guarantee the operation in portable devices (smartphone, tablet) Android and iOS. An OSS PACS is useful for making tutorials and workshops on post-processing techniques for educational and training purposes.

Pituitary adenylate cyclase activating polypeptide (PACAP) and its receptor 1 (PAC1) in the human infant brain and changes in the Sudden Infant Death Syndrome (SIDS).

PubMed

Huang, J; Waters, K A; Machaalani, R

2017-07-01

Pituitary adenylate cyclase activating polypeptide (PACAP) and its complementary receptor, PAC1, are crucial in central respiratory control. PACAP Knockout (KO) mice exhibit a SIDS-like phenotype, with an inability to overcome noxious insults, compression of baseline ventilation, and death in the early post-neonatal period. PAC1 KO demonstrate similar attributes to PACAP-null mice, but with the addition of increased pulmonary artery pressure, consequently leading to heart failure and death. This study establishes a detailed interpretation of the neuroanatomical distribution and localization of both PACAP and PAC1 in the human infant brainstem and hippocampus, to determine whether any changes in expression are evident in infants who died of Sudden Infant Death Syndrome (SIDS) and any relationships to risk factors of SIDS including smoke exposure and sleep related parameters. Immunohistochemistry for PACAP and PAC1 was performed on formalin fixed and paraffin embedded human infant brain tissue of SIDS (n=32) and non-SIDS (n=12). The highest expression of PACAP was found in the hypoglossal (XII) of the brainstem medulla and lowest expression in the subiculum of the hippocampus. Highest expression of PAC1 was also found in XII of the medulla and lowest in the midbrain dorsal raphe (MBDR) and inferior colliculus. SIDS compared to non-SIDS had higher PACAP in the MBDR (p<0.05) and lower PAC1 in the medulla arcuate nucleus (p<0.001). Correlations were found between PACAP and PAC1 with the risk factors of smoke exposure, bed sharing, upper respiratory tract infection (URTI) and seasonal temperatures. The findings of this study show for the first time that some abnormalities of the PACAP system are evident in the SIDS brain and could contribute to the mechanisms of infants succumbing to SIDS. Copyright © 2017 Elsevier Inc. All rights reserved.

Predicting clinical image delivery time by monitoring PACS queue behavior.

PubMed

King, Nelson E; Documet, Jorge; Liu, Brent

2006-01-01

The expectation of rapid image retrieval from PACS users contributes to increased information technology (IT) infrastructure investments to increase performance as well as continuing demands upon PACS administrators to respond to "slow" system performance. The ability to provide predicted delivery times to a PACS user may curb user expectations for "fastest" response especially during peak hours. This, in turn, could result in a PACS infrastructure tailored to more realistic performance demands. A PACS with a stand-alone architecture under peak load typically holds study requests in a queue until the DICOM C-Move command can take place. We investigate the contents of a stand-alone architecture PACS RetrieveSend queue and identified parameters and behaviors that enable a more accurate prediction of delivery time. A prediction algorithm for studies delayed in a stand-alone PACS queue can be extendible to other potential bottlenecks such as long-term storage archives. Implications of a queue monitor in other PACS architectures are also discussed.

Effect of PAC dosage in a pilot-scale PAC-MBR treating micro-polluted surface water.

PubMed

Hu, Jingyi; Shang, Ran; Deng, Huiping; Heijman, Sebastiaan G J; Rietveld, Luuk C

2014-02-01

To address the water scarcity issue and advance the traditional drinking water treatment technique, a powdered activated carbon-amended membrane bioreactor (PAC-MBR) is proposed for micro-polluted surface water treatment. A pilot-scale study was carried out by initially dosing different amounts of PAC into the MBR. Comparative results showed that 2g/L performed the best among 0, 1, 2 and 3g/L PAC-MBR regarding organic matter and ammonia removal as well as membrane flux sustainability. 1g/L PAC-MBR exhibited a marginal improvement in pollutant removal compared to the non-PAC system. The accumulation of organic matter in the bulk mixture of 3g/L PAC-MBR led to poorer organic removal and severer membrane fouling. Molecular weight distribution of the bulk liquid in 2g/L PAC-MBR revealed the synergistic effects of PAC adsorption/biodegradation and membrane rejection on organic matter removal. Additionally, a lower amount of soluble extracellular polymer substances in the bulk can be secured in 21 days operation. Copyright © 2013 Elsevier Ltd. All rights reserved.

PCaPAC 2006 Proceedings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pavel Chevtsov; Matthew Bickley

2007-03-30

The 6-th international PCaPAC (Personal Computers and Particle Accelerator Controls) workshop was held at Jefferson Lab, Newport News, Virginia, from October 24-27, 2006. The main objectives of the conference were to discuss the most important issues of the use of PCs and modern IT technologies for controls of accelerators and to give scientists, engineers, and technicians a forum to exchange the ideas on control problems and their solutions. The workshop consisted of plenary sessions and poster sessions. No parallel sessions were held.Totally, more than seventy oral and poster presentations as well as tutorials were made during the conference, on themore » basis of which about fifty papers were submitted by the authors and included in this publication. This printed version of the PCaPAC 2006 Proceedings is published at Jefferson Lab according to the decision of the PCaPAC International Program Committee of October 26, 2006.« less

Acceptance testing for PACS: from methodology to design to implementation

NASA Astrophysics Data System (ADS)

Liu, Brent J.; Huang, H. K.

2004-04-01

Acceptance Testing (AT) is a crucial step in the implementation process of a PACS within a clinical environment. AT determines whether the PACS is ready for clinical use and marks the official sign off of the PACS product. Most PACS vendors have Acceptance Testing (AT) plans, however, these plans do not provide a complete and robust evaluation of the full system. In addition, different sites will have different special requirements that vendor AT plans do not cover. The purpose of this paper is to introduce a protocol for AT design and present case studies of AT performed on clinical PACS. A methodology is presented that includes identifying testing components within PACS, quality assurance for both functionality and performance, and technical testing focusing on key single points-of-failure within the PACS product. Tools and resources that provide assistance in performing AT are discussed. In addition, implementation of the AT within the clinical environment and the overall implementation timeline of the PACS process are presented. Finally, case studies of actual AT of clinical PACS performed in the healthcare environment will be reviewed. The methodology for designing and implementing a robust AT plan for PACS was documented and has been used in PACS acceptance tests in several sites. This methodology can be applied to any PACS and can be used as a validation for the PACS product being acquired by radiology departments and hospitals. A methodology for AT design and implementation was presented that can be applied to future PACS installations. A robust AT plan for a PACS installation can increase both the utilization and satisfaction of a successful implementation of a PACS product that benefits both vendor and customer.

Cannabidiol inhibits paclitaxel-induced neuropathic pain through 5-HT(1A) receptors without diminishing nervous system function or chemotherapy efficacy.

PubMed

Ward, Sara Jane; McAllister, Sean D; Kawamura, Rumi; Murase, Ryuchi; Neelakantan, Harshini; Walker, Ellen A

2014-02-01

Paclitaxel (PAC) is associated with chemotherapy-induced neuropathic pain (CIPN) that can lead to the cessation of treatment in cancer patients even in the absence of alternate therapies. We previously reported that chronic administration of the non-psychoactive cannabinoid cannabidiol (CBD) prevents PAC-induced mechanical and thermal sensitivity in mice. Hence, we sought to determine receptor mechanisms by which CBD inhibits CIPN and whether CBD negatively effects nervous system function or chemotherapy efficacy. The ability of acute CBD pretreatment to prevent PAC-induced mechanical sensitivity was assessed, as was the effect of CBD on place conditioning and on an operant-conditioned learning and memory task. The potential interaction of CBD and PAC on breast cancer cell viability was determined using the MTT assay. PAC-induced mechanical sensitivity was prevented by administration of CBD (2.5 - 10 mg·kg⁻¹) in female C57Bl/6 mice. This effect was reversed by co-administration of the 5-HT(1A) antagonist WAY 100635, but not the CB₁ antagonist SR141716 or the CB₂ antagonist SR144528. CBD produced no conditioned rewarding effects and did not affect conditioned learning and memory. Also, CBD + PAC combinations produce additive to synergistic inhibition of breast cancer cell viability. Our data suggest that CBD is protective against PAC-induced neurotoxicity mediated in part by the 5-HT(1A) receptor system. Furthermore, CBD treatment was devoid of conditioned rewarding effects or cognitive impairment and did not attenuate PAC-induced inhibition of breast cancer cell viability. Hence, adjunct treatment with CBD during PAC chemotherapy may be safe and effective in the prevention or attenuation of CIPN. © 2013 The British Pharmacological Society.

Cannabidiol inhibits paclitaxel-induced neuropathic pain through 5-HT1A receptors without diminishing nervous system function or chemotherapy efficacy

PubMed Central

Ward, Sara Jane; McAllister, Sean D; Kawamura, Rumi; Murase, Ryuchi; Neelakantan, Harshini; Walker, Ellen A

2014-01-01

Background and Purpose Paclitaxel (PAC) is associated with chemotherapy-induced neuropathic pain (CIPN) that can lead to the cessation of treatment in cancer patients even in the absence of alternate therapies. We previously reported that chronic administration of the non-psychoactive cannabinoid cannabidiol (CBD) prevents PAC-induced mechanical and thermal sensitivity in mice. Hence, we sought to determine receptor mechanisms by which CBD inhibits CIPN and whether CBD negatively effects nervous system function or chemotherapy efficacy. Experimental Approach The ability of acute CBD pretreatment to prevent PAC-induced mechanical sensitivity was assessed, as was the effect of CBD on place conditioning and on an operant-conditioned learning and memory task. The potential interaction of CBD and PAC on breast cancer cell viability was determined using the MTT assay. Key Results PAC-induced mechanical sensitivity was prevented by administration of CBD (2.5 – 10 mg·kg−1) in female C57Bl/6 mice. This effect was reversed by co-administration of the 5-HT1A antagonist WAY 100635, but not the CB1 antagonist SR141716 or the CB2 antagonist SR144528. CBD produced no conditioned rewarding effects and did not affect conditioned learning and memory. Also, CBD + PAC combinations produce additive to synergistic inhibition of breast cancer cell viability. Conclusions and Implications Our data suggest that CBD is protective against PAC-induced neurotoxicity mediated in part by the 5-HT1A receptor system. Furthermore, CBD treatment was devoid of conditioned rewarding effects or cognitive impairment and did not attenuate PAC-induced inhibition of breast cancer cell viability. Hence, adjunct treatment with CBD during PAC chemotherapy may be safe and effective in the prevention or attenuation of CIPN. PMID:24117398

Cloning and expression analysis of cDNAs for ABA 8'-hydroxylase during sweet cherry fruit maturation and under stress conditions.

PubMed

Ren, Jie; Sun, Liang; Wu, Jiefang; Zhao, Shengli; Wang, Canlei; Wang, Yanping; Ji, Kai; Leng, Ping

2010-11-15

Abscisic acid (ABA) plays a key role in various aspects of plant growth and development, including adaptation to environmental stress and fruit maturation in sweet cherry fruit. In higher plants, the level of ABA is determined by synthesis and catabolism. In order to gain insight into ABA synthesis and catabolism in sweet cherry fruit during maturation and under stress conditions, four cDNAs of PacCYP707A1 -PacCYP707A4 for 8'-hydroxylase, a key enzyme in the oxidative catabolism of ABA, and one cDNA of PacNCED1 for 9-cis-epoxycarotenoid dioxygenase, a key enzyme in the ABA biosynthetic pathway, were isolated from sweet cherry fruit (Prunus avium L.). The timing and pattern of PacNCED1 expression was coincident with that of ABA accumulation, which was correlated to maturation of sweet cherry fruit. All four PacCYP707As were expressed at varying intensities throughout fruit development and appeared to play overlapping roles in ABA catabolism throughout sweet cherry fruit development. The application of ABA enhanced the expression of PacCYP707A1 -PacCYP707A3 as well as PacNCED1, but downregulated the PacCYP707A4 transcript level. Expressions of PacCYP707A1, PacCYP707A3 and PacNCED1 were strongly increased by water stress. No significant differences in PacCYP707A2 and PacCYP707A4 expression were observed between dehydrated and control fruits. The results suggest that endogenous ABA content is modulated by a dynamic balance between biosynthesis and catabolism, which are regulated by PacNCED1 and PacCYP707As transcripts, respectively, during fruit maturation and under stress conditions. Copyright © 2010 Elsevier GmbH. All rights reserved.

Informatics in radiology (infoRAD): Vendor-neutral case input into a server-based digital teaching file system.

PubMed

Kamauu, Aaron W C; DuVall, Scott L; Robison, Reid J; Liimatta, Andrew P; Wiggins, Richard H; Avrin, David E

2006-01-01

Although digital teaching files are important to radiology education, there are no current satisfactory solutions for export of Digital Imaging and Communications in Medicine (DICOM) images from picture archiving and communication systems (PACS) in desktop publishing format. A vendor-neutral digital teaching file, the Radiology Interesting Case Server (RadICS), offers an efficient tool for harvesting interesting cases from PACS without requiring modifications of the PACS configurations. Radiologists push imaging studies from PACS to RadICS via the standard DICOM Send process, and the RadICS server automatically converts the DICOM images into the Joint Photographic Experts Group format, a common desktop publishing format. They can then select key images and create an interesting case series at the PACS workstation. RadICS was tested successfully against multiple unmodified commercial PACS. Using RadICS, radiologists are able to harvest and author interesting cases at the point of clinical interpretation with minimal disruption in clinical work flow. RSNA, 2006

PACS for imaging centers.

PubMed

Farnsworth, T J

2003-01-01

PACS can be a difficult and confusing decision for any radiology provider, but it can be an even more dynamic question for an outpatient imaging center. Every center represents a unique situation and requires a specialized solution. Typically, most of what is said and discussed about PACS concentrates on solutions and requirements for hospital radiology facilities. Administrators of imaging centers have different problems from hospital administrators, and they need different answers. For imaging centers, the financial justification for PACS may be less immediate than for hospitals. The first thing that must be understood is that no PAC system can make a typical imaging center completely filmless, at least not for quite a while. A hospital has the ability to dictate to its internal referring physicians how a radiological study is delivered, whereas in an imaging center environment, the roles are very much reversed. Once the justification are made for the financial viability of PACS in an imaging center, the next question is how to finance the acquisition of PACS. The decision will depend on how you cost justify your PACS, as well as the shape of your business model, and it will come to a decision between capital purchase or contracting with an application service provider, or ASP. Historically, in the hospital-dominated marketplace, PAC systems have been treated as capital acquisitions. However, for most imaging center, owning the system is more of a problem than a benefit. ASPs increasingly represent a successful alternative for imaging centers. One of the biggest things to consider with PACS is how to store all of those images. There are typically two options, on-site and off-site, with a new "hybrid" option surfacing more recently. Each option has benefits for the user, but the benefits of off-site storage are increasing as the technology advances. Some of the benefits are data security and access. Other issues to address are HIPAA compliance, standardized interfaces such as HL-7, Web access and the choice of view stations.

Application of two bicistronic systems involving 2A and IRES sequences to the biosynthesis of carotenoids in rice endosperm.

PubMed

Ha, Sun-Hwa; Liang, Ying Shi; Jung, Harin; Ahn, Mi-Jeong; Suh, Seok-Cheol; Kweon, Soon-Jong; Kim, Dong-Hern; Kim, Young-Mi; Kim, Ju-Kon

2010-10-01

Coordination of multiple transgenes is essential for metabolic engineering of biosynthetic pathways. Here, we report the utilization of two bicistronic systems involving the 2A sequence from the foot-and-mouth disease virus and the internal ribosome entry site (IRES) sequence from the crucifer-infecting tobamovirus to the biosynthesis of carotenoids in rice endosperm. Two carotenoid biosynthetic genes, phytoene synthase (Psy) from Capsicum and carotene desaturase (CrtI) from Pantoea, were linked via either the synthetic 2A sequence that was optimized for rice codons or the IRES sequence under control of the rice globulin promoter, generating PAC (Psy-2A-CrtI) and PIC (Psy-IRES-CrtI) constructs, respectively. The transgenic endosperm of PAC rice had a more intense golden color than did PIC rice, demonstrating that 2A was more efficient than IRES in coordinating gene expression. The 2A and IRES constructs were equally effective in driving transgene transcription. However, immunoblot analysis of CRTI, a protein encoded by the downstream open reading frame of the bicistronic constructs, revealed that 2A was ninefold more effective than IRES in driving translation. The PAC endosperms accumulated an average of 1.3 μg/g of total carotenoids, which was ninefold higher than was observed for PIC endosperms. In particular, accumulation of β-carotene was much higher in PAC endosperms than in PIC endosperms. Collectively, these results demonstrate that both 2A and IRES systems can coordinate the expression of two biosynthetic genes, with the 2A system exhibiting greater efficiency. Thus, the 2A expression system described herein is an effective new tool for multigene stacking in crop biotechnology. © 2010 The Authors. Plant Biotechnology Journal © 2010 Society for Experimental Biology and Blackwell Publishing Ltd.

Wireless remote control of clinical image workflow: using a PDA for off-site distribution and disaster recovery.

PubMed

Documet, Jorge; Liu, Brent J; Documet, Luis; Huang, H K

2006-07-01

This paper describes a picture archiving and communication system (PACS) tool based on Web technology that remotely manages medical images between a PACS archive and remote destinations. Successfully implemented in a clinical environment and also demonstrated for the past 3 years at the conferences of various organizations, including the Radiological Society of North America, this tool provides a very practical and simple way to manage a PACS, including off-site image distribution and disaster recovery. The application is robust and flexible and can be used on a standard PC workstation or a Tablet PC, but more important, it can be used with a personal digital assistant (PDA). With a PDA, the Web application becomes a powerful wireless and mobile image management tool. The application's quick and easy-to-use features allow users to perform Digital Imaging and Communications in Medicine (DICOM) queries and retrievals with a single interface, without having to worry about the underlying configuration of DICOM nodes. In addition, this frees up dedicated PACS workstations to perform their specialized roles within the PACS workflow. This tool has been used at Saint John's Health Center in Santa Monica, California, for 2 years. The average number of queries per month is 2,021, with 816 C-MOVE retrieve requests. Clinical staff members can use PDAs to manage image workflow and PACS examination distribution conveniently for off-site consultations by referring physicians and radiologists and for disaster recovery. This solution also improves radiologists' effectiveness and efficiency in health care delivery both within radiology departments and for off-site clinical coverage.

Learn from experience: insights of 200+ PACS customers.

PubMed

Swaton, Norm

2002-01-01

This article is based on a PACS study published in June 2001 by KLAS Enterprises. The study offers unique insight into the performance, underlying technology, product depth and breadth, and "real world" issues facing 10 of the leading PACS vendors and their clients as rated at more than 200 of their client sites by CIOs, department directors and vendor executives. The driving force behind this report reflects the heightened interest in PACS systems in general and PACS' contributions to the benefits associated with an electronic medical record. This research was sponsored by 10 healthcare provider organizations (not vendors), ranging from a 150-bed acute-care hospital to a seven-hospital IDN. Most of the data in the report focuses on the use of PACS in the radiology department, since comparatively few sites are using PACS systems in other departments, such as cardiology or pathology. The participating vendors supplied their customer lists, which contributed to the majority of clients surveyed. Clients surveyed in the study vary widely in size, ranging from 50 to 2,000 beds, with about 46 percent of those surveyed having a hospital size of more than 400 beds. The customers represent a broad cross-section of PACS clients, ranging from 10 percent to 95 percent filmless, with large-scale users making up the majority of respondents. Each of the customers were asked to numerically rate their vendor on 28 aspects of performance, as well as to answer 12 questions relating to customer satisfaction. Based on study results, success with PACS can be distilled into some basic principles. There are other issues that will help with a successful PACS selection and implementation, but the following list should help anyone get started. If you are able to focus on and accomplish these few things, you stand a better chance of building and meeting your business case. Pre-sell your PACS concept to the radiologists, technicians, IS/IT staff supporting it and to the referring physicians. Make your system user-friendly. Select a vendor that has a history of partnering with their clients. Find a vendor and system that you can afford and that provides enterprise-wide distribution and access to images. Move quickly from printed film to digital images. Know yourself. Know your goals, Do your homework. Ask for help.

Radiative forcing associated with particulate carbon emissions resulting from the use of mercury control technology.

PubMed

Lin, Guangxing; Penner, Joyce E; Clack, Herek L

2014-09-02

Injection of powdered activated carbon (PAC) adsorbents into the flue gas of coal fired power plants with electrostatic precipitators (ESPs) is the most mature technology to control mercury emissions for coal combustion. However, the PAC itself can penetrate ESPs to emit into the atmosphere. These emitted PACs have similar size and optical properties to submicron black carbon (BC) and thus could increase BC radiative forcing unintentionally. The present paper estimates, for the first time, the potential emission of PAC together with their climate forcing. The global average maximum potential emissions of PAC is 98.4 Gg/yr for the year 2030, arising from the assumed adoption of the maximum potential PAC injection technology, the minimum collection efficiency, and the maximum PAC injection rate. These emissions cause a global warming of 2.10 mW m(-2) at the top of atmosphere and a cooling of -2.96 mW m(-2) at the surface. This warming represents about 2% of the warming that is caused by BC from direct fossil fuel burning and 0.86% of the warming associated with CO2 emissions from coal burning in power plants. Its warming is 8 times more efficient than the emitted CO2 as measured by the 20-year-integrated radiative forcing per unit of carbon input (the 20-year Global Warming Potential).

Distributed PACS using distributed file system with hierarchical meta data servers.

PubMed

Hiroyasu, Tomoyuki; Minamitani, Yoshiyuki; Miki, Mitsunori; Yokouchi, Hisatake; Yoshimi, Masato

2012-01-01

In this research, we propose a new distributed PACS (Picture Archiving and Communication Systems) which is available to integrate several PACSs that exist in each medical institution. The conventional PACS controls DICOM file into one data-base. On the other hand, in the proposed system, DICOM file is separated into meta data and image data and those are stored individually. Using this mechanism, since file is not always accessed the entire data, some operations such as finding files, changing titles, and so on can be performed in high-speed. At the same time, as distributed file system is utilized, accessing image files can also achieve high-speed access and high fault tolerant. The introduced system has a more significant point. That is the simplicity to integrate several PACSs. In the proposed system, only the meta data servers are integrated and integrated system can be constructed. This system also has the scalability of file access with along to the number of file numbers and file sizes. On the other hand, because meta-data server is integrated, the meta data server is the weakness of this system. To solve this defect, hieratical meta data servers are introduced. Because of this mechanism, not only fault--tolerant ability is increased but scalability of file access is also increased. To discuss the proposed system, the prototype system using Gfarm was implemented. For evaluating the implemented system, file search operating time of Gfarm and NFS were compared.

Planning for PACS: a comprehensive guide to nontechnical considerations.

PubMed

Cohen, Mervyn D; Rumreich, Lori L; Garriot, Kimberley M; Jennings, S Gregory

2005-04-01

A complete picture archiving and communication system (PACS) installation is one of the largest projects a radiology department will undertake. Although technology issues are important, they often draw focus away from many other significant issues This paper describes in detail all of these other necessary components that need to be addressed if a PACS installation is to be relatively trouble free, provides guidelines for successful PACS implementation, and details pitfalls to be avoided.

Integration Of An MR Image Network Into A Clinical PACS

NASA Astrophysics Data System (ADS)

Ratib, Osman M.; Mankovich, Nicholas J.; Taira, Ricky K.; Cho, Paul S.; Huang, H. K.

1988-06-01

A direct link between a clinical pediatric PACS module and a FONAR MRI image network was implemented. The original MR network combines together the MR scanner, a remote viewing station and a central archiving station. The pediatric PACS directly connects to the archiving unit through an Ethernet TCP-IP network adhering to FONAR's protocol. The PACS communication software developed supports the transfer of patient studies and the patient information directly from the MR archive database to the pediatric PACS. In the first phase of our project we developed a package to transfer data between a VAX-111750 and the IBM PC I AT-based MR archive database through the Ethernet network. This system served as a model for PACS-to-modality network communication. Once testing was complete on this research network, the software and network hardware was moved to the clinical pediatric VAX for full PACS integration. In parallel to the direct transmission of digital images to the Pediatric PACS, a broadband communication system in video format was developed for real-time broadcasting of images originating from the MR console to 8 remote viewing stations distributed in the radiology department. These analog viewing stations allow the radiologists to directly monitor patient positioning and to select the scan levels during a patient examination from remote locations in the radiology department. This paper reports (1) the technical details of this implementation, (2) the merits of this network development scheme, and (3) the performance statistics of the network-to-PACS interface.

Determinant Factors in Applying Picture Archiving and Communication Systems (PACS) in Healthcare.

PubMed

Abdekhoda, Mohammadhiwa; Salih, Kawa Mirza

2017-01-01

Meaningful use of picture archiving and communication systems (PACS) can change the workflow for accessing digital images, lead to faster turnaround time, reduce tests and examinations, and increase patient throughput. This study was carried out to identify determinant factors that affect the adoption of PACS by physicians. This was a cross-sectional study in which 190 physicians working in a teaching hospital affiliated with Tehran University of Medical Sciences were randomly selected. Physicians' perceptions concerning the adoption of PACS were assessed by the conceptual path model of the Unified Theory of Acceptance and Use of Technology (UTAUT). Collected data were analyzed with regression analysis. Structural equation modeling was applied to test the final model that was developed. The results show that the UTAUT model can explain about 61 percent of the variance on in the adoption of PACS ( R 2 = 0.61). The findings also showed that performance expectancy, effort expectancy, social influences, and behavior intention have a direct and significant effect on the adoption of PACS. However, facility condition showed to have no significant effect on physicians' behavior intentions. Implementation of new technology such as PACS in the healthcare sector is unavoidable. Our study clearly identified significant and nonsignificant factors that may affect the adoption of PACS. Also, this study acknowledged that physicians' perception is a key factor to manage the implementation of PACS optimally, and this fact should be considered by healthcare managers and policy makers.

Determinant Factors in Applying Picture Archiving and Communication Systems (PACS) in Healthcare

PubMed Central

Abdekhoda, Mohammadhiwa; Salih, Kawa Mirza

2017-01-01

Objectives Meaningful use of picture archiving and communication systems (PACS) can change the workflow for accessing digital images, lead to faster turnaround time, reduce tests and examinations, and increase patient throughput. This study was carried out to identify determinant factors that affect the adoption of PACS by physicians. Methods This was a cross-sectional study in which 190 physicians working in a teaching hospital affiliated with Tehran University of Medical Sciences were randomly selected. Physicians’ perceptions concerning the adoption of PACS were assessed by the conceptual path model of the Unified Theory of Acceptance and Use of Technology (UTAUT). Collected data were analyzed with regression analysis. Structural equation modeling was applied to test the final model that was developed. Results The results show that the UTAUT model can explain about 61 percent of the variance on in the adoption of PACS (R2 = 0.61). The findings also showed that performance expectancy, effort expectancy, social influences, and behavior intention have a direct and significant effect on the adoption of PACS. However, facility condition showed to have no significant effect on physicians’ behavior intentions. Conclusions Implementation of new technology such as PACS in the healthcare sector is unavoidable. Our study clearly identified significant and nonsignificant factors that may affect the adoption of PACS. Also, this study acknowledged that physicians’ perception is a key factor to manage the implementation of PACS optimally, and this fact should be considered by healthcare managers and policy makers. PMID:28855856

Study on user interface of pathology picture archiving and communication system.

PubMed

Kim, Dasueran; Kang, Peter; Yun, Jungmin; Park, Sung-Hye; Seo, Jeong-Wook; Park, Peom

2014-01-01

It is necessary to improve the pathology workflow. A workflow task analysis was performed using a pathology picture archiving and communication system (pathology PACS) in order to propose a user interface for the Pathology PACS considering user experience. An interface analysis of the Pathology PACS in Seoul National University Hospital and a task analysis of the pathology workflow were performed by observing recorded video. Based on obtained results, a user interface for the Pathology PACS was proposed. Hierarchical task analysis of Pathology PACS was classified into 17 tasks including 1) pre-operation, 2) text, 3) images, 4) medical record viewer, 5) screen transition, 6) pathology identification number input, 7) admission date input, 8) diagnosis doctor, 9) diagnosis code, 10) diagnosis, 11) pathology identification number check box, 12) presence or absence of images, 13) search, 14) clear, 15) Excel save, 16) search results, and 17) re-search. And frequently used menu items were identified and schematized. A user interface for the Pathology PACS considering user experience could be proposed as a preliminary step, and this study may contribute to the development of medical information systems based on user experience and usability.

Migration of medical image data archived using mini-PACS to full-PACS.

PubMed

Jung, Haijo; Kim, Hee-Joung; Kang, Won-Suk; Lee, Sang-Ho; Kim, Sae-Rome; Ji, Chang Lyong; Kim, Jung-Han; Yoo, Sun Kook; Kim, Ki-Hwang

2004-06-01

This study evaluated the migration to full-PACS of medical image data archived using mini-PACS at two hospitals of the Yonsei University Medical Center, Seoul, Korea. A major concern in the migration of medical data is to match the image data from the mini-PACS with the hospital OCS (Ordered Communication System). Prior to carrying out the actual migration process, the principles, methods, and anticipated results for the migration with respect to both cost and effectiveness were evaluated. Migration gateway workstations were established and a migration software tool was developed. The actual migration process was performed based on the results of several migration simulations. Our conclusions were that a migration plan should be carefully prepared and tailored to the individual hospital environment because the server system, archive media, network, OCS, and policy for data management may be unique.

Effect of point-of-use, activated carbon filters on the bacteriological quality of rural groundwater supplies.

PubMed Central

Synder, J W; Mains, C N; Anderson, R E; Bissonnette, G K

1995-01-01

The water quality of 24 rural, domestic groundwater supplies treated with point-of-use, powdered activated carbon (PAC) filters was monitored to determine how such treatment might impact the bacteriological quality of private, residential drinking water supplies. Heterotrophic-plate-count (HPC) and total coliform analyses were performed on raw, PAC-treated, and overnight or stagnant (first-draw) PAC-treated water samples. Densities of HPC bacteria were elevated by 0.86 and 0.20 orders of magnitude for spring and well water systems, respectively, in PAC-treated effluents following overnight stagnation compared with levels in untreated treated effluents. Densities of HPC bacteria in PAC-treated effluents were significantly reduced (P < 0.01) below influent levels, however, after the point-of-use device was flushed for 2 min. While PAC significantly reduced the number of coliforms in product waters (P < 0.01), these indicator organisms were still detected in some effluents. Seasonal variations were evident in microbial counts from spring but not well water systems. It appears that aside from periods following stagnant-water use, such as overnight, PAC treatment does not compromise the bacteriological quality of drinking water obtained from underground sources. PMID:8534096

Suspended particulate matter collection methods influence the quantification of polycyclic aromatic compounds in the river system.

PubMed

Abuhelou, Fayez; Mansuy-Huault, Laurence; Lorgeoux, Catherine; Catteloin, Delphine; Collin, Valéry; Bauer, Allan; Kanbar, Hussein Jaafar; Gley, Renaud; Manceau, Luc; Thomas, Fabien; Montargès-Pelletier, Emmanuelle

2017-10-01

In this study, we compared the influence of two different collection methods, filtration (FT) and continuous flow field centrifugation (CFC), on the concentration and the distribution of polycyclic aromatic compounds (PACs) in suspended particulate matter (SPM) occurring in river waters. SPM samples were collected simultaneously with FT and CFC from a river during six sampling campaigns over 2 years, covering different hydrological contexts. SPM samples were analyzed to determine the concentration of PACs including 16 polycyclic aromatic hydrocarbons (PAHs), 11 oxygenated PACs (O-PACs), and 5 nitrogen PACs (N-PACs). Results showed significant differences between the two separation methods. In half of the sampling campaigns, PAC concentrations differed from a factor 2 to 30 comparing FT and CFC-collected SPMs. The PAC distributions were also affected by the separation method. FT-collected SPM were enriched in 2-3 ring PACs whereas CFC-collected SPM had PAC distributions dominated by medium to high molecular weight compounds typical of combustion processes. This could be explained by distinct cut-off threshold of the two separation methods and strongly suggested the retention of colloidal and/or fine matter on glass-fiber filters particularly enriched in low molecular PACs. These differences between FT and CFC were not systematic but rather enhanced by high water flow rates.

Prometheus payment model: application to hip and knee replacement surgery.

PubMed

Rastogi, Amita; Mohr, Beth A; Williams, Jeffery O; Soobader, Mah-Jabeen; de Brantes, Francois

2009-10-01

The Prometheus Payment Model offers a potential solution to the failings of the current fee-for-service system and various forms of capitation. At the core of the Prometheus model are evidence-informed case rates (ECRs), which include a bundle of typical services that are informed by evidence and/or expert opinion as well as empirical data analysis, payment based on the severity of patients, and allowances for potentially avoidable complications (PACs) and other provider-specific variations in payer costs. We outline the methods and findings of the hip and knee arthroplasty ECRs with an emphasis on PACs. Of the 2076 commercially insured patients undergoing hip arthroplasty in our study, PAC costs totaled $7.8 million (14% of total costs; n = 699 index PAC stays). Similarly, PAC costs were $12.7 million (14% of total costs; n = 897 index PAC stays) for 3403 patients undergoing knee arthroplasty. By holding the providers clinically and financially responsible for PACs, and by segmenting and quantifying the type of PACs generated during and after the procedure, the Prometheus model creates an opportunity for providers to focus on the reduction of PACs, including readmissions, making the data actionable and turn the waste related to PAC costs into potential savings.

Integrating powdered activated carbon into wastewater tertiary filter for micro-pollutant removal.

PubMed

Hu, Jingyi; Aarts, Annelies; Shang, Ran; Heijman, Bas; Rietveld, Luuk

2016-07-15

Integrating powdered activated carbon (PAC) into wastewater tertiary treatment is a promising technology to reduce organic micro-pollutant (OMP) discharge into the receiving waters. To take advantage of the existing tertiary filter, PAC was pre-embedded inside the filter bed acting as a fixed-bed adsorber. The pre-embedding (i.e. immobilization) of PAC was realized by direct dosing a PAC solution on the filter top, which was then promoted to penetrate into the filter media by a down-flow of tap water. In order to examine the effectiveness of this PAC pre-embedded filter towards OMP removal, batch adsorption tests, representing PAC contact reactor (with the same PAC mass-to-treated water volume ratio as in the PAC pre-embedded filter) were performed as references. Moreover, as a conventional dosing option, PAC was dosed continuously with the filter influent (i.e. the wastewater secondary effluent with the investigated OMPs). Comparative results confirmed a higher OMP removal efficiency associated with the PAC pre-embedded filter, as compared to the batch system with a practical PAC residence time. Furthermore, over a filtration period of 10 h (approximating a realistic filtration cycle for tertiary filters), the continuous dosing approach resulted in less OMP removal. Therefore, it was concluded that the pre-embedding approach can be preferentially considered when integrating PAC into the wastewater tertiary treatment for OMP elimination. Copyright © 2016 Elsevier Ltd. All rights reserved.

A role for PacMYBA in ABA-regulated anthocyanin biosynthesis in red-colored sweet cherry cv. Hong Deng (Prunus avium L.).

PubMed

Shen, Xinjie; Zhao, Kai; Liu, Linlin; Zhang, Kaichun; Yuan, Huazhao; Liao, Xiong; Wang, Qi; Guo, Xinwei; Li, Fang; Li, Tianhong

2014-05-01

The MYB transcription factors and plant hormone ABA have been suggested to play a role in fruit anthocyanin biosynthesis, but supporting genetic evidence has been lacking in sweet cherry. The present study describes the first functional characterization of an R2R3-MYB transcription factor, PacMYBA, from red-colored sweet cherry cv. Hong Deng (Prunus avium L.). Transient promoter assays demonstrated that PacMYBA physically interacted with several anthocyanin-related basic helix-loop-helix (bHLH) transcription factors to activate the promoters of PacDFR, PacANS and PacUFGT, which are thought to be involved in anthocyanin biosynthesis. Furthermore, the immature seeds of transgenic Arabidopsis plants overexpressing PacMYBA exhibited ectopic pigmentation. Silencing of PacMYBA, using a Tobacco rattle virus (TRV)-induced gene silencing technique, resulted in sweet cherry fruit that lacked red pigment. ABA treatment significantly induced anthocyanin accumulation, while treatment with the ABA biosynthesis inhibitor nordihydroguaiaretic acid (NDGA) blocked anthocyanin production. PacMYBA expression peaked after 2 h of pre-incubation in ABA and was 15.2-fold higher than that of sweet cherries treated with NDGA. The colorless phenotype was also observed in the fruits silenced in PacNCED1, which encodes a key enzyme in the ABA biosynthesis pathway. The endogenous ABA content as well as the transcript levels of six structural genes and PacMYBA in PacNCED1-RNAi (RNA interference) fruit were significantly lower than in the TRV vector control fruit. These results suggest that PacMYBA plays an important role in ABA-regulated anthocyanin biosynthesis and ABA is a signal molecule that promotes red-colored sweet cherry fruit accumulating anthocyanin.

Impact of PACS on dictation turnaround time and productivity.

PubMed

Lepanto, Luigi; Paré, Guy; Aubry, David; Robillard, Pierre; Lesage, Jacques

2006-03-01

This study was conducted to measure the impact of PACS on dictation turnaround time and productivity. The radiology information system (RIS) database was interrogated to calculate the time interval between image production and dictation for every exam performed during three 90-day periods (the 3 months preceding PACS implementation, the 3 months immediately following PACS deployment, and a 3-month period 1 year after PACS implementation). Data were obtained for three exam types: chest radiographs, abdominal CT, and spine MRI. The mean dictation turnaround times obtained during the different pre- and post-PACS periods were compared using analysis of variance (ANOVA). Productivity was also determined for each period and for each exam type, and was expressed as the number of studies interpreted per full-time equivalent (FTE) radiologist. In the immediate post-PACS period, dictation turnaround time decreased 20% (p < 0.001) for radiography, but increased 13% (ns) for CT and 28% (p < 0.001) for MRI. One year after PACS was implemented, dictation turnaround time decreased 45% (p < 0.001) for radiography and 36% (p < 0.001) for MRI. For CT, 1 year post-PACS, turnaround times returned to pre-PACS levels. Productivity in the immediate post-PACS period increased 3% and 38% for radiography and CT, respectively, whereas a 6% decrease was observed for MRI. One year after implementation, productivity increased 27%, 98%, and 19% in radiography, CT, and MRI, respectively. PACS benefits, namely, shortened dictation turnaround time and increased productivity, are evident 1 year after PACS implementation. In the immediate post-PACS period, results vary with the different imaging modalities.

Serendipitous observations of asteroids in Herschel PACS and SPIRE maps

NASA Astrophysics Data System (ADS)

Szakáts, R.; Kiss, Cs.; Marton, G.; Varga-Verebélyi, E.; Müller, T.; Pál, A.

2017-09-01

We present our methods and results in finding serendipitous solar system objects on Herschel PACS and SPIRE maps. We can use this data to supplement the Herschel PACS and SPIRE point source catalogs with flags of possible contamination and to obtain thermal infrared fluxes for these asteroids.

Lower Critical Solution Temperature (LCST) and drug conjugation of polyacetal

NASA Astrophysics Data System (ADS)

de Silva, Chathuranga; Samanta, Sanjoy; Leophairatana, Porakrit; Koberstein, Jeffrey

There has been an increasing focus in polymer research for materials that can efficiently deliver therapeutics to a pre-identified solid tumor target. Due to their unique properties, stimuli responsive polymers (SRPs) have been of particular interest. One such novel SRP is a polyacetal-based copolymer (PAC). PAC shows a remarkable temperature response (LCST) that is linearly dependent on composition. Here, we discuss the fundamental physical origins of this LCST behavior, exhibited by this polymer. Our results indicate that the observed LCST scales linearly with the number of carbon and oxygen atoms in the polymer repeat units, allowing for precise control over the LCST. We design PAC to include cancer therapeutics in its polymer-backbone, utilizing strategies to modify step-growth polymerization to obtain, for the first time, temperature-responsive main-chain drug conjugates. The temperature response in these main-chain drug conjugates allow for effective delivery of therapeutics to the tumor site, followed by acid-hydrolysis in acidic local tumor environments, to release pristine therapeutics directly at the tumor site. Due to these reasons, we foresee PAC to be in the forefront of soft-matter SRP drug-delivery systems.

Influence of Drugs Carried in Lipid Nanoparticles in Coronary Disease of Rabbit Transplanted Heart.

PubMed

Barbieri, Lucas R; Lourenço-Filho, Domingos D; Tavares, Elaine R; Carvalho, Priscila O; Gutierrez, Paulo S; Maranhão, Raul C; Stolf, Noedir A G

2017-08-01

Coronary allograft vasculopathy is an inflammatory-proliferative process that compromises the long-term success of heart transplantation and currently has no effective prevention and treatment. Lipid nanoparticles, termed LDE can carry chemotherapeutic agents in the circulation and concentrates them in the heart. Twenty-eight rabbits fed a cholesterol-rich diet and submitted to heterotopic heart transplantation were treated with cyclosporine A (10 mg/kg daily) and allocated to four groups of 7 animals treated with intravenous LDE-methotrexate (MTX; 4 mg/kg weekly), with LDE-paclitaxel (PACLI; 4 mg/kg weekly), or with LDE-PACLI (4 mg/kg weekly) and LDE-MTX (4 mg/kg weekly). A control group was treated with only weekly intravenous saline solution. Animals were euthanized 6 weeks later for morphometric, histologic, immunohistochemical, and gene expression analysis of the graft and native hearts. Compared with controls, grafts of rabbits treated with LDE-PACLI showed 50% reduction of coronary stenosis, and in the LDE-MTX and LDE-MTX/PACLI stenosis was approximately 18% less than in control, but this difference was not statistically significant. In the three treatment groups, macrophage infiltration was decreased. In the LDE-MTX group, gene expression of proinflammatory factors tumor necrosis factor-α, monocyte chemoattractant protein 1, interleukin 18, vascular cellular adhesion molecule 1, and matrix metalloproteinase 12 was strongly diminished, whereas expression of antiinflammatory interleukin 10 increased. In the LDE-PACLI and LDE-PACLI/MTX groups, proinflammatory and antiinflammatory gene expressions were not consistently changed by the treatments. LDE-PACLI promoted strong improvement of cardiac allograft vasculopathy, but the decrease in coronary stenosis by LDE-MTX and LDE-MTX/PACLI was not significant. All three treatments decreased macrophage infiltration in the graft. These results may encourage future clinical trials to test this new therapeutic approach to coronary allograft vasculopathy. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Design and implementation of disaster recovery and business continuity solution for radiology PACS.

PubMed

Mansoori, Bahar; Rosipko, Beverly; Erhard, Karen K; Sunshine, Jeffrey L

2014-02-01

In the digital era of radiology, picture archiving and communication system (PACS) has a pivotal role in retrieving and storing the images. Integration of PACS with all the health care information systems e.g., health information system, radiology information system, and electronic medical record has greatly improved access to patient data at anytime and anywhere throughout the entire enterprise. In such an integrated setting, seamless operation depends critically on maintaining data integrity and continuous access for all. Any failure in hardware or software could interrupt the workflow or data and consequently, would risk serious impact to patient care. Thus, any large-scale PACS now have an indispensable requirement to include deployment of a disaster recovery plan to ensure secure sources of data. This paper presents our experience with designing and implementing a disaster recovery and business continuity plan. The selected architecture with two servers in each site (local and disaster recovery (DR) site) provides four different scenarios to continue running and maintain end user service. The implemented DR at University Hospitals Health System now permits continuous access to the PACS application and its contained images for radiologists, other clinicians, and patients alike.

User acceptance of a picture archiving and communication system (PACS) in a Saudi Arabian hospital radiology department

PubMed Central

2012-01-01

Background Compared with the increasingly widespread use of picture archiving and communication systems (PACSs), knowledge concerning users’ acceptance of such systems is limited. Knowledge of acceptance is needed given the large (and growing) financial investment associated with the implementation of PACSs, and because the level of user acceptance influences the degree to which the benefits of the systems for healthcare can be realized. Methods A Technology Acceptance Model (TAM) was used to assess the level of acceptance of the host PACS by staff in the radiology department at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. A questionnaire survey of 89 PACS users was employed to obtain data regarding user characteristics, perceived usefulness (PU) (6 items), perceived ease of use (PEU) (4 items), a change construct (4 items), and a behavior (acceptance) construct (9 items). Respondents graded each item in each construct using five-point likert scales. Results Surveyed users reported high levels of PU (4.33/5), PEU (4.15/5), change (4.26/5), and acceptance (3.86/5). The three constructs of PU, PEU, and change explained 41 % of the variation in PACS user acceptance. PU was the most important predictor, explaining 38 % of the variation on its own. The most important single item in the explanatory constructs was that users found PACS to have improved the quality of their work in providing better patient care. Technologists had lower acceptance ratings than did clinicians/radiologists, but no influence on acceptance level was found due to gender, age, or length of experience using the PACS. Although not directly measured, there appeared to be no cultural influence on either the level of acceptance or its determinants. Conclusions User acceptance must be considered when an organization implements a PACS, in order to enhance its successful adoption. Health organizations should adopt a PACS that offers all required functions and which is likely to generate high PU on the part of its users, rather than a system that is easy to use. Training/familiarization programs should aim at establishing high levels of PU in all users, particularly technologists. Health organizations are advised to measure all the factors that influence the acceptance of a PACS by their staff, in order to optimize the productivity of the system and realize the potential benefits to the greatest extent possible. PMID:22640490

Tablet PC as a mobil PACS terminal using wireless LAN

NASA Astrophysics Data System (ADS)

Tsao, Bo-Shen; Ching, Yu-Tai; Lee, Wen-Jeng; Chen, Shyh-Jye; Chang, Chia-Hung; Chen, Chien-Jung; Yen, York; Lee, Yuan-Ten

2003-05-01

A PACS mobile terminal has applications in ward round, emergency room and remote teleradiology consultation. Personal Digital Assistants (PDAs) have the highest mobility and are used for many medical applications. However, their roles are limited in the field of radiology due to small screen size. In this study, we built a wireless PACS terminal using a hand-held tablet-PC. A tablet PC (X-pilot, LEO systems, Taiwan) running the WinCE operating systems was used as our mobile PACS terminal. This device is equipped with 800×600 resolution 10.4 inch TFT monitor. The network connection between the tablet PC and the server was linked via wireless LAN (IEEE 802.11b).

Java-based cryptosystem for PACS and tele-imaging

NASA Astrophysics Data System (ADS)

Tjandra, Donny; Wong, Stephen T. C.; Yu, Yuan-Pin

1998-07-01

Traditional PACS systems are based on two-tier client server architectures, and require the use of costly, high-end client workstations for image viewing. Consequently, PACS systems using the two-tier architecture do not scale well as data increases in size and complexity. Furthermore, use of dedicated viewing workstations incurs costs in deployment and maintenance. To address these issues, the use of digital library technologies, such as the World Wide Web, Java, and CORBA, is being explored to distribute PACS data to serve a broader range of healthcare providers in an economic and efficient manner. Integration of PACS systems with digital library technologies allows access to medical information through open networks such as the Internet. However, use of open networks to transmit medical data introduces problems with maintaining privacy and integrity of patient information. Cryptography and digital timestamping is used to protect sensitive information from unauthorized access or tampering. A major concern when using cryptography and digital timestamping is the performance degradation associated with the mathematical calculations needed to encrypt/decrypt an image dataset, or to calculate the hash value of an image. The performance issue is compounded by the extra layer associated with the CORBA middleware, and the use of programming languages interpreted at the client side, such as Java. This paper study the extent to which Java-based cryptography and digital timestamping affects performance in a PACS system integrated with digital library technologies.

Computers in imaging and health care: now and in the future.

PubMed

Arenson, R L; Andriole, K P; Avrin, D E; Gould, R G

2000-11-01

Early picture archiving and communication systems (PACS) were characterized by the use of very expensive hardware devices, cumbersome display stations, duplication of database content, lack of interfaces to other clinical information systems, and immaturity in their understanding of the folder manager concepts and workflow reengineering. They were implemented historically at large academic medical centers by biomedical engineers and imaging informaticists. PACS were nonstandard, home-grown projects with mixed clinical acceptance. However, they clearly showed the great potential for PACS and filmless medical imaging. Filmless radiology is a reality today. The advent of efficient softcopy display of images provides a means for dealing with the ever-increasing number of studies and number of images per study. Computer power has increased, and archival storage cost has decreased to the extent that the economics of PACS is justifiable with respect to film. Network bandwidths have increased to allow large studies of many megabytes to arrive at display stations within seconds of examination completion. PACS vendors have recognized the need for efficient workflow and have built systems with intelligence in the management of patient data. Close integration with the hospital information system (HIS)-radiology information system (RIS) is critical for system functionality. Successful implementation of PACS requires integration or interoperation with hospital and radiology information systems. Besides the economic advantages, secure rapid access to all clinical information on patients, including imaging studies, anytime and anywhere, enhances the quality of patient care, although it is difficult to quantify. Medical image management systems are maturing, providing access outside of the radiology department to images and clinical information throughout the hospital or the enterprise via the Internet. Small and medium-sized community hospitals, private practices, and outpatient centers in rural areas will begin realizing the benefits of PACS already realized by the large tertiary care academic medical centers and research institutions. Hand-held devices and the Worldwide Web are going to change the way people communicate and do business. The impact on health care will be huge, including radiology. Computer-aided diagnosis, decision support tools, virtual imaging, and guidance systems will transform our practice as value-added applications utilizing the technologies pushed by PACS development efforts. Outcomes data and the electronic medical record (EMR) will drive our interactions with referring physicians and we expect the radiologist to become the informaticist, a new version of the medical management consultant.

Tracking PACS usage with open source tools.

PubMed

French, Todd L; Langer, Steve G

2011-08-01

A typical choice faced by Picture Archiving and Communication System (PACS) administrators is deciding how many PACS workstations are needed and where they should be sited. Oftentimes, the social consequences of having too few are severe enough to encourage oversupply and underutilization. This is costly, at best in terms of hardware and electricity, and at worst (depending on the PACS licensing and support model) in capital costs and maintenance fees. The PACS administrator needs tools to asses accurately the use to which her fleet is being subjected, and thus make informed choices before buying more workstations. Lacking a vended solution for this challenge, we developed our own.

PACS-Based Computer-Aided Detection and Diagnosis

NASA Astrophysics Data System (ADS)

Huang, H. K. (Bernie); Liu, Brent J.; Le, Anh HongTu; Documet, Jorge

The ultimate goal of Picture Archiving and Communication System (PACS)-based Computer-Aided Detection and Diagnosis (CAD) is to integrate CAD results into daily clinical practice so that it becomes a second reader to aid the radiologist's diagnosis. Integration of CAD and Hospital Information System (HIS), Radiology Information System (RIS) or PACS requires certain basic ingredients from Health Level 7 (HL7) standard for textual data, Digital Imaging and Communications in Medicine (DICOM) standard for images, and Integrating the Healthcare Enterprise (IHE) workflow profiles in order to comply with the Health Insurance Portability and Accountability Act (HIPAA) requirements to be a healthcare information system. Among the DICOM standards and IHE workflow profiles, DICOM Structured Reporting (DICOM-SR); and IHE Key Image Note (KIN), Simple Image and Numeric Report (SINR) and Post-processing Work Flow (PWF) are utilized in CAD-HIS/RIS/PACS integration. These topics with examples are presented in this chapter.

Cranberry Proanthocyanidins - Protein complexes for macrophage activation.

PubMed

Carballo, Sergio M; Haas, Linda; Krueger, Christian G; Reed, Jess D

2017-09-20

In this work we characterize the interaction of cranberry (Vaccinium macrocarpon) proanthocyanidins (PAC) with bovine serum albumin (BSA) and hen egg-white lysozyme (HEL) and determine the effects of these complexes on macrophage activation and antigen presentation. We isolated PAC from cranberry and complexed the isolated PAC with BSA and HEL. The properties of the PAC-protein complexes were studied by matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS), gel electrophoresis and zeta-potential. The effects of PAC-BSA complexes on macrophage activation were studied in RAW 264.7 macrophage like cells after treatment with lipopolysaccharide (LPS). Fluorescence microscopy was used to study the endocytosis of PAC-BSA complexes. The effects of the PAC complexes on macrophage antigen presentation were studied in an in vitro model of HEL antigen presentation by mouse peritoneal mononuclear cells to a T-cell hybridoma. The mass spectra of the PAC complexes with BSA and HEL differed from the spectra of the proteins alone by the presence of broad shoulders on the singly and doubly charged protein peaks. Complexation with PAC altered the electrophoretic mobility shift assay in native agarose gel and the electrophoretic mobility (ζ-potential) values. These results indicate that the PAC-protein complexes are stable and alter the protein structure without precipitating the protein. Fluorescence microscopy showed that the RAW 264.7 macrophages endocytosed BSA and PAC-BSA complexes in discrete vesicles that surrounded the nucleus. Macrophages treated with increasing amounts of PAC-BSA complexes had significantly reduced COX-2 and iNOS expression in response to treatment with lipopolysaccharide (LPS) in comparison to the controls. The PAC-HEL complexes modulated antigen uptake, processing and presentation in murine peritoneal macrophages. After 4 h of pre-incubation, only trace amounts of IL-2 were detected in the co-cultures treated with HEL alone, whereas the PAC-HEL complex had already reached the maximum IL-2 expression. Cranberry PAC may increase the rate of endocytosis of HEL and subsequent expression of IL-2 by the T-cell hybridomas. These results suggest that PAC-protein complexes modulate aspects of innate and acquired immune responses in macrophages.

Improved methods for venous access: the Port-A-Cath, a totally implanted catheter system.

PubMed

Strum, S; McDermed, J; Korn, A; Joseph, C

1986-04-01

We prospectively evaluated the performance and rate of long-term complications with the Port-A-Cath (PAC), a totally implanted vascular access system. Two catheter styles were evaluated, a small-bore (SB) catheter (0.51-mm diameter) and a large-bore (LB) catheter (1.02-mm diameter), in conjunction with the use of a strict catheter care protocol. The PAC performed well, and with both SB and LB systems, no significant extravasation, skin necrosis, hematoma, septum damage or leakage, or subcutaneous portal infections occurred after 7,240 days of implantation and 1,435 days of use. Complications with the PAC system consisted of catheter occlusion (seven patients, 21.5%) and one instance of possible catheter infection (3.1%). Occlusions were limited to patients implanted with the SB catheter (seven of 16, 43.8%), and five of the seven (71.4%) occurred in patients receiving continuous infusion chemotherapy and/or total parenteral nutrition. Patency of the PAC system was maintained using a regular flushing schedule once every 30 days, a significant advantage compared with the daily maintenance schedule required with externally placed venous catheters. The results of this study suggest that the PAC system can provide a safe and reliable method for venous access in patients requiring intermittent or prolonged intravenous therapy.

Integration of CBIR in radiological routine in accordance with IHE

NASA Astrophysics Data System (ADS)

Welter, Petra; Deserno, Thomas M.; Fischer, Benedikt; Wein, Berthold B.; Ott, Bastian; Günther, Rolf W.

2009-02-01

Increasing use of digital imaging processing leads to an enormous amount of imaging data. The access to picture archiving and communication systems (PACS), however, is solely textually, leading to sparse retrieval results because of ambiguous or missing image descriptions. Content-based image retrieval (CBIR) systems can improve the clinical diagnostic outcome significantly. However, current CBIR systems are not able to integrate their results with clinical workflow and PACS. Existing communication standards like DICOM and HL7 leave many options for implementation and do not ensure full interoperability. We present a concept of the standardized integration of a CBIR system for the radiology workflow in accordance with the Integrating the Healthcare Enterprise (IHE) framework. This is based on the IHE integration profile 'Post-Processing Workflow' (PPW) defining responsibilities as well as standardized communication and utilizing the DICOM Structured Report (DICOM SR). Because nowadays most of PACS and RIS systems are not yet fully IHE compliant to PPW, we also suggest an intermediate approach with the concepts of the CAD-PACS Toolkit. The integration is independent of the particular PACS and RIS system. Therefore, it supports the widespread application of CBIR in radiological routine. As a result, the approach is exemplarily applied to the Image Retrieval in Medical Applications (IRMA) framework.

Children's hospitals and PACS: six profiles of planning and implementation.

PubMed

Keen, C

1999-01-01

Six pediatric hospitals were interviewed at length about the status of PACS in their facilities. Children's Hospital Medical Center in Cincinnati, Ohio entered electronic imaging communications in 1993. Several nearby clinics were connected through teleradiology and by 1998, the radiology department had developed a business plan for the implementation of PACS. Two hospitals in Atlanta, Egleston Hospital and Scottish Rite Children's. Medical Center, merged in 1998 to become one entity with two medical campuses. They now treat 60 percent of Atlanta's pediatric patients. Merging incompatible systems has been the administrator's most immediate problem. One director of imaging services is responsible for the recently merged Mary Bridge Children's Hospital and Tacoma General Hospital, plus a network of clinics and medical facilities scatted throughout Tacoma and the South Puget Sound area in Washington state. A state-of-the-art mini-PACS and teleradiology system were implemented at Primary Children's Medical Center, Salt Lake City, in 1991. Over the years, it has added modalities into an electronic system that now results in significantly improved use of physicians' time and patient relations. St. Louis Children's Hospital, with both a director of radiology and a PACS administrator, has implemented teleradiology and an ultrasound mini-PACS, and has plans for an enterprise-wide PACS. Children's Hospital in Birmingham, Ala., a major trauma center, provides specialized pediatric care to nearly all 67 counties in Alabama. With a 20-year history of online computerization, it is now reengineering its emergency department and will implement CR there first.

Making the PACS workstation a browser of image processing software: a feasibility study using inter-process communication techniques.

PubMed

Wang, Chunliang; Ritter, Felix; Smedby, Orjan

2010-07-01

To enhance the functional expandability of a picture archiving and communication systems (PACS) workstation and to facilitate the integration of third-part image-processing modules, we propose a browser-server style method. In the proposed solution, the PACS workstation shows the front-end user interface defined in an XML file while the image processing software is running in the background as a server. Inter-process communication (IPC) techniques allow an efficient exchange of image data, parameters, and user input between the PACS workstation and stand-alone image-processing software. Using a predefined communication protocol, the PACS workstation developer or image processing software developer does not need detailed information about the other system, but will still be able to achieve seamless integration between the two systems and the IPC procedure is totally transparent to the final user. A browser-server style solution was built between OsiriX (PACS workstation software) and MeVisLab (Image-Processing Software). Ten example image-processing modules were easily added to OsiriX by converting existing MeVisLab image processing networks. Image data transfer using shared memory added <10ms of processing time while the other IPC methods cost 1-5 s in our experiments. The browser-server style communication based on IPC techniques is an appealing method that allows PACS workstation developers and image processing software developers to cooperate while focusing on different interests.

IHE profiles applied to regional PACS.

PubMed

Fernandez-Bayó, Josep

2011-05-01

PACS has been widely adopted as an image storage solution that perfectly fits the radiology department workflow and that can be easily extended to other hospital departments. Integrations with other hospital systems, like the Radiology Information System, the Hospital Information System and the Electronic Patient Record are fully achieved but still challenging aims. PACS also creates the perfect environment for teleradiology and teleworking setups. One step further is the regional PACS concept where different hospitals or health care enterprises share the images in an integrated Electronic Patient Record. Among the different solutions available to share images between different hospitals IHE (Integrating the Healthcare Enterprise) organization presents the Cross Enterprise Document Sharing profile (XDS) which allows sharing images from different hospitals even if they have different PACS vendors. Adopting XDS has multiple advantages, images do not need to be duplicated in a central archive to be shared among the different healthcare enterprises, they only need to be indexed and published in a central document registry. In the XDS profile IHE defines the mechanisms to publish and index the images in the central document registry. It also defines the mechanisms that each hospital will use to retrieve those images regardless on the Hospital PACS they are stored. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Performance enhancement with powdered activated carbon (PAC) addition in a membrane bioreactor (MBR) treating distillery effluent.

PubMed

Satyawali, Yamini; Balakrishnan, Malini

2009-10-15

This work investigated the effect of powdered activated carbon (PAC) addition on the operation of a membrane bioreactor (MBR) treating sugarcane molasses based distillery wastewater (spentwash). The 8L reactor was equipped with a submerged 30 microm nylon mesh filter with 0.05 m(2) filtration area. Detailed characterization of the commercial wood charcoal based PAC was performed before using it in the MBR. The MBR was operated over 200 days at organic loading rates (OLRs) varying from 4.2 to 6.9 kg m(-3)d(-1). PAC addition controlled the reactor foaming during start up and enhanced the critical flux by around 23%; it also prolonged the duration between filter cleaning. Operation at higher loading rates was possible and for a given OLR, the chemical oxygen demand (COD) removal was higher with PAC addition. However, biodegradation in the reactor was limited and the high molecular weight compounds were not affected by PAC supplementation. The functional groups on PAC appear to interact with the polysaccharide portion of the sludge, which may reduce its propensity to interact with the nylon mesh.

Improving the performance of membrane bioreactors by powdered activated carbon dosing with cost considerations.

PubMed

Yang, W; Paetkau, M; Cicek, N

2010-01-01

Effects of powdered activated carbon (PAC) dosing on the overall performance of membrane bioreactors (MBR) were investigated in two bench-scale submerged MBRs. Positive impacts of PAC dosing on membrane fouling and the removal of 17beta-estradiol (E2) and 17alpha-ethyinylestradiol (EE2) were demonstrated over a six-month stable operational period. PAC dosing in the MBR increased the removal rates of E2 and EE2 by 3.4% and 15.8%, respectively. The average soluble extracellular polymeric substances (EPS) and colloidal total organic carbon (TOC) concentrations in the PAC-MBR sludge was 60.1% and 61.8% lower than the control MBR sludge, respectively. Lower soluble EPS and colloidal TOC concentrations in the PAC-MBR sludge resulted in a slower rate of trans-membrane pressure (TMP) increase during MBRs operation, which could prolong the lifespan of membranes. Cost assessment showed that PAC dosing could reduce the operating cost for membrane cleaning and/or membrane replacement by about 25%. The operating cost for PAC dosing could be offset by the benefit from its reducing the cost for membrane maintenance.

Strengthening your ties to referring physicians through RIS/PACS integration.

PubMed

Worthy, Susan; Rounds, Karla C; Soloway, Connie B

2003-01-01

Many imaging centers are turning to technology solutions to increase refering physician satisfaction, implementing such enhancements as automated report distribution, picture archiving and communications system (PACS), radiology information systems (RIS), and web-based results access. However, without seamless integration, these technology investments don't address the challenge at its core: convenient and reliable, two-way communication and interaction with referring physicians. In an integrated RIS/PACS solution, patient tracking in the RIS and PACS study status are logged and available to users. The time of the patient's registration at the imaging center, the exam start and completion time, the patient's departure time from the imaging center, and results status are all tracked and logged. An integrated RIS/PACS solution provides additional support to the radiologist, a critical factor that can improve the turnaround time of results to referring physicians. The RIS/PACS enhances the interpretation by providing the patient's history, which gives the radiologist additional insight and decreases the likelihood of missing a diagnostic element. In a tightly integrated RIS/PACS solution, results information is more complete. Physicians can view reports with associated images selected by the radiologist. They will also have full order information and complete imaging history including prior reports and images. Referring physicians can access and view images and exam notes at the same time that the radiologist is interpreting the exam. Without the benefit of an integrated RIS/PACS system, the referring physician would have to wait for the signed transcription to be released. In a seamlessly integrated solution, film-tracking modules within the RIS are fused with digital imaging workflow in the PACS. Users can see at a glance if a historical exam is available on film and benefit when a complete study history--both film-based and digital--is presented with the current case. It is up to the imaging center to market the benefits of reduced errors, reduced turnaround times, and a higher level of service to referring physician community, and encourage them to take advantage of the convenience it provides. The savvy imaging center will also regard the integrated RIS/PACS as a valuable marketing tool for use in attracting radiologists.

PACS and electronic health records

NASA Astrophysics Data System (ADS)

Cohen, Simona; Gilboa, Flora; Shani, Uri

2002-05-01

Electronic Health Record (EHR) is a major component of the health informatics domain. An important part of the EHR is the medical images obtained over a patient's lifetime and stored in diverse PACS. The vision presented in this paper is that future medical information systems will convert data from various medical sources -- including diverse modalities, PACS, HIS, CIS, RIS, and proprietary systems -- to HL7 standard XML documents. Then, the various documents are indexed and compiled to EHRs, upon which complex queries can be posed. We describe the conversion of data retrieved from PACS systems through DICOM to HL7 standard XML documents. This enables the EHR system to answer queries such as 'Get all chest images of patients at the age of 20-30, that have blood type 'A' and are allergic to pine trees', which a single PACS cannot answer. The integration of data from multiple sources makes our approach capable of delivering such answers. It enables the correlation of medical, demographic, clinical, and even genetic information. In addition, by fully indexing all the tagged data in DICOM objects, it becomes possible to offer access to huge amounts of valuable data, which can be better exploited in the specific radiology domain.

Fault tolerant high-performance PACS network design and implementation

NASA Astrophysics Data System (ADS)

Chimiak, William J.; Boehme, Johannes M.

1998-07-01

The Wake Forest University School of Medicine and the Wake Forest University/Baptist Medical Center (WFUBMC) are implementing a second generation PACS. The first generation PACS provided helpful information about the functional and temporal requirements of the system. It highlighted the importance of image retrieval speed, system availability, RIS/HIS integration, the ability to rapidly view images on any PACS workstation, network bandwidth, equipment redundancy, and the ability for the system to evolve using standards-based components. This paper deals with the network design and implementation of the PACS. The physical layout of the hospital areas served by the PACS, the choice of network equipment and installation issues encountered are addressed. Efforts to optimize fault tolerance are discussed. The PACS network is a gigabit, mixed-media network based on LAN emulation over ATM (LANE) with a rapid migration from LANE to Multiple Protocols Over ATM (MPOA) planned. Two fault-tolerant backbone ATM switches serve to distribute network accesses with two load-balancing 622 megabit per second (Mbps) OC-12 interconnections. The switch was sized to be upgradable to provide a 2.54 Gbps OC-48 interconnection with an OC-12 interconnection as a load-balancing backup. Modalities connect with legacy network interface cards to a switched-ethernet device. This device has two 155 Mbps OC-3 load-balancing uplinks to each of the backbone ATM switches of the PACS. This provides a fault-tolerant logical connection to the modality servers which pass verified DICOM images to the PACS servers and proper PACS diagnostic workstations. Where fiber pulls were prohibitively expensive, edge ATM switches were installed with an OC-12 uplink to a backbone ATM switches. The PACS and data base servers are fault-tolerant, hot-swappable Sun Enterprise Servers with an OC-12 connection to a backbone ATM switch and a fast-ethernet connection to a back-up network. The workstations come with 10/100 BASET autosense cards. A redundant switched-ethernet network will be installed to provide yet another degree of network fault-tolerance. The switched-ethernet devices are connected to each of the backbone ATM switches with two-load-balancing OC-3 connections to provide fault-tolerant connectivity in the event of a primary network failure.

The health system cost of post-abortion care in Uganda

PubMed Central

Vlassoff, Michael; Mugisha, Frederick; Sundaram, Aparna; Bankole, Akinrinola; Singh, Susheela; Amanya, Leo; Kiggundu, Charles; Mirembe, Florence

2014-01-01

This article presents estimates based on the research conducted in 2010 of the cost to the Ugandan health system of providing post-abortion care (PAC), filling a gap in knowledge of the cost of unsafe abortion. Thirty-nine public and private health facilities were sampled representing three levels of health care, and data were collected on drugs, supplies, material, personnel time and out-of-pocket expenses. In addition, direct non-medical costs in the form of overhead and capital costs were also measured. Our results show that the average annual PAC cost per client, across five types of abortion complications, was $131. The total cost of PAC nationally, including direct non-medical costs, was estimated to be $13.9 million per year. Satisfying all demand for PAC would raise the national cost to $20.8 million per year. This shows that PAC consumes a substantial portion of the total expenditure in reproductive health in Uganda. Investing more resources in family planning programmes to prevent unwanted and mistimed pregnancies would help reduce health systems costs. PMID:23274438

Bridging the gap: linking a legacy hospital information system with a filmless radiology picture archiving and communications system within a nonhomogeneous environment.

PubMed

Rubin, R K; Henri, C J; Cox, R D

1999-05-01

A health level 7 (HL7)-conformant data link to exchange information between the mainframe hospital information system (HIS) of our hospital and our home-grown picture archiving and communications system (PACS) is a result of a collaborative effort between the HIS department and the PACS development team. Based of the ability to link examination requisitions and image studies, applications have been generated to optimise workflow and to improve the reliability and distribution of radiology information. Now, images can be routed to individual radiologists and clinicians; worklists facilitate radiology reporting; applications exist to create, edit, and view reports and images via the internet; and automated quality control now limits the incidence of "lost" cases and errors in image routing. By following the HL7 standard to develop the gateway to the legacy system, the development of a radiology information system for booking, reading, reporting, and billing remains universal and does not preclude the option to integrate off-the-shelf commercial products.

Particle counter as a tool to control pre-hydrolyzed coagulant dosing and rapid filtration efficiency in a conventional treatment system.

PubMed

Gumińska, Jolanta; Kłos, Marcin

2015-01-01

Filtration efficiency in a conventional water treatment system was analyzed in the context of pre-hydrolyzed coagulant overdosing. Two commercial coagulants of different aluminum speciation were tested. A study was carried out at a water treatment plant supplied with raw water of variable quality. The lack of stability of water quality caused many problems with maintaining the optimal coagulant dose. The achieved results show that the type of coagulant had a very strong influence on the effectiveness of filtration resulting from the application of an improper coagulant dose. The overdosing of high basicity coagulant (PAC85) caused a significant increase of fine particles in the outflow from the sedimentation tanks, which could not be retained in the filter bed due to high surface charge and the small size of hydrolysis products. When using a coagulant of lower basicity (PAC70), it was much easier to control the dose of coagulant and to adjust it to the changing water quality.

Doxycycline exerted neuroprotective activity by enhancing the activation of neuropeptide GPCR PAC1.

PubMed

Yu, Rongjie; Zheng, Lijun; Cui, Yue; Zhang, Huahua; Ye, Heng

2016-04-01

Doxycycline has significant neuroprotective effect with anti-inflammatory and anti-apoptotic activity. We found for the first time that doxycycline specially promoted the proliferation of Chinese hamster ovary (CHO) cells with high expression of neuropeptide pituitary adenylate cyclase-activating polypeptide (PACAP) preferring G protein-coupled receptor (GPCR), PACAP receptor 1(PAC1) and induced the internalization of PAC1 tagged with yellow fluorescent protein (YFP) indicating doxycycline interacted with PAC1. The homology modeling of PAC1 and molecular docking of doxycycline with PAC1 showed the theoretical binding of doxycycline to PAC1 at the site where PACAP(30-37) recognized. The competition binding assay and PAC1 site-specific mutation of Asp116, which formed two hydrogen bonds with Dox, confirmed the binding of doxycycline to PAC1 imitating PACAP(30-37). Doxycycline (100 ng/mL) significantly promoted the proliferative activities of vasoactive intestinal polypeptide (VIP) and oligopeptide HSDGIF responsible for the activation of PAC1 in PAC1-CHO cells, indicating that doxycycline facilitated the binding and the activation of PAC1 imitating PACAP(28-38). In Neuro2a cells with endogenous expression of PAC1 and its ligands, doxycycline not only promoted the proliferation of Neuro2a cells but also protected the cells from scopolamine induced apoptosis, which was inhibited by cAMP-PKA signal pathway inhibitor H-89, PAC1 shRNA or PACAP antagonist PACAP(6-38). The in vivo study showed long-term treatment with doxycycline (100ug/kg) had significant effect against scopolamine induced amnesia, and the synergetic anti-apoptotic, anti-oxidative and neuroprotective effect of doxycycline with VIP was more efficient than doxycycline alone or VIP alone, indicating doxycycline enhanced the activation of PAC1 in vivo effectively. Furthermore, doxycycline analogue minocycline also had similar theoretically binding site on PAC1 to doxycycline and displayed corresponding similar activity on PAC1 to doxycycline. All these results confirmed for the first time that doxycycline specially targeted PAC1 imitating PACAP(30-37) and acted as an enhancer by facilitating the subsequent ligand binding and the activation of PAC1. The confirmation of PAC1 as a novel molecular target of doxycycline and the novel mechanism by which doxycycline enhances the activity of PAC1 will help further clinical development of doxycycline as novel therapy for nervous system diseases such as neurodegenerative diseases targeting PAC1. Copyright © 2015 Elsevier Ltd. All rights reserved.

The impact of image storage organization on the effectiveness of PACS.

PubMed

Hindel, R

1990-11-01

Picture archiving communication system (PACS) requires efficient handling of large amounts of data. Mass storage systems are cost effective but slow, while very fast systems, like frame buffers and parallel transfer disks, are expensive. The image traffic can be divided into inbound traffic generated by diagnostic modalities and outbound traffic into workstations. At the contact points with medical professionals, the responses must be fast. Archiving, on the other hand, can employ slower but less expensive storage systems, provided that the primary activities are not impeded. This article illustrates a segmentation architecture meeting these requirements based on a clearly defined PACS concept.

How can the impact of PACS on inpatient length of hospital stay be established?

NASA Astrophysics Data System (ADS)

Bryan, Stirling; Muris, Nicole; Keen, Justin; Weatherburn, Gwyneth C.; Buxton, Martin J.

1994-05-01

Many have argued that the introduction of a large-scale PACS system into a hospital will bring about reductions in the length of inpatient hospital stays. There is currently no convicting empirical evidence to support such claims. As part of the independent evaluation exercise being undertaken alongside the Hammersmith Hospital PACS implementation, an assessment is being made of the impact of PACS on length of stay for selected patient groups. This paper reports the general research methods being employed to undertake this assessment and provides some baseline results from the analysis of total hip replacement patients and total knee replacement patients treated prior to the introduction of PACS.

PACS: implementation in the U.S. Department of Defense

NASA Astrophysics Data System (ADS)

Chacko, Anna K.; Wider, Ronald; Romlein, John R.; Cawthon, Michael A.; Richardson, Ronald R., Jr.; Lollar, H. William; Cook, Jay F.; Timboe, Harold L.; Johnson, Thomas G.; Fellows, Douglas W.

2000-05-01

The Department of Defense has been a leader in Radiology re- engineering for the past decade. Efforts have included the development of two landmark PACS specifications (MDIS and DIN- PACS), respective vendor selection and implementation programs. A Tri-Service (Army, Navy and Air Force) Radiology re-engineering program was initiated which identified transitioning to digital imaging, PACS and teleradiology as key enabling technologies in a changing business scenario. Subsequently, the systematic adjustment of procurement process for radiological imaging equipment included a focus on specifying PACS-capable-digital imaging modalities and mini- PACS as stepping stones to make the hospitals and health clinics PACS-ready. The success of the PACS and teleradiology program in the DOD is evidenced by the near filmless operation of most Army and Air Force Medical Centers, several community hospitals and several operational teleradiology constellations. Additionally, the MDIS PACSystem has become the commercial PACS product for General Electric Medical Systems. The DOD continues to forge ahead in the PACS arena by implementing advanced configurations and operational concepts such as the VRE (Virtual Radiology Environment), the negotiation of Regional Archiving and Regional PACS Maintenance Programs. Newer regulations (HIPAA, the FDA approval of digital mammography) have been promulgated impacting the culture and conduct of our business. Incorporating their requirements at the very outset will enable us to streamline the delivery of radiology. The DOD community has embraced the information age at multiple levels. The Healthcare portion of this community with these initiatives is integrating itself into DOD's future. The future holds great possibilities, promises and challenges for the DOD PACS programs.

Submerged membrane adsorption bioreactor as a pretreatment in seawater desalination for biofouling control.

PubMed

Jeong, Sanghyun; Naidu, Gayathri; Vigneswaran, Saravanamuthu

2013-08-01

Submerged membrane adsorption bioreactor (SMABR) was investigated as a pretreatment to reverse osmosis (RO). SMABR removed organic matter by adsorption and biological degradation. At a powder activated carbon (PAC) residence time of 66 d (1.5% of PAC replacement daily), higher organic removal was achieved with removal of a majority of biopolymers (94-97%) and humics (71-76%). A continuous MBR operation with the optimal PAC residence time of 66 d was conducted and compared with MBR with no PAC replenishment in terms of the removal of organic and microbes. High removal of organics of up to 72% was maintained with only a marginal increment of trans-membrane pressure and stable bioactivity (total cell number and adenosine tri-phosphate) during the 50d of operation. The SMABR was found to be a sustainable biological pretreatment to RO with only a small amount of PAC requirement (2.14 g of PAC/m(3) of seawater treated). Copyright © 2013 Elsevier Ltd. All rights reserved.

Integrating medical imaging analyses through a high-throughput bundled resource imaging system

NASA Astrophysics Data System (ADS)

Covington, Kelsie; Welch, E. Brian; Jeong, Ha-Kyu; Landman, Bennett A.

2011-03-01

Exploitation of advanced, PACS-centric image analysis and interpretation pipelines provides well-developed storage, retrieval, and archival capabilities along with state-of-the-art data providence, visualization, and clinical collaboration technologies. However, pursuit of integrated medical imaging analysis through a PACS environment can be limiting in terms of the overhead required to validate, evaluate and integrate emerging research technologies. Herein, we address this challenge through presentation of a high-throughput bundled resource imaging system (HUBRIS) as an extension to the Philips Research Imaging Development Environment (PRIDE). HUBRIS enables PACS-connected medical imaging equipment to invoke tools provided by the Java Imaging Science Toolkit (JIST) so that a medical imaging platform (e.g., a magnetic resonance imaging scanner) can pass images and parameters to a server, which communicates with a grid computing facility to invoke the selected algorithms. Generated images are passed back to the server and subsequently to the imaging platform from which the images can be sent to a PACS. JIST makes use of an open application program interface layer so that research technologies can be implemented in any language capable of communicating through a system shell environment (e.g., Matlab, Java, C/C++, Perl, LISP, etc.). As demonstrated in this proof-of-concept approach, HUBRIS enables evaluation and analysis of emerging technologies within well-developed PACS systems with minimal adaptation of research software, which simplifies evaluation of new technologies in clinical research and provides a more convenient use of PACS technology by imaging scientists.

Using experience with bidirectional HL7-ACR-NEMA interfaces between the federal government HIS/RIS and commercial PACS to plan for DICOM

NASA Astrophysics Data System (ADS)

Kuzmak, Peter M.; Norton, Gary S.; Dayhoff, Ruth E.

1995-05-01

The Department of Veterans Affairs has developed a bidirectional HL7 - ACR-NEMA V 2.0 interface for connecting existing federal government hospital/radiology information systems (HIS/RIS) to commercial picture archive and communication systems (PACS). The interface has been in use since October 1993 at the Baltimore VAMC between the VA's HIS/RIS (DHCP) and a commercial PACS, and handles both text and image transfer. The text-only portion of the interface has been ported to work with a second vendor's PACS, and to work with the Department of Defense HIS/RIS (CHCS). Currently the interface is in production at two VA and three DoD sites. The common benefit experienced at all these sites is that passing patient, order, and report information directly from the HIS/RIS to the PACS greatly improves the flow of work in the Radiology Department. Image transfer to the DHCP Imaging System at the Baltimore VAMC demonstrated the advantage of providing `reference quality' (1K X 1K X 8-bit) radiology images to treating clinicians throughout the hospital. Experience has shown that the gateway must handle transactions between the HIS/RIS and the PACS quickly in order to keep up with the volume, and must provide an audit trail for system diagnostic purposes. Work is underway to construct a HL7 - DICOM gateway built upon the operational experience gathered from the existing interface.

Acceptability of picture archiving and communication system (PACS) among hospital healthcare personnel based on a unified theory of acceptance and use of technology.

PubMed

Ahmadi, Maryam; Mehrabi, Nahid; Sheikhtaheri, Abbas; Sadeghi, Mojtaba

2017-09-01

The picture archiving and communication system (PACS) is a healthcare system technology which manages medical images and integrates equipment through a network. There are some theories about the use and acceptance of technology by people to describe the behavior and attitudes of end users towards information technologies. We investigated the influential factors on users' acceptance of PACS in the military hospitals of Tehran. In this applied analytical and cross-sectional study, 151 healthcare employees of military hospitals who had experience in using the PACS system were investigated. Participants were selected by census. The following variables were considered: performance expectancy, efforts expectancy, social influence, facilitating conditions and behavioral intention. Data were gathered using a questionnaire. Its validity and reliability were approved by a panel of experts and was piloted with 30 hospital healthcare staff (Cronbach's alpha =0.91). Spearman correlation coefficient and multiple linear regression analysis were used in analyzing the data. Expected performance, efforts expectancy, social impact and facilitating conditions had a significant relationship with behavioral intention. The multiple regression analysis indicated that only performance expectancy can predict the user's behavioral intentions to use PACS technology. Performance and effort expectancies are quite influential in accepting the use of PACS in hospitals. All healthcare personnel should become aware that using such technology is necessary in a hospital. Knowing the influencing factors that affect the acceptance of using new technology can help in improving its use, especially in a healthcare system. This can improve the offered healthcare services' quality.

Standardised high dose versus low dose cranberry Proanthocyanidin extracts for the prevention of recurrent urinary tract infection in healthy women [PACCANN]: a double blind randomised controlled trial protocol.

PubMed

Asma, Babar; Vicky, Leblanc; Stephanie, Dudonne; Yves, Desjardins; Amy, Howell; Sylvie, Dodin

2018-05-02

Urinary tract infections (UTIs) are amongst the most common bacterial infections affecting women. Although antibiotics are the treatment of choice for UTI, cranberry derived products have been used for many years to prevent UTIs, with limited evidence as to their efficacy. Our objective is to assess the efficacy of a cranberry extract capsule standardized in A-type linkage proanthocyanidins (PACs) for the prevention of recurrent urinary tract infection. We will perform a 1:1 randomized, controlled, double blind clinical trial in women aged 18 years or more who present ≥2 UTIs in 6 months or ≥ 3 UTIs in 12 months. One hundred and forty-eight women will be recruited and randomized in two groups to either receive an optimal dose of cranberry extract quantified and standardized in PACs (2 × 18.5 mg PACs per day) or a control dose (2 × 1 mg PACs per day). The primary outcome for the trial is the mean number of new symptomatic UTIs in women during a 6-month intervention period. Secondary outcomes are: (1) To evaluate the mean number of new symptomatic UTIs with pyuria as demonstrated by a positive leucocyte esterase test; (2) To detect the mean number of new symptomatic culture-confirmed UTIs; (3) To quantify urinary PACs metabolites in women who take a daily dose of 37 mg PACs per day compared to women who take a daily dose of 2 mg per day for 6 months; (4) To characterize women who present recurrent UTI based on known risk factors for recurrent UTI; (5) To describe the side effects of daily intake of cranberry extract containing 37 mg PACs compared to 2 mg PACs. This report provides comprehensive methodological data for this randomized controlled trial. The results of this trial will inform urologists, gynaecologists, family physicians and other healthcare professionals caring for healthy women with recurrent UTI, as to the benefits of daily use of an optimal dose of cranberry extract for the prevention of recurrent UTI. Clinicaltrials.gov, identifier: NCT02572895 October 8th 2015.

Metronidazole removal in powder-activated carbon and concrete-containing graphene adsorption systems: Estimation of kinetic, equilibrium and thermodynamic parameters and optimization of adsorption by a central composite design.

PubMed

Manjunath, S V; Kumar, S Mathava; Ngo, Huu Hao; Guo, Wenshan

2017-12-06

Metronidazole (MNZ) removal by two adsorbents, i.e., concrete-containing graphene (CG) and powder-activated carbon (PAC), was investigated via batch-mode experiments and the outcomes were used to analyze the kinetics, equilibrium and thermodynamics of MNZ adsorption. MNZ sorption on CG and PAC has followed the pseudo-second-order kinetic model, and the thermodynamic parameters revealed that MNZ adsorption was spontaneous on PAC and non-spontaneous on CG. Subsequently, two-parameter isotherm models, i.e., Langmuir, Freundlich, Temkin, Dubinin-Radushkevich and Elovich models, were applied to evaluate the MNZ adsorption capacity. The maximum MNZ adsorption capacities ([Formula: see text]) of PAC and CG were found to be between 25.5-32.8 mg/g and 0.41-0.002 mg/g, respectively. Subsequently, the effects of pH, temperature and adsorbent dosage on MNZ adsorption were evaluated by a central composite design (CCD) approach. The CCD experiments have pointed out the complete removal of MNZ at a much lower PAC dosage by increasing the system temperature (i.e., from 20°C to 40°C). On the other hand, a desorption experiment has shown 3.5% and 1.7% MNZ removal from the surface of PAC and CG, respectively, which was insignificant compared to the sorbed MNZ on the surface by adsorption. The overall findings indicate that PAC and CG with higher graphene content could be useful in MNZ removal from aqueous systems.

Principal component analysis to assess the efficiency and mechanism for enhanced coagulation of natural algae-laden water using a novel dual coagulant system.

PubMed

Ou, Hua-Se; Wei, Chao-Hai; Deng, Yang; Gao, Nai-Yun; Ren, Yuan; Hu, Yun

2014-02-01

A novel dual coagulant system of polyaluminum chloride sulfate (PACS) and polydiallyldimethylammonium chloride (PDADMAC) was used to treat natural algae-laden water from Meiliang Gulf, Lake Taihu. PACS (Aln(OH)mCl3n-m-2k(SO4)k) has a mass ratio of 10 %, a SO4 (2-)/Al3 (+) mole ratio of 0.0664, and an OH/Al mole ratio of 2. The PDADMAC ([C8H16NCl]m) has a MW which ranges from 5 × 10(5) to 20 × 10(5) Da. The variations of contaminants in water samples during treatments were estimated in the form of principal component analysis (PCA) factor scores and conventional variables (turbidity, DOC, etc.). Parallel factor analysis determined four chromophoric dissolved organic matters (CDOM) components, and PCA identified four integrated principle factors. PCA factor 1 had significant correlations with chlorophyll-a (r=0.718), protein-like CDOM C1 (0.689), and C2 (0.756). Factor 2 correlated with UV254 (0.672), humic-like CDOM component C3 (0.716), and C4 (0.758). Factors 3 and 4 had correlations with NH3-N (0.748) and T-P (0.769), respectively. The variations of PCA factors scores revealed that PACS contributed less aluminum dissolution than PAC to obtain equivalent removal efficiency of contaminants. This might be due to the high cationic charge and pre-hydrolyzation of PACS. Compared with PACS coagulation (20 mg L(-1)), the removal of PCA factors 1, 2, and 4 increased 45, 33, and 12 %, respectively, in combined PACS-PDADMAC treatment (0.8 mg L(-1) +20 mg L(-1)). Since PAC contained more Al (0.053 g/1 g) than PACS (0.028 g/1 g), the results indicated that PACS contributed less Al dissolution into the water to obtain equivalent removal efficiency.

Performance characteristics of the Mayo/IBM PACS

NASA Astrophysics Data System (ADS)

Persons, Kenneth R.; Gehring, Dale G.; Pavicic, Mark J.; Ding, Yingjai

1991-07-01

The Mayo Clinic and IBM (at Rochester, Minnesota) have jointly developed a picture archiving system for use with Mayo's MRI and Neuro CT imaging modalities. The communications backbone of the PACS is a portion of the Mayo institutional network: a series of 4-Mbps token rings interconnected by bridges and fiber optic extensions. The performance characteristics of this system are important to understand because they affect the response time a PACS user can expect, and the response time for non-PACS users competing for resources on the institutional network. The performance characteristics of each component and the average load levels of the network were measured for various load distributions. These data were used to quantify the response characteristics of the existing system and to tune a model developed by North Dakota State University Department of Computer Science for predicting response times of more complex topologies.

The HERSCHEL/PACS early Data Products

NASA Astrophysics Data System (ADS)

Wieprecht, E.; Wetzstein, M.; Huygen, R.; Vandenbussche, B.; De Meester, W.

2006-07-01

ESA's Herschel Space Observatory to be launched in 2007, is the first space observatory covering the full far-infrared and submillimeter wavelength range (60 - 670 microns). The Photodetector Array Camera & Spectrometer (PACS) is one of the three science instruments. It contains two Ge:Ga photoconductor arrays and two bolometer arrays to perform imaging line spectroscopy and imaging photometry in the 60 - 210 micron wavelength band. The HERSCHEL ground segment (Herschel Common Science System - HCSS) is implemented using JAVA technology and written in a common effort by the HERSCHEL Science Center and the three instrument teams. The PACS Common Software System (PCSS) is based on the HCSS and used for the online and offline analysis of PACS data. For telemetry bandwidth reasons PACS science data are partially processed on board, compressed, cut into telemetry packets and transmitted to the ground. These steps are instrument mode dependent. We will present the software model which allows to reverse the discrete on board processing steps and evaluate the data. After decompression and reconstruction the detector data and instrument status information are organized in two main PACS Products. The design of these JAVA classes considers the individual sampling rates, data formats, memory and performance optimization aspects and comfortable user interfaces.

Removal of Trace Pharmaceuticals from Water using coagulation and powdered activated carbon as pretreatment to ultrafiltration membrane system.

PubMed

Sheng, Chenguang; Nnanna, A G Agwu; Liu, Yanghe; Vargo, John D

2016-04-15

In this study, the efficacy of water treatment technologies: ultra-filtration (UF), powdered activated carbon (PAC), coagulation (COA) and a combination of these technologies (PAC/UF and COA/UF) to remove target pharmaceuticals (Acetaminophen, Bezafibrate, Caffeine, Carbamazepine, Cotinine, Diclofenac, Gemfibrozil, Ibuprofen, Metoprolol, Naproxen, Sulfadimethoxine, Sulfamethazine, Sulfamethoxazole, Sulfathiazole, Triclosan and Trimethoprim) was investigated. Samples of wastewater from municipal WWTPs were analyzed using direct aqueous injection High Performance Liquid Chromatography with Tandem Quadrupole Mass Spectrometric (LC/MS/MS) detection. On concentration basis, results showed an average removal efficiency of 29%, 50%, and 7%, respectively, for the UF, PAC dosage of 50ppm, and COA dosage of 10ppm. When PAC dosage of 100ppm was used as pretreatment to the combined PAC and UF in-line membrane system, a 90.3% removal efficiency was achieved. The removal efficiency of UF in tandem with COA was 33%, an increase of 4% compared with the single UF treatment. The adsorption effect of PAC combined with the physical separation process of UF revealed the best treatment strategy for removing pharmaceutical contaminant from water. Copyright © 2016 Elsevier B.V. All rights reserved.

Introduction to Agronomy, Grain Crops, Weeds and Controls. A Learning Activity Pac in Agricultural Education Courses in Wisconsin.

ERIC Educational Resources Information Center

Wisconsin State Dept. of Public Instruction, Madison. Div. of Instructional Services.

This learning activity pac contains information to help the teachers of high school vocational agriculture in the instructional area of agronomy. Each of the two main sections, grain crops and weeds and controls, includes teacher and student units for the section lessons. Teacher units include special instructions--equipment needed (film…

Looking beyond Grades: Comparing Self-Esteem and Perceived Academic Control as Predictors of First-Year College Students' Well-Being

ERIC Educational Resources Information Center

Stupnisky, Robert H.; Perry, Raymond P.; Renaud, Robert D.; Hladkyj, Steve

2013-01-01

Previous research has found perceived academic control (PAC) to be a better predictor of first-year college students' grades than self-esteem; however, it is uncertain which construct is more important for students' well-being. The current study compared PAC and self-esteem on first-year college students' emotions, perceived stress, and…

Enterprise-wide PACS: beyond radiology, an architecture to manage all medical images.

PubMed

Bandon, David; Lovis, Christian; Geissbühler, Antoine; Vallée, Jean-Paul

2005-08-01

Picture archiving and communication systems (PACS) have the vocation to manage all medical images acquired within the hospital. To address the various situations encountered in the imaging specialties, the traditional architecture used for the radiology department has to evolve. We present our preliminarily results toward an enterprise-wide PACS intended to support all kind of image production in medicine, from biomolecular images to whole-body pictures. Our solution is based on an existing radiologic PACS system from which images are distributed through an electronic patient record to all care facilities. This platform is enriched with a flexible integration framework supporting digital image communication in medicine (DICOM) and DICOM-XML formats. In addition, a generic workflow engine highly customizable is used to drive work processes. Echocardiology; hematology; ear, nose, and throat; and dermatology, including wounds, follow-up is the first implemented extensions outside of radiology. We also propose a global strategy for further developments based on three possible architectures for an enterprise-wide PACS.

Assessing Attachment in Psychotherapy: Validation of the Patient Attachment Coding System (PACS).

PubMed

Talia, Alessandro; Miller-Bottome, Madeleine; Daniel, Sarah I F

2017-01-01

The authors present and validate the Patient Attachment Coding System (PACS), a transcript-based instrument that assesses clients' in-session attachment based on any session of psychotherapy, in multiple treatment modalities. One-hundred and sixty clients in different types of psychotherapy (cognitive-behavioural, cognitive-behavioural-enhanced, psychodynamic, relational, supportive) and from three different countries were administered the Adult Attachment Interview (AAI) prior to treatment, and one session for each client was rated with the PACS by independent coders. Results indicate strong inter-rater reliability, and high convergent validity of the PACS scales and classifications with the AAI. These results present the PACS as a practical alternative to the AAI in psychotherapy research and suggest that clinicians using the PACS can assess clients' attachment status on an ongoing basis by monitoring clients' verbal activity. These results also provide information regarding the ways in which differences in attachment status play out in therapy sessions and further the study of attachment in psychotherapy from a pre-treatment client factor to a process variable. Copyright © 2015 John Wiley & Sons, Ltd. The Patient Attachment Coding System is a valid measure of attachment that can classify clients' attachment based on any single psychotherapy transcript, in many therapeutic modalities Client differences in attachment manifest in part independently of the therapist's contributions Client adult attachment patterns are likely to affect psychotherapeutic processes. Copyright © 2015 John Wiley & Sons, Ltd.

Transition from partial to full PACS at a 450,000 exams/year hospital

NASA Astrophysics Data System (ADS)

Ro, Duk-Woo; Byun, Hong Sik; Choo, In W.; Kim, Bo K.; Lim, Jae H.

1997-05-01

The purpose of this paper is to describe the transition of a 1,100 beds tertiary hospital from 50 percent softcopy operation to full PACS operation. For the past 2 years, radiologists and clinicians have been using PACS to provide softcopy services to the outpatient clinics and inpatient wards of orthopedics surgery, neurosurgery and neurology as well as emergency room, surgical intensive care unit, medical intensive unit, pediatrics intensive care unit and neonatal intensive care unit. The examinations requested by these departments account for about 50 percent of hospital's radiological exams. In September 1996, we began the second phase of PACS implementation and installed additional workstations in the remaining wards and clinics, interfaced to PACS additional imaging modalities, and increased the capacity of both the image server and optical juke boxes. As of January 1997, we are in the final phase of moving away from conventional film system to full PACS operation.

PACS--and beyond. A journey to the digital promised land.

PubMed

Viau, Mark A

2004-01-01

A successful picture archiving and communication system (PACS) integration depends on much more than the technology; marketing also plays a large role. This fact was evident from the inception of the PACS project at Boca Raton Community Hospital (BRCH). Strategic and effective marketing efforts should target technologists, nurses, physicians (including radiologists), administration, and colleagues in other departments. The buy-in of these users is critical to the project's success. BRCH's first marketing effort took place during the initial PACS presentation made to the hospital's board of directors. Once approval was given and a 6-month implementation target was set, a strategic and effective marketing/education plan commenced. Posters, brochures, t-shirts, and promotional items were distributed in a coordinated effort to target hospital staff and referring physician offices. Through its "Got PACS?" branding and other identity materials, BRCH implemented a marketing plan that informed, educated, and engaged PACS users.

Going all digital in a university hospital: a unified large-scale PACS for multiple departments and hospitals

NASA Astrophysics Data System (ADS)

Vogl, Raimund

2001-08-01

In 1997, a large PACS was first introduced at Innsbruck University Hospital in the context of a new traumatology centre. In the subsequent years, this initial PACS setting covering only one department was expanded to most of the hospital campus, with currently some 250 viewing stations attached. Constantly connecting new modalities and viewing stations created the demand for several redesigns from the original PACS configuration to cope with the increasing data load. We give an account of these changes necessary to develop a multi hospital PACS and the considerations that lead us there. Issues of personnel for running a large scale PACS are discussed and we give an outlook to the new information systems currently under development for archiving and communication of general medical imaging data and for simple telemedicine networking between several large university hospitals.

PACS-1 Mediates Phosphorylation-Dependent Ciliary Trafficking of the CNG Channel in Olfactory Sensory Neurons

PubMed Central

Jenkins, Paul M.; Zhang, Lian; Thomas, Gary; Martens, Jeffrey R.

2009-01-01

Impaired ciliary protein transport in olfactory sensory neurons (OSNs) leads to anosmia, and is a newly recognized clinical manifestation of a class of human disorders called ciliopathies. Surprisingly little is known regarding the mechanisms controlling trafficking to this unique neuronal compartment. Here, we show a novel role for phosphofurin acidic cluster-sorting protein 1 (PACS-1) in the ciliary trafficking of the olfactory CNG channel. PACS-1 is an intracellular sorting protein that mediates its effects through the binding of acidic clusters on cargo protein. This interaction is dependent on CK2 phosphorylation of both PACS-1 and its cargo. We show that CNGB1b contains two putative PACS-1 binding sites, which are phosphorylated by the serine/threonine protein kinase, CK2. Additionally, we show that PACS-1 is expressed in OSNs and interacts in complex with the CNG channel. CK2 inhibition in native OSNs causes a loss of CNG channel from cilia and subsequent olfactory dysfunction, while adenoviral expression of mutant PACS-1 causes similar mislocalization. These results provide a mechanism for the subunit-dependent ciliary trafficking of the CNG channel and offer insight into the mechanisms of ciliary transport. PMID:19710307

PACS-1 mediates phosphorylation-dependent ciliary trafficking of the cyclic-nucleotide-gated channel in olfactory sensory neurons.

PubMed

Jenkins, Paul M; Zhang, Lian; Thomas, Gary; Martens, Jeffrey R

2009-08-26

Impaired ciliary protein transport in olfactory sensory neurons (OSNs) leads to anosmia, and is a newly recognized clinical manifestation of a class of human disorders called ciliopathies. Surprisingly little is known regarding the mechanisms controlling trafficking to this unique neuronal compartment. Here, we show a novel role for phosphofurin acidic cluster-sorting protein 1 (PACS-1) in the ciliary trafficking of the olfactory cyclic-nucleotide-gated (CNG) channel. PACS-1 is an intracellular sorting protein that mediates its effects through the binding of acidic clusters on cargo protein. This interaction is dependent on CK2 phosphorylation of both PACS-1 and its cargo. We show that CNGB1b contains two putative PACS-1 binding sites, which are phosphorylated by the serine/threonine protein kinase, CK2. Additionally, we show that PACS-1 is expressed in OSNs and interacts in complex with the CNG channel. CK2 inhibition in native OSNs causes a loss of CNG channel from cilia and subsequent olfactory dysfunction, while adenoviral expression of mutant PACS-1 causes similar mislocalization. These results provide a mechanism for the subunit-dependent ciliary trafficking of the CNG channel and offer insight into the mechanisms of ciliary transport.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qiao, Hongzhu; Rao, N.S.V.; Protopopescu, V.

Regression or function classes of Euclidean type with compact support and certain smoothness properties are shown to be PAC learnable by the Nadaraya-Watson estimator based on complete orthonormal systems. While requiring more smoothness properties than typical PAC formulations, this estimator is computationally efficient, easy to implement, and known to perform well in a number of practical applications. The sample sizes necessary for PAC learning of regressions or functions under sup norm cost are derived for a general orthonormal system. The result covers the widely used estimators based on Haar wavelets, trignometric functions, and Daubechies wavelets.

Data on performance of air stripping tower- PAC integrated system for removing of odor, taste, dye and organic materials from drinking water-A case study in Saqqez, Iran.

PubMed

Pirsaheb, Meghdad; Mohammadi, Jalil; Khosravi, Touba; Sharafi, Hooshmnd; Moradi, Masoud

2018-06-01

Unpleasant taste or smell are more importantly constituents of drinking-water, lead to complaints from consumers. Dye and organic matter as well change in disinfection practice may generate taste and an odorous compound in treated water. According to low efficiency of conventional methods to remove taste and odor compounds, present study was aimed to evaluate the performance of air stripping tower- Poly Aluminum Chloride (PAC) integrated system to remove odor and taste, dye and organic materials from drinking water. Different air to water ratio and PAC doses were used to remove considered parameters in certain condition. The results of this study indicated that the maximum removal efficiency of 86.2, 76.47, 58.46 and 41.27% of taste and odor, dye, COD and TOC were achieved by the air stripping tower- PAC integrated system, respectively. However, the physico-chemical characteristics of water and adsorbent effect on the of substances removal efficiency considerably. It can be stated that the air striping tower - PAC integrated system is able to reduce the odor and taste-causing substances and organic matter to a level which is recommended by the Institute of Standards and Industrial Research of Iran.

The health system cost of post-abortion care in Rwanda

PubMed Central

Vlassoff, Michael; Musange, Sabine F; Kalisa, Ina R; Ngabo, Fidele; Sayinzoga, Felix; Singh, Susheela; Bankole, Akinrinola

2015-01-01

Based on research conducted in 2012, we estimate the cost to the Rwandan health-care system of providing post-abortion care (PAC) due to unsafe abortions, a subject of policy importance not studied before at the national level. Thirty-nine public and private health facilities representing three levels of health care were randomly selected for data collection from key care providers and administrators for all five regions. Using an ingredients approach to costing, data were gathered on drugs, supplies, material, personnel time and hospitalization. Additionally, direct non-medical costs such as overhead and capital costs were also measured. We found that the average annual PAC cost per client, across five types of abortion complications, was $93. The total cost of PAC nationally was estimated to be $1.7 million per year, 49% of which was expended on direct non-medical costs. Satisfying all demands for PAC would raise the national cost to $2.5 million per year. PAC comprises a significant share of total expenditure in reproductive health in Rwanda. Investing more resources in provision of contraceptive services to prevent unwanted or mistimed pregnancies would likely reduce health systems costs. PMID:24548846

[Economic effects of integrated RIS-PACS solution in the university environment].

PubMed

Kröger, M; Nissen-Meyer, S; Wetekam, V; Reiser, M

1999-04-01

The goal of the current article is to demonstrate how qualitative and monetary effects resulting from an integrated RIS/PACS installation can be evaluated. First of all, the system concept of a RIS/PACS solution for a university hospital is defined and described. Based on this example, a generic method for the evaluation of qualitative and monetary effects as well as associated risks is depicted and demonstrated. To this end, qualitative analyses, investment calculations and risk analysis are employed. The sample analysis of a RIS/PACS solution specially designed for a university hospital demonstrates positive qualitative and monetary effects of the system. Under ideal conditions the payoff time of the investments is reached after 4 years of an assumed 8 years effective life of the system. Furthermore, under conservative assumptions, the risk analysis shows a probability of 0% for realising a negative net present value at the end of the payoff time period. It should be pointed out that the positive result of this sample analysis will not necessarily apply to other clinics or hospitals. However, the same methods may be used for the individual evaluation of the qualitative and monetary effects of a RIS/PACS installation in any clinic.

Acceptability of picture archiving and communication system (PACS) among hospital healthcare personnel based on a unified theory of acceptance and use of technology

PubMed Central

Ahmadi, Maryam; Mehrabi, Nahid; Sheikhtaheri, Abbas; Sadeghi, Mojtaba

2017-01-01

Background and aim The picture archiving and communication system (PACS) is a healthcare system technology which manages medical images and integrates equipment through a network. There are some theories about the use and acceptance of technology by people to describe the behavior and attitudes of end users towards information technologies. We investigated the influential factors on users’ acceptance of PACS in the military hospitals of Tehran. Methods In this applied analytical and cross-sectional study, 151 healthcare employees of military hospitals who had experience in using the PACS system were investigated. Participants were selected by census. The following variables were considered: performance expectancy, efforts expectancy, social influence, facilitating conditions and behavioral intention. Data were gathered using a questionnaire. Its validity and reliability were approved by a panel of experts and was piloted with 30 hospital healthcare staff (Cronbach’s alpha =0.91). Spearman correlation coefficient and multiple linear regression analysis were used in analyzing the data. Results Expected performance, efforts expectancy, social impact and facilitating conditions had a significant relationship with behavioral intention. The multiple regression analysis indicated that only performance expectancy can predict the user’s behavioral intentions to use PACS technology. Conclusion Performance and effort expectancies are quite influential in accepting the use of PACS in hospitals. All healthcare personnel should become aware that using such technology is necessary in a hospital. Knowing the influencing factors that affect the acceptance of using new technology can help in improving its use, especially in a healthcare system. This can improve the offered healthcare services’ quality. PMID:29038717

Performance of the Mayo-IBM PAC system

NASA Astrophysics Data System (ADS)

Persons, Kenneth R.; Reardon, Frank J.; Gehring, Dale G.; Hangiandreou, Nicholas J.

1994-05-01

The Mayo Clinic and IBM (at Rochester, Minnesota) have jointly developed a picture archived system for use with Mayo's MRI and CT imaging modalities. This PACS is made up of over 50 computers that work cooperatively to provide archival, retrieval and image distribution services for Mayo's Department of Radiology. This paper will examine the performance characteristics of the system.

Strict integrity control of biomedical images

NASA Astrophysics Data System (ADS)

Coatrieux, Gouenou; Maitre, Henri; Sankur, Bulent

2001-08-01

The control of the integrity and authentication of medical images is becoming ever more important within the Medical Information Systems (MIS). The intra- and interhospital exchange of images, such as in the PACS (Picture Archiving and Communication Systems), and the ease of copying, manipulation and distribution of images have brought forth the security aspects. In this paper we focus on the role of watermarking for MIS security and address the problem of integrity control of medical images. We discuss alternative schemes to extract verification signatures and compare their tamper detection performance.

Development of a mini-mobile digital radiography system by using wireless smart devices.

PubMed

Jeong, Chang-Won; Joo, Su-Chong; Ryu, Jong-Hyun; Lee, Jinseok; Kim, Kyong-Woo; Yoon, Kwon-Ha

2014-08-01

The current technologies that trend in digital radiology (DR) are toward systems using portable smart mobile as patient-centered care. We aimed to develop a mini-mobile DR system by using smart devices for wireless connection into medical information systems. We developed a mini-mobile DR system consisting of an X-ray source and a Complementary Metal-Oxide Semiconductor (CMOS) sensor based on a flat panel detector for small-field diagnostics in patients. It is used instead of the systems that are difficult to perform with a fixed traditional device. We also designed a method for embedded systems in the development of portable DR systems. The external interface used the fast and stable IEEE 802.11n wireless protocol, and we adapted the device for connections with Picture Archiving and Communication System (PACS) and smart devices. The smart device could display images on an external monitor other than the monitor in the DR system. The communication modules, main control board, and external interface supporting smart devices were implemented. Further, a smart viewer based on the external interface was developed to display image files on various smart devices. In addition, the advantage of operators is to reduce radiation dose when using remote smart devices. It is integrated with smart devices that can provide X-ray imaging services anywhere. With this technology, it can permit image observation on a smart device from a remote location by connecting to the external interface. We evaluated the response time of the mini-mobile DR system to compare to mobile PACS. The experimental results show that our system outperforms conventional mobile PACS in this regard.

An industrial application of the JPL ACTS with energy recovery

NASA Technical Reports Server (NTRS)

Humphrey, M. F.; Wilson, G. E.; Schroepfer, T. W.

1980-01-01

The JPL Activated Carbon Treatment System (ACTS) uses sewage solids derived from municipal wastewater treatment systems as a source of organic material for powdered activated carbons (PAC). The PAC is used for the COD removal from wastewater and as a filter aid in the recovery of additional sewage solids.

Mycorrhiza reduces adverse effects of dark septate endophytes (DSE) on growth of conifers.

PubMed

Reininger, Vanessa; Sieber, Thomas N

2012-01-01

Mycorrhizal roots are frequently colonized by fungi of the Phialocephala fortinii s.l.-Acephala applanata species complex (PAC). These ascomycetes are common and widespread colonizers of tree roots. Some PAC strains reduce growth increments of their hosts but are beneficial in protecting roots against pathogens. Nothing is known about the effects of PAC on mycorrhizal fungi and the PAC-mycorrhiza association on plant growth, even though these two fungal groups occur closely together in natural habitats. We expect reduced colonization rates and reduced negative effects of PAC on host plants if roots are co-colonized by an ectomycorrhizal fungus (ECM). Depending on the temperature regime interactions among the partners in this tripartite ECM-PAC-plant system might also change. To test our hypotheses, effects of four PAC genotypes (two pathogenic and two non-pathogenic on the Norway spruce), mycorrhization by Laccaria bicolor (strain S238N) and two temperature regimes (19°C and 25°C) on the biomass of the Douglas-fir (Pseudotsuga menziesii) and Norway spruce (Picea abies) seedlings were studied. Mycorrhization compensated the adverse effects of PAC on the growth of the Norway spruce at both temperatures. The growth of the Douglas-fir was not influenced either by PAC or mycorrhization at 19°C, but at 25°C mycorrhization had a similar protective effect as in the Norway spruce. The compensatory effects probably rely on the reduction of the PAC-colonization density by mycorrhizae. Temperature and the PAC strain only had a differential effect on the biomass of the Norway spruce but not on the Douglas-fir. Higher temperature reduced mycorrhization of both hosts. We conclude that ectomycorrhizae form physical and/or physiological barriers against PAC leading to reduced PAC-colonization of the roots. Additionally, our results indicate that global warming could cause a general decrease of mycorrhization making primary roots more accessible to other symbionts and pathogens.

Adoption of PACS by the Department of Veterans Affairs: the past, the present, and future plans

NASA Astrophysics Data System (ADS)

Siegel, Eliot L.; Reiner, Bruce I.; Kuzmak, Peter M.

2000-05-01

The diffusion of PACS technology within the Department of Veterans Affairs has followed the 'S' curve transition originally described by Ryan and Gross in 1943. They described a paradigm that describes the diffusion of a new technology into the community. However the rate of adoption of filmless radiology by the VA has been much higher than that of the general healthcare system. This is likely due to the fact that the VA and Department of Defense medical systems are somewhat isolated and independent from other health care systems and are subject to a different rate of diffusion of technology. The early introduction and success of PACS in the VA undoubtedly accelerated its acceptance throughout the system. An additional impetus to the growth of PACS in the VA has been the development of an image management system that has been incorporated into the electronic medical record. The universal use of the VISTA HIS and RIS system throughout the VA and the fact that it was developed 'in-house' as well as its extensive support for DICOM functionality have also played a major role in facilitating the acceptance of Picture Archival and Communication Systems throughout the VA.

Evaluation of PACS in a multihospital environment

NASA Astrophysics Data System (ADS)

Siegel, Eliot L.; Reiner, Bruce I.; Protopapas, Zenon

1998-07-01

Although a number of authors have described the challenges and benefits of filmless operation using a hospital-wide Picture Archival and Communication System (PACS), there have been few descriptions of a multi-hospital wide area PACS. The purpose of this paper is to describe our two and a half year experience with PACS in an integrated multi-facility health care environment, the Veterans Affairs Maryland Health Care System (VAMHCS). On June 17, 1995 the Radiology and Nuclear Medicine services became integrated for four medical centers forming the VA Maryland Health Care System creating a single multi-facility imaging department. The facilities consisted of the Baltimore VA (acute and outpatient care, tertiary referral center), Ft. Howard (primarily long term care), Perry Point (primarily psychiatric care), and the Baltimore Rehabilitation and extended care facility (nursing home). The combined number of studies at all four sites is slightly more than 80,000 examinations per year. In addition to residents and fellows, the number of radiologists at Baltimore was approximately seven, with two at Perry Point, one at Ft. Howard, and no radiologists at the Rehabilitation and Extended Care facility. A single HIS/RIS, which is located physically at the Baltimore VAMC is utilized for all four medical centers. The multi- facility image management and communication system utilizes two separate PAC Systems that are physically located at the Baltimore VA Medical Center (BVAMC). The commercial system (GE Medical Systems) has been in place in Baltimore for more than 41/2 years and is utilized primarily in the acquisition, storage, distribution and display of radiology and nuclear medicine studies. The second PACS is the VISTA Imaging System, which has been developed as a module of the VA's HIS/RIS by and for the Department of Veterans Affairs. All of the radiology images obtained on the commercial PACS are requested by the VISTA Imaging System using DICOM query/retrieve commands and are stored on a separate server and optical jukebox. Additionally, the VISTA system is used to store all images obtained by all specialties in the medical center including pathology, dermatology, GI medicine, surgery, podiatry, ophthalmology, etc. Using this two PAC system approach, the hospital is able to achieve redundancy with regard to image storage, retrieval, and display of radiology images. The transition to a 'virtual' multi-facility imaging department was accomplished over a period of two years. Initially, Perry Point and Ft. Howard replaced their general radiographic film processors with Computed Radiography (CR) units. The CR units and subsequently, the CT and Ultrasound systems at Perry Point were interfaced (DeJarnette Research Systems) with the commercial PACS located in Baltimore. A HIS/RIS to modality interface was developed (DeJarnette and Fuji Medical Systems) between the computed radiography and CT units and VISTA Information System at Baltimore. A digital dictation system was recently implemented across the multi- facility network. The integration of the three radiology departments into a single virtual imaging department serving four medical centers has resulted in a number of benefits. Economically, there has been the elimination via attrition of one and a half radiologist FTE's (full time equivalents) and an administrative position resulting in an annual savings of more than $375,000 per year. Additionally, the expenditures for moonlighter coverage for vacation, meeting, and sick leave have been eliminated. There is now subspecialty coverage for primary or secondary interpretation and for peer review.

Mice lacking the PACAP type I receptor have impaired photic entrainment and negative masking.

PubMed

Hannibal, Jens; Brabet, Philippe; Fahrenkrug, Jan

2008-12-01

The retinohypothalamic tract (RHT) is a retinofugal neuronal pathway which, in mammals, mediates nonimage-forming vision to various areas in the brain involved in circadian timing, masking behavior, and regulation of the pupillary light reflex. The RHT costores the two neurotransmitters glutamate and pituitary adenylate cyclase activating peptide (PACAP), which in a rather complex interplay are mediators of photic adjustment of the circadian system. To further characterize the role of PACAP/PACAP receptor type 1 (PAC1) receptor signaling in light entrainment of the clock and in negative masking behavior, we extended previous studies in mice lacking the PAC1 receptor (PAC1 KO) by examining their phase response to single light pulses using Aschoff type II regime, their ability to entrain to non-24-h light-dark (LD) cycles and large phase shifts of the LD cycle (jet lag), as well as their negative masking response during different light intensities. A prominent finding in PAC1 KO mice was a significantly decreased phase delay of the endogenous rhythm at early night. In accordance, PAC1 KO mice had a reduced ability to entrain to T cycles longer than 26 h and needed more time to reentrain to large phase delays, which was prominent at low light intensities. The data obtained at late night indicated that PACAP/PAC1 receptor signaling is less important during the phase-advancing part of the phase-response curve. Finally, the PAC1 KO mice showed impaired negative masking behavior at low light intensities. Our findings substantiate a role for PACAP/PAC1 receptor signaling in nonimage-forming vision and indicate that the system is particularly important at lower light intensities.

PAC1- and VPAC2 receptors in light regulated behavior and physiology: Studies in single and double mutant mice.

PubMed

Hannibal, Jens; Georg, Birgitte; Fahrenkrug, Jan

2017-01-01

The two sister peptides, pituitary adenylate cyclase activating polypeptide (PACAP) and vasoactive intestinal polypeptide (VIP) and their receptors, the PAC1 -and the VPAC2 receptors, are involved in regulation of the circadian timing system. PACAP as a neurotransmitter in the retinohypothalamic tract (RHT) and VIP as a neurotransmitter, involved in synchronization of SCN neurons. Behavior and physiology in VPAC2 deficient mice are strongly regulated by light most likely as a result of masking. Consequently, we used VPAC2 and PAC1/VPAC2 double mutant mice in comparison with PAC1 receptor deficient mice to further elucidate the role of PACAP in the light mediated regulation of behavior and physiology of the circadian system. We compared circadian rhythms in mice equipped with running wheels or implanted radio-transmitter measuring core body temperature kept in a full photoperiod ((FPP)(12:12 h light dark-cycles (LD)) and skeleton photo periods (SPP) at high and low light intensity. Furthermore, we examined the expression of PAC1- and VPAC2 receptors in the SCN of the different genotypes in combination with visualization of PACAP and VIP and determined whether compensatory changes in peptide and/or receptor expression in the reciprocal knockouts (KO) (PAC1 and VPAC2) had occurred. Our data demonstrate that in although being closely related at both ligand and receptor structure/sequence, PACAP/PAC1 receptor signaling are independent of VIP/VPAC2 receptor signaling and vice versa. Furthermore, lack of either of the receptors does not result in compensatory changes at neither the physiological or anatomical level. PACAP/PAC1 signaling is important for light regulated behavior, VIP/VPAC2signaling for stable clock function and both signaling pathways may play a role in shaping diurnality versus nocturnality.

Features and limitations of mobile tablet devices for viewing radiological images.

PubMed

Grunert, J H

2015-03-01

Mobile radiological image display systems are becoming increasingly common, necessitating a comparison of the features of these systems, specifically the operating system employed, connection to stationary PACS, data security and rang of image display and image analysis functions. In the fall of 2013, a total of 17 PACS suppliers were surveyed regarding the technical features of 18 mobile radiological image display systems using a standardized questionnaire. The study also examined to what extent the technical specifications of the mobile image display systems satisfy the provisions of the Germany Medical Devices Act as well as the provisions of the German X-ray ordinance (RöV). There are clear differences in terms of how the mobile systems connected to the stationary PACS. Web-based solutions allow the mobile image display systems to function independently of their operating systems. The examined systems differed very little in terms of image display and image analysis functions. Mobile image display systems complement stationary PACS and can be used to view images. The impacts of the new quality assurance guidelines (QS-RL) as well as the upcoming new standard DIN 6868 - 157 on the acceptance testing of mobile image display units for the purpose of image evaluation are discussed. © Georg Thieme Verlag KG Stuttgart · New York.

An Examination of the First 30 Days After Patients are Discharged to the Community From Hip Fracture Postacute Care.

PubMed

Leland, Natalie E; Gozalo, Pedro; Christian, Thomas J; Bynum, Julie; Mor, Vince; Wetle, Terrie F; Teno, Joan M

2015-10-01

Postacute care (PAC) rehabilitation aims to maximize independence and facilitate a safe community transition. Yet little is known about PAC patients' success in staying home after discharge or differences on this outcome across PAC providers. Examine the percentage of PAC patients who remain in the community at least 30 days after discharge (ie, successful community discharge) after hip fracture rehabilitation and describe differences among PAC facilities based on this outcome. Retrospective observational study. Community-dwelling, Medicare fee-for-service beneficiaries 75 years of age and above who experienced their first hip fracture between 1999 and 2007 (n=880,779). PAC facilities admitting hip fracture patients in 2006. Successful community discharge, sites of readmission after PAC discharge. Between 1999 and 2007, 57% of patients achieved successful community discharge. Black were less likely (adjusted odds ratios=0.84; 95% confidence interval, 0.82-0.86) than similar whites to achieve successful community discharge. Among all who reentered the community (n=581,095), 14% remained in the community <30 days. Acute hospitals (67.5%) and institutional PAC (16.8%) were the most common sites of reentry. The median proportion of successful community discharge among facilities was 49% (interquartile range, 33%-66%). Lowest-quartile facilities admitted older (85.9 vs. 84.1 y of age), sicker patients (eg, higher rates of hospital complications 6.0% vs. 4.6%), but admitted fewer annually (7.1 vs. 19.3), compared with the highest quartile. Reentry into the health care system after PAC community discharge is common. Because of the distinct care needs of the PAC population there is a need for a quality measure that complements the current 30-day hospital readmission outcome and captures the objectives of PAC rehabilitation.

North by Northwestern: initial experience with PACS at Northwestern Memorial Hospital

NASA Astrophysics Data System (ADS)

Channin, David S.; Hawkins, Rodney C.; Enzmann, Dieter R.

2000-05-01

This paper describes the initial phases and configuration of the Picture Archive and Communication System (PACS) deployed at Northwestern Memorial Hospital. The primary goals of the project were to improve service to patients, improve service to referring physicians, and improve the process of radiology. Secondary goals were to enhance the academic mission, and modernize institutional information systems. The system consists of a large number of heterogeneous imaging modalities sending imaging studies via DICOM to a GE medical Systems PathSpeed PACS. The radiology department workflow is briefly described. The system is currently storing approximately 140,000 studies and over 5 million images, growing by approximately 600 studies and 25,000 images per day. Data reflecting use of the short term and long term storage is provided.

Clinical experiences utilizing wireless remote control and an ASP model backup archive for a disaster recovery event

NASA Astrophysics Data System (ADS)

Liu, Brent J.; Documet, Luis; Documet, Jorge; Huang, H. K.; Muldoon, Jean

2004-04-01

An Application Service Provider (ASP) archive model for disaster recovery for Saint John"s Health Center (SJHC) clinical PACS data has been implemented using a Fault-Tolerant Archive Server at the Image Processing and Informatics Laboratory, Marina del Rey, CA (IPIL) since mid-2002. The purpose of this paper is to provide clinical experiences with the implementation of an ASP model backup archive in conjunction with handheld wireless technologies for a particular disaster recovery scenario, an earthquake, in which the local PACS archive and the hospital are destroyed and the patients are moved from one hospital to another. The three sites involved are: (1) SJHC, the simulated disaster site; (2) IPIL, the ASP backup archive site; and (3) University of California, Los Angeles Medical Center (UCLA), the relocated patient site. An ASP backup archive has been established at IPIL to receive clinical PACS images daily using a T1 line from SJHC for backup and disaster recovery storage. Procedures were established to test the network connectivity and data integrity on a regular basis. In a given disaster scenario where the local PACS archive has been destroyed and the patients need to be moved to a second hospital, a wireless handheld device such as a Personal Digital Assistant (PDA) can be utilized to route images to the second hospital site with a PACS and reviewed by radiologists. To simulate this disaster scenario, a wireless network was implemented within the clinical environment in all three sites: SJHC, IPIL, and UCLA. Upon executing the disaster scenario, the SJHC PACS archive server simulates a downtime disaster event. Using the PDA, the radiologist at UCLA can query the ASP backup archive server at IPIL for PACS images and route them directly to UCLA. Implementation experiences integrating this solution within the three clinical environments as well as the wireless performance are discussed. A clinical downtime disaster scenario was implemented and successfully tested. Radiologists were able to successfully query PACS images utilizing a wireless handheld device from the ASP backup archive at IPIL and route the PACS images directly to a second clinical site at UCLA where they and the patients are located at that time. In a disaster scenario, using a wireless device, radiologists at the disaster health care center can route PACS data from an ASP backup archive server to be reviewed in a live clinical PACS environment at a secondary site. This solution allows Radiologists to use a wireless handheld device to control the image workflow and to review PACS images during a major disaster event where patients must be moved to a secondary site.

Definition and evaluation of the data-link layer of PACnet

NASA Astrophysics Data System (ADS)

Alsafadi, Yasser H.; Martinez, Ralph; Sanders, William H.

1991-07-01

PACnet is a 200-500 Mbps dual-ring fiber optic network designed to implement a picture archiving and communication system (PACS) in a hospital environment. The network consists of three channels: an image transfer channel, a command and control channel, and a real-time data channel. An initial network interface unit (NIU) design for PACnet consisted of a functional description of the protocols and NIU major components. In order to develop a demonstration prototype, additional definition of protocol algorithms of each channel is necessary. Using the International Standards Organization/Open Systems Interconnection (ISO/OSI) reference model as a guide, the definition of the data link layer is extended. This definition covers interface service specifications for the two constituent sublayers: logical link control (LLC) and medium access control (MAC). Furthermore, it describes procedures for data transfer, mechanisms of error detection and fault recovery. A performance evaluation study was then made to determine how the network performs under various application scenarios. The performance evaluation study was performed using stochastic activity networks, which can formally describe the network behavior. The results of the study demonstrate the feasibility of PACnet as an integrated image, data, and voice network for PACS.

PACS in Töölö hospital.

PubMed

Kinnunen, J; Pohjonen, H

2001-07-01

A 3-year PACS project was started in 1997 and completed in 1999 with filmless radiology and surgery. An efficient network for transferring images provides the infrastructure for integration of different distributed imaging systems and enables efficient handling of all patient-related information on one display station. Because of the need for high-speed communications and the massive amount of image data transferred in radiology, ATM (25, 155 Mbit/s) was chosen to be the main technology used. Both hardware and software redundancy of the system have been carefully planned. The size of the Dicom image library utilizing MO discs is currently 1.2 TB with 300 GB RAID capacity. For the increasing amount of teleradiologic consultations, a special Dicom gateway is planned. It allows a centralized and resilient handling and routing of received images around the hospital. Hospital-wide PACS has already improved the speed and quality of patient care by providing instant access to diagnostic information at multiple locations simultaneously. The benefits of PACS are considered from the viewpoint of the entire hospital: PACS offers a method for efficiently transporting patient-related images and reports to the referring physicians.

PACS storage technology update: holographic storage.

PubMed

Colang, John E; Johnston, James N

2006-01-01

This paper focuses on the emerging technology of holographic storage and its effect on picture archiving and communication systems (PACS). A review of the emerging technology is presented, which includes a high level description of holographic drives and the associated substrate media, the laser and optical technology, and the spatial light modulator. The potential advantages and disadvantages of holographic drive and storage technology are evaluated. PACS administrators face myriad complex and expensive storage solutions and selecting an appropriate system is time-consuming and costly. Storage technology may become obsolete quickly because of the exponential nature of the advances in digital storage media. Holographic storage may turn out to be a low cost, high speed, high volume storage solution of the future; however, data is inconclusive at this early stage of the technology lifecycle. Despite the current lack of quantitative data to support the hypothesis that holographic technology will have a significant effect on PACS and standards of practice, it seems likely from the current information that holographic technology will generate significant efficiencies. This paper assumes the reader has a fundamental understanding of PACS technology.

Percent area coverage through image analysis

NASA Astrophysics Data System (ADS)

Wong, Chung M.; Hong, Sung M.; Liu, De-Ling

2016-09-01

The notion of percent area coverage (PAC) has been used to characterize surface cleanliness levels in the spacecraft contamination control community. Due to the lack of detailed particle data, PAC has been conventionally calculated by multiplying the particle surface density in predetermined particle size bins by a set of coefficients per MIL-STD-1246C. In deriving the set of coefficients, the surface particle size distribution is assumed to follow a log-normal relation between particle density and particle size, while the cross-sectional area function is given as a combination of regular geometric shapes. For particles with irregular shapes, the cross-sectional area function cannot describe the true particle area and, therefore, may introduce error in the PAC calculation. Other errors may also be introduced by using the lognormal surface particle size distribution function that highly depends on the environmental cleanliness and cleaning process. In this paper, we present PAC measurements from silicon witness wafers that collected fallouts from a fabric material after vibration testing. PAC calculations were performed through analysis of microscope images and compare them to values derived through the MIL-STD-1246C method. Our results showed that the MIL-STD-1246C method does provide a reasonable upper bound to the PAC values determined through image analysis, in particular for PAC values below 0.1.

Using Field-Metered Data to Quantify Annual Energy Use of Portable Air Conditioners

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burke, Thomas; Willem, Henry; Ni, Chun Chun

2014-12-01

As many regions of the United States experience rising temperatures, consumers have come to rely increasingly on cooling appliances (including portable air conditioners) to provide a comfortable indoor temperature. Home occupants sometimes use a portable air conditioner (PAC) to maintain a desired indoor temperature in a single room or enclosed space. Although PACs in residential use are few compared to centrally installed and room air conditioning (AC) units, the past few years have witnessed an increase of PACs use throughout the United States. There is, however, little information and few research projects focused on the energy consumption and performance ofmore » PACs, particularly studies that collect information from field applications of PACs. The operation and energy consumption of PACs may differ among geographic locations and households, because of variations in cooling load, frequency, duration of use, and other user-selected settings. In addition, the performance of building envelope (thermal mass and air leakage) as well as inter-zonal mixing within the building would substantially influence the ability to control and maintain desirable indoor thermal conditions. Lawrence Berkeley National Laboratory (LBNL) conducted an initial field-metering study aimed at increasing the knowledge and data related to PAC operation and energy consumption in the United States.« less

Removal of Suspended Solids in Anaerobically Digested Slurries of Livestock and Poultry Manure by Coagulation Using Different Dosages of Polyaluminum Chloride

NASA Astrophysics Data System (ADS)

Li, P.; Zhang, C. J.; Zhao, T. K.; Zhong, H.

2017-01-01

In this study, anaerobically digested slurries of livestock and poultry manure were pretreated by coagulation-sedimentation using an inorganic polymer coagulant, polyaluminum chloride (PAC). The effect of different PAC dosages on suspended solids (SS) removal and pH in the biogas slurries was assessed to provide reference values for reducing the organic load of biogas slurry in the coagulation-sedimentation process and explore the feasibility of reducing the difficulty in subsequent utilization or processing of biogas slurry. The results showed that for the pig slurry containing approximately 5000 mg/L SS, the removal rate of SS reached up to 81.6% with the coagulant dosage of 0.28 g/L PAC. For the chicken slurry containing approximately 2600 mg/L SS, the removal rate of SS was 30.2% with the coagulant dosage of 0.33 g/L PAC. The removal rate of SS in both slurries of livestock and poultry manure exhibited a downward trend with high PAC dosage. Therefore, there is a need to control the PAC dosage in practical use. The pH changed little in the two types of biogas slurries after treatment with different PAC dosages and both were in line with the standard values specified in the “Standards for Irrigation Water Quality”.

Design and implementation of GRID-based PACS in a hospital with multiple imaging departments

NASA Astrophysics Data System (ADS)

Yang, Yuanyuan; Jin, Jin; Sun, Jianyong; Zhang, Jianguo

2008-03-01

Usually, there were multiple clinical departments providing imaging-enabled healthcare services in enterprise healthcare environment, such as radiology, oncology, pathology, and cardiology, the picture archiving and communication system (PACS) is now required to support not only radiology-based image display, workflow and data flow management, but also to have more specific expertise imaging processing and management tools for other departments providing imaging-guided diagnosis and therapy, and there were urgent demand to integrate the multiple PACSs together to provide patient-oriented imaging services for enterprise collaborative healthcare. In this paper, we give the design method and implementation strategy of developing grid-based PACS (Grid-PACS) for a hospital with multiple imaging departments or centers. The Grid-PACS functions as a middleware between the traditional PACS archiving servers and workstations or image viewing clients and provide DICOM image communication and WADO services to the end users. The images can be stored in distributed multiple archiving servers, but can be managed with central mode. The grid-based PACS has auto image backup and disaster recovery services and can provide best image retrieval path to the image requesters based on the optimal algorithms. The designed grid-based PACS has been implemented in Shanghai Huadong Hospital and been running for two years smoothly.

Multigeneration data migration from legacy systems

NASA Astrophysics Data System (ADS)

Ratib, Osman M.; Liu, Brent J.; Kho, Hwa T.; Tao, Wenchao; Wang, Cun; McCoy, J. Michael

2003-05-01

The migration of image data from different generations of legacy archive systems represents a technical challenge and in incremental cost in transitions to newer generations of PACS. UCLA medical center has elected to completely replace the existing PACS infrastructure encompassing several generations of legacy systems by a new commercial system providing enterprise-wide image management and communication. One of the most challenging parts of the project was the migration of large volumes of legacy images into the new system. Planning of the migration required the development of specialized software and hardware, and included different phases of data mediation from existing databases to the new PACS database prior to the migration of the image data. The project plan included a detailed analysis of resources and cost of data migration to optimize the process and minimize the delay of a hybrid operation where the legacy systems need to remain operational. Our analysis and project planning showed that the data migration represents the most critical path in the process of PACS renewal. Careful planning and optimization of the project timeline and resources allocated is critical to minimize the financial impact and the time delays that such migrations can impose on the implementation plan.

Enhanced fitness: a randomized controlled trial of the effects of home-based physical activity counseling on glycemic control in older adults with prediabetes mellitus.

PubMed

Morey, Miriam C; Pieper, Carl F; Edelman, David E; Yancy, William S; Green, Jennifer B; Lum, Helen; Peterson, Matthew J; Sloane, Richard; Cowper, Patricia A; Bosworth, Hayden B; Huffman, Kim M; Cavanaugh, James T; Hall, Katherine S; Pearson, Megan P; Taylor, Gregory A

2012-09-01

To determine whether a home-based multicomponent physical activity counseling (PAC) intervention is effective in reducing glycemic measures in older outpatients with prediabetes mellitus. Controlled clinical trial. Primary care clinics of the Durham Veterans Affairs (VA) Medical Center between September 29, 2008, and March 25, 2010. Three hundred two overweight (body mass index 25-45 kg/m(2) ), older (60-89) outpatients with impaired glucose tolerance (fasting blood glucose 100-125 mg/dL, glycosylated hemoglobin (HbA1c) <7%) randomly assigned to a PAC intervention group (n = 180) or a usual care control group (n = 122). A 12-month, home-based multicomponent PAC program including one in-person baseline counseling session, regular telephone counseling, physician endorsement in clinic with monthly automated encouragement, and customized mailed materials. All study participants, including controls, received a consultation in a VA weight management program. The primary outcome was a homeostasis model assessment of insulin resistance (HOMA-IR), calculated from fasting insulin and glucose levels at baseline and 3 and 12 months. HbA1c was the secondary indicator of glycemic control. Other secondary outcomes were anthropometric measures and self-reported physical activity, health-related quality of life, and physical function. There were no significant differences between the PAC and control groups over time for any of the glycemic indicators. Both groups had small declines over time of approximately 6% in fasting blood glucose (P < .001), and other glycemic indicators remained stable. The declines in glucose were not sufficient to affect the change in HOMA-IR scores due to fluctuations in insulin over time. Endurance physical activity increased significantly in the PAC group (P < .001) and not in the usual care group. Home-based telephone counseling increased physical activity levels but was insufficient to improve glycemic indicators in older outpatients with prediabetes mellitus. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

T2- and diffusion-weighted magnetic resonance imaging at 3T for the detection of prostate cancer with and without endorectal coil: An intraindividual comparison of image quality and diagnostic performance.

PubMed

Baur, Alexander D J; Daqqaq, Tareef; Wagner, Moritz; Maxeiner, Andreas; Huppertz, Alexander; Renz, Diane; Hamm, Bernd; Fischer, Thomas; Durmus, Tahir

2016-06-01

To intraindividually compare image quality and diagnostic performance of multiparametric MRI (mpMRI) at 3T for the detection of prostate cancer (PCa) using a pelvic phased-array coil (PAC) and a combined endorectal and pelvic phased-array coil (ERC-PAC). Forty-five patients were prospectively included and received mpMRI of the prostate using a PAC and an ERC-PAC during one imaging session. Two radiologists evaluated image quality and the most suspicious lesion according to the PI-RADS scoring system. Results of MRI-TRUS-fusion biopsy of the prostate served as reference standard. Patient comfort and acceptance were assessed using a standardized questionnaire. Overall image quality for T2WI was rated significantly better with an ERC-PAC compared to a PAC (p=0.0038). The weighted kappa for PI-RADS scores for T2WI and DWI with a PAC and an ERC-PAC was 0.70 and 0.73, respectively. For a PI-RADS sum score including T2WI and DWI the area under the curve with a PAC and an ERC-PAC were 0.95-0.99 and 0.93-0.97, respectively (p=0.1395). For T2WI and DWI performed at 3T index PCa lesion identification and evaluation did not differ significantly with both coil setups. Patients preferred MRI without an ERC. Therefore, the use of an ERC may be omitted in a prostate cancer detection setting. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Digital imaging and electronic patient records in pathology using an integrated department information system with PACS.

PubMed

Kalinski, Thomas; Hofmann, Harald; Franke, Dagmar-Sybilla; Roessner, Albert

2002-01-01

Picture archiving and communication systems have been widely used in radiology thus far. Owing to the progress made in digital photo technology, their use in medicine opens up further opportunities. In the field of pathology, digital imaging offers new possiblities for the documentation of macroscopic and microscopic findings. Digital imaging has the advantage that the data is permanently and readily available, independent of conventional archives. In the past, PACS was a separate entity. Meanwhile, however, PACS has been integrated in DIS, the department information system, which was also run separately in former times. The combination of these two systems makes the administration of patient data, findings and images easier. Moreover, thanks to the introduction of special communication standards, a data exchange between different department information systems and hospital information systems (HIS) is possible. This provides the basis for a communication platform in medicine, constituting an electronic patient record (EPR) that permits an interdisciplinary treatment of patients by providing data of findings and images from clinics treating the same patient. As the pathologic diagnosis represents a central and often therapy-determining component, it is of utmost importance to add pathologic diagnoses to the EPR. Furthermore, the pathologist's work is considerably facilitated when he is able to retrieve additional data from the patient file. In this article, we describe our experience gained with the combined PACS and DIS systems recently installed at the Department of Pathology, University of Magdeburg. Moreover, we evaluate the current situation and future prospects for PACS in pathology.

Enterprise-scale image distribution with a Web PACS.

PubMed

Gropper, A; Doyle, S; Dreyer, K

1998-08-01

The integration of images with existing and new health care information systems poses a number of challenges in a multi-facility network: image distribution to clinicians; making DICOM image headers consistent across information systems; and integration of teleradiology into PACS. A novel, Web-based enterprise PACS architecture introduced at Massachusetts General Hospital provides a solution. Four AMICAS Web/Intranet Image Servers were installed as the default DICOM destination of 10 digital modalities. A fifth AMICAS receives teleradiology studies via the Internet. Each AMICAS includes: a Java-based interface to the IDXrad radiology information system (RIS), a DICOM autorouter to tape-library archives and to the Agfa PACS, a wavelet image compressor/decompressor that preserves compatibility with DICOM workstations, a Web server to distribute images throughout the enterprise, and an extensible interface which permits links between other HIS and AMICAS. Using wavelet compression and Internet standards as its native formats, AMICAS creates a bridge to the DICOM networks of remote imaging centers via the Internet. This teleradiology capability is integrated into the DICOM network and the PACS thereby eliminating the need for special teleradiology workstations. AMICAS has been installed at MGH since March of 1997. During that time, it has been a reliable component of the evolving digital image distribution system. As a result, the recently renovated neurosurgical ICU will be filmless and use only AMICAS workstations for mission-critical patient care.

Dietary proanthocyanidins boost hepatic NAD(+) metabolism and SIRT1 expression and activity in a dose-dependent manner in healthy rats.

PubMed

Aragonès, Gerard; Suárez, Manuel; Ardid-Ruiz, Andrea; Vinaixa, Maria; Rodríguez, Miguel A; Correig, Xavier; Arola, Lluís; Bladé, Cinta

2016-04-22

Proanthocyanidins (PACs) have been reported to modulate multiple targets by simultaneously controlling many pivotal metabolic pathways in the liver. However, the precise mechanism of PAC action on the regulation of the genes that control hepatic metabolism remains to be clarified. Accordingly, we used a metabolomic approach combining both nuclear magnetic resonance and mass spectrometry analysis to evaluate the changes induced by different doses of grape-seed PACs in the liver of healthy rats. Here, we report that PACs significantly increased the hepatic nicotinamide adenine dinucleotide (NAD(+)) content in a dose-dependent manner by specifically modulating the hepatic concentrations of the major NAD(+) precursors as well as the mRNA levels of the genes that encode the enzymes involved in the cellular metabolism of NAD(+). Notably, Sirtuin 1 (Sirt1) gene expression was also significantly up-regulated in a dose-response pattern. The increase in both the NAD(+) availability and Sirt1 mRNA levels, in turn, resulted in the hepatic activation of SIRT1, which was significantly associated with improved protection against hepatic triglyceride accumulation. Our data clearly indicates that PAC consumption could be a valid tool to enhance hepatic SIRT1 activity through the modulation of NAD(+) levels.

Dietary proanthocyanidins boost hepatic NAD+ metabolism and SIRT1 expression and activity in a dose-dependent manner in healthy rats

PubMed Central

Aragonès, Gerard; Suárez, Manuel; Ardid-Ruiz, Andrea; Vinaixa, Maria; Rodríguez, Miguel A.; Correig, Xavier; Arola, Lluís; Bladé, Cinta

2016-01-01

Proanthocyanidins (PACs) have been reported to modulate multiple targets by simultaneously controlling many pivotal metabolic pathways in the liver. However, the precise mechanism of PAC action on the regulation of the genes that control hepatic metabolism remains to be clarified. Accordingly, we used a metabolomic approach combining both nuclear magnetic resonance and mass spectrometry analysis to evaluate the changes induced by different doses of grape-seed PACs in the liver of healthy rats. Here, we report that PACs significantly increased the hepatic nicotinamide adenine dinucleotide (NAD+) content in a dose-dependent manner by specifically modulating the hepatic concentrations of the major NAD+ precursors as well as the mRNA levels of the genes that encode the enzymes involved in the cellular metabolism of NAD+. Notably, Sirtuin 1 (Sirt1) gene expression was also significantly up-regulated in a dose-response pattern. The increase in both the NAD+ availability and Sirt1 mRNA levels, in turn, resulted in the hepatic activation of SIRT1, which was significantly associated with improved protection against hepatic triglyceride accumulation. Our data clearly indicates that PAC consumption could be a valid tool to enhance hepatic SIRT1 activity through the modulation of NAD+ levels. PMID:27102823

Neurocognitive mechanisms of perception-action coordination: a review and theoretical integration.

PubMed

Ridderinkhof, K Richard

2014-10-01

The present analysis aims at a theoretical integration of, and a systems-neuroscience perspective on, a variety of historical and contemporary views on perception-action coordination (PAC). We set out to determine the common principles or lawful linkages between sensory and motor systems that explain how perception is action-oriented and how action is perceptually guided. To this end, we analyze the key ingredients to such an integrated framework, examine the architecture of dual-system conjectures of PAC, and endeavor in an historical analysis of the key characteristics, mechanisms, and phenomena of PACs. This analysis will reveal that dual-systems views are in need of fundamental re-thinking, and its elements will be amalgamated with current views on action-oriented predictive processing into a novel integrative theoretical framework (IMPPACT: Impetus, Motivation, and Prediction in Perception-Action Coordination theory). From this framework and its neurocognitive architecture we derive a number of non-trivial predictions regarding conative, motive-driven PAC. We end by presenting a brief outlook on how IMPPACT might present novel insights into certain pathologies and into action expertise. Copyright © 2014 Elsevier Ltd. All rights reserved.

Security model for picture archiving and communication systems.

PubMed

Harding, D B; Gac, R J; Reynolds, C T; Romlein, J; Chacko, A K

2000-05-01

The modern information revolution has facilitated a metamorphosis of health care delivery wrought with the challenges of securing patient sensitive data. To accommodate this reality, Congress passed the Health Insurance Portability and Accountability Act (HIPAA). While final guidance has not fully been resolved at this time, it is up to the health care community to develop and implement comprehensive security strategies founded on procedural, hardware and software solutions in preparation for future controls. The Virtual Radiology Environment (VRE) Project, a landmark US Army picture archiving and communications system (PACS) implemented across 10 geographically dispersed medical facilities, has addressed that challenge by planning for the secure transmission of medical images and reports over their local (LAN) and wide area network (WAN) infrastructure. Their model, which is transferable to general PACS implementations, encompasses a strategy of application risk and dataflow identification, data auditing, security policy definition, and procedural controls. When combined with hardware and software solutions that are both non-performance limiting and scalable, the comprehensive approach will not only sufficiently address the current security requirements, but also accommodate the natural evolution of the enterprise security model.

CONTROL OF ORGANIC DRINKING WATER QUALITY BY PRECIPITATIVE PROCESSES

EPA Science Inventory

Plant and bench studies were conducted on a highly colored surface water using Alum and Polyvalent Aluminum Chloride (PAC1) coagulation to minimize THMPF. Optimum coagulation pH and dose were identified by season for Alum and PAC1 for color, DOC, THMPF and TOXFP removal. Aluminum...

Perfluorooctane sulfonate adsorption on powder activated carbon: Effect of phosphate (P) competition, pH, and temperature.

PubMed

Qian, Jin; Shen, Mengmeng; Wang, Peifang; Wang, Chao; Li, Kun; Liu, Jingjing; Lu, Bianhe; Tian, Xin

2017-09-01

Powdered activated carbon (PAC), as an adsorbent, was applied to remove perfluorooctane sulfonate (PFOS) from aqueous solution. Laboratory batch experiments were performed to investigate the influences of phosphate (P) competition, temperature, and pH for PFOS adsorption onto PAC. The results showed that higher temperature favored PFOS adsorption in single and binary systems. The kinetic data fitted very well to the pseudo second-order kinetic model. Thermodynamically, the endothermic enthalpy of the PFOS adsorption in single and binary systems were 125.07 and 21.25 kJ mol -1 , respectively. The entropy of the PFOS adsorption in single and binary systems were 0.479 and 0.092 kJ mol -1  K -1 , respectively. And the Gibbs constants were negative. These results indicated that the adsorption processes were spontaneous. The adsorption isotherms of PFOS agreed well with the Langmuir model. In the single system, PFOS adsorption decreased with increased pH value. The difference in the amount of PFOS adsorption between the single and binary systems increased at higher pH. Frustrated total internal reflection (FTIR) demonstrated that P competition increased the hydrophilicity of the PAC and the electrostatic repulsion between PFOS and PAC, then the PFOS adsorption amount decreased. It also demonstrated that, at higher temperature, increased PFOS adsorption was mainly due to the higher diffusion rate of PFOS molecules and greater number of active sites opened on the PAC surface. Copyright © 2017 Elsevier Ltd. All rights reserved.

Implementation and Validation of PACS Integrated Peer Review for Discrepancy Recording of Radiology Reporting.

PubMed

Olthof, A W; van Ooijen, P M A

2016-09-01

The purpose of this work is to demonstrate the possibility of implementation of a PACS-integrated peer review system based on RADPEER™ classification providing a step-wise implementation plan utilizing features already present in the standard PACS implementation and without the requirement of additional software development. Furthermore, we show the usage and effects of the system during the first 30 months of usage. To allow fast and easy implementation into the daily workflow the key-word feature of the PACS was used. This feature allows to add a key-word to an imaging examination for easy searching in the PACS database (e.g. by entering keywords for different kinds of pathology). For peer review we implemented a keyword structure including a code for each of the existing RADPEER™ scoring language terms and a keyword with the phrase "second reading" followed by the name of the individual radiologist. The use of the short-keys to enter the codes in relation to the peer review was a simple to use solution. During the study 599 reports were peer reviewed. The active participation in this study of the radiologists varies and ranges from 3 to 327 reviews per radiologist. The number of peer review is highest in CT and CR. There are no significant technical obstacles to implement a PACS-integrated RADPEER™ -system based on key-words allowing easy integration of peer review into the daily routine without the requirement of additional software. Peer review implemented in a non-random setting based on relevant priors could already help in increasing the quality of radiological reporting and serve as continuing education among peers. Decisiveness, tact and trust are needed to promote use of the system and collaborative discussion of the results by radiologist.

PACS-Graz, 1985-2000: from a scientific pilot to a state-wide multimedia radiological information system

NASA Astrophysics Data System (ADS)

Gell, Guenther

2000-05-01

1971/72 began the implementation of a computerized radiological documentation system as the Department of Radiology of the University of Graz, which developed over the years into a full RIS. 1985 started a scientific cooperation with SIEMENS to develop a PACS. The two systems were linked and evolved into a highly integrated RIS-PACS for the state wide hospital system in Styria. During its lifetime the RIS, originally implemented in FORTRAN on a UNIVAC 494 mainframe migrated to a PDP15, on to a PDP11, then VAX and Alphas. The flexible original record structure with variable length fields and the powerful retrieval language were retained. The data acquisition part with the user interface was rewritten several times and many service programs have been added. During our PACS cooperation many ideas like the folder concept or functionalities of the GUI have been designed and tested and were then implemented in the SIENET product. The actual RIS/PACS supports the whole workflow in the Radiology Department. It is installed in a 2.300 bed university hospital and the smaller hospitals of the State of Styria. Modalities from different vendors are connected via DICOM to the RIS (modality worklist) and to the PACS. PACSubsystems from other vendors have been integrated. Images are distributed to referring clinics and for teleconsultation and image processing and reports are available on line to all connected hospitals. We spent great efforts to guarantee optimal support of the workflow and to ensure an enhanced cost/benefit ratio for each user (class). Another special feature is selective image distribution. Using the high level retrieval language individual filters can be constructed easily to implement any image distribution policy agreed upon by radiologists and referring clinicians.

A case for automated tape in clinical imaging.

PubMed

Bookman, G; Baune, D

1998-08-01

Electronic archiving of radiology images over many years will require many terabytes of storage with a need for rapid retrieval of these images. As more large PACS installations are installed and implemented, a data crisis occurs. The ability to store this large amount of data using the traditional method of optical jukeboxes or online disk alone becomes an unworkable solution. The amount of floor space number of optical jukeboxes, and off-line shelf storage required to store the images becomes unmanageable. With the recent advances in tape and tape drives, the use of tape for long term storage of PACS data has become the preferred alternative. A PACS system consisting of a centrally managed system of RAID disk, software and at the heart of the system, tape, presents a solution that for the first time solves the problems of multi-modality high end PACS, non-DICOM image, electronic medical record and ADT data storage. This paper will examine the installation of the University of Utah, Department of Radiology PACS system and the integration of automated tape archive. The tape archive is also capable of storing data other than traditional PACS data. The implementation of an automated data archive to serve the many other needs of a large hospital will also be discussed. This will include the integration of a filmless cardiology department and the backup/archival needs of a traditional MIS department. The need for high bandwidth to tape with a large RAID cache will be examined and how with an interface to a RIS pre-fetch engine, tape can be a superior solution to optical platters or other archival solutions. The data management software will be discussed in detail. The performance and cost of RAID disk cache and automated tape compared to a solution that includes optical will be examined.

The role of the primary auditory cortex in the neural mechanism of auditory verbal hallucinations

PubMed Central

Kompus, Kristiina; Falkenberg, Liv E.; Bless, Josef J.; Johnsen, Erik; Kroken, Rune A.; Kråkvik, Bodil; Larøi, Frank; Løberg, Else-Marie; Vedul-Kjelsås, Einar; Westerhausen, René; Hugdahl, Kenneth

2013-01-01

Auditory verbal hallucinations (AVHs) are a subjective experience of “hearing voices” in the absence of corresponding physical stimulation in the environment. The most remarkable feature of AVHs is their perceptual quality, that is, the experience is subjectively often as vivid as hearing an actual voice, as opposed to mental imagery or auditory memories. This has lead to propositions that dysregulation of the primary auditory cortex (PAC) is a crucial component of the neural mechanism of AVHs. One possible mechanism by which the PAC could give rise to the experience of hallucinations is aberrant patterns of neuronal activity whereby the PAC is overly sensitive to activation arising from internal processing, while being less responsive to external stimulation. In this paper, we review recent research relevant to the role of the PAC in the generation of AVHs. We present new data from a functional magnetic resonance imaging (fMRI) study, examining the responsivity of the left and right PAC to parametrical modulation of the intensity of auditory verbal stimulation, and corresponding attentional top-down control in non-clinical participants with AVHs, and non-clinical participants with no AVHs. Non-clinical hallucinators showed reduced activation to speech sounds but intact attentional modulation in the right PAC. Additionally, we present data from a group of schizophrenia patients with AVHs, who do not show attentional modulation of left or right PAC. The context-appropriate modulation of the PAC may be a protective factor in non-clinical hallucinations. PMID:23630479

Nrf2-peroxiredoxin I axis in polymorphous adenocarcinoma is associated with low matrix metalloproteinase 2 level.

PubMed

Brod, J M; Demasi, Ana Paula Dias; Montalli, V A; Teixeira, L N; Furuse, C; Aguiar, M C; Soares, A B; Sperandio, M; Araujo, V C

2017-12-01

Polymorphous adenocarcinoma (PAC) is a malignant epithelial neoplasm that affects almost exclusively the minor salivary glands, generally described as having a relatively good prognosis. Aberrant nuclear factor erythroid 2 (NF-E2)-related factor (Nrf2) activation in tumor cells has been associated with induction of antioxidant enzymes, such as peroxiredoxin I (Prx I) and increased matrix metalloproteinase (MMP) expression. In this context, the aim of the present study was to evaluate the expression of Nrf2 and correlate it with Prx I and MMP-2 secretion in PAC. Thirty-one cases of PAC from oral biopsies were selected and immunohistochemically analyzed for Nrf2 and Prx I. MMP-2 quantification was performed on primary cell cultures derived from PAC. Oral squamous cell carcinoma (OSCC) cell cultures were used as control. A high immunoexpression of Nrf2 was observed in both the cytoplasm and the nucleus of neoplastic cells from PAC. Nuclear staining for Nrf2 suggested its activation in the majority of the PAC cells, which was confirmed by the high expression of its target gene, Prx I. Quantification of MMP-2 secretion showed lower levels in PAC cell cultures when compared to OSCC cell cultures (p < 0.05). In conclusion, although Nrf2 overexpression has been frequently associated with high-grade malignancies, such relationship is not infallible and, in fact, the opposite may occur in low-grade tumors, such as PAC of minor salivary glands.

Ultrareliable PACS: design and clinical evaluation

NASA Astrophysics Data System (ADS)

Goble, John C.; Kronander, Torbjorn; Wilske, Nils-Olof; Yngvesson, Jonas T.; Ejderholm, Henrik; Ekstrom, Marie

1999-07-01

We describe our experience in the design, installation and clinical evaluation o fan ultra-reliable PACS - a system in which the fundamental design constraint was system availability. This syste has ben constructed using commercial, off-the-shelf hardware and software, using an open system, standards-based approach. The system is deployed in the film-free Department of Pediatric Radiology at the Astrid Lindgren Barnsjukhus a nit of the Karolinska Institute in Stockholm, Sweden.

The health system cost of post-abortion care in Rwanda.

PubMed

Vlassoff, Michael; Musange, Sabine F; Kalisa, Ina R; Ngabo, Fidele; Sayinzoga, Felix; Singh, Susheela; Bankole, Akinrinola

2015-03-01

Based on research conducted in 2012, we estimate the cost to the Rwandan health-care system of providing post-abortion care (PAC) due to unsafe abortions, a subject of policy importance not studied before at the national level. Thirty-nine public and private health facilities representing three levels of health care were randomly selected for data collection from key care providers and administrators for all five regions. Using an ingredients approach to costing, data were gathered on drugs, supplies, material, personnel time and hospitalization. Additionally, direct non-medical costs such as overhead and capital costs were also measured. We found that the average annual PAC cost per client, across five types of abortion complications, was $93. The total cost of PAC nationally was estimated to be $1.7 million per year, 49% of which was expended on direct non-medical costs. Satisfying all demands for PAC would raise the national cost to $2.5 million per year. PAC comprises a significant share of total expenditure in reproductive health in Rwanda. Investing more resources in provision of contraceptive services to prevent unwanted or mistimed pregnancies would likely reduce health systems costs. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014.

Measurement of Aerosol and Cloud Particles with PACS and HARP Hyperangular Imaging Polarimeters

NASA Astrophysics Data System (ADS)

Martins, J.; Fernandez-Borda, R.; Remer, L. A.; Sparr, L.; Buczkowski, S.; Munchak, L. A.

2013-12-01

PACS is new hyper-angular imaging polarimeter for aeorosol and cloud measurerents designed to meet the requirements of the proposed ACE decadal survey mission. The full PACS system consists of three wide field of view (110deg cross track) telescopes covering the UV, VNIR, and SWIR spectral ranges with angular coverage between +55 deg forward to -55deg backwards. The angular density can be selected to cover up to 100 different viewing angles at selected wavelengths. PACS_VNIR is a prototype airborne instrument designed to demonstrate PACS capability by deploying just one of the three wavelength modules of the full PACS. With wavelengths at 470, 550, 675, 760 and 875nm, PACS_VNIR flew for the first time during the PODEX experiment in January/February 2013 aboard the NASA ER-2 aircraft. PACS SWIR (1.64, 1.88, 2.1, and 2.25um) is currently under construction and should be operational in the lab by Fall/2013. PACS_ UV has been fully designed, but is not yet under construction. During the PODEX flights PACS_VNIR collected data for aerosol and clouds over variable surface types including, water, vegetation, urban areas, and snow. The data is currently being calibrated, geolocated and prepared for the inversion of geophysical parameters including water cloud size distribution and aerosol microphysical parameters. The large density of angles in PACS allows for the characterization of cloudbow features in relatively high spatial resolution in a pixel to pixel basis. This avoids the need for assumptions of cloud homogeneity over any distance. The hyperangle capability also allows detailed observation of cloud ice particles, surface characterization, and optimum selection of the number of angles desired for aerosol retrievals. The aerosol and cloud retrieval algorithms under development for the retrieval of particle microphysical properties from the PACS data will be discussed in this presentation. As an extension of the PACS concept we are currently developing the HARP (Hyper-Angular Rainbow Polarimeter) Cubesat satellite funded by the NASA/ESTO/InVEST program. HARP will demonstrate the PACS concept from space and will allow for high resolution angular measurements of polarized radiances over different aerosol and cloud scenarios. The HARP concept and strategy will be presented and discussed as part of the general PACS measurement strategy.

Architecture of distributed picture archiving and communication systems for storing and processing high resolution medical images

NASA Astrophysics Data System (ADS)

Tokareva, Victoria

2018-04-01

New generation medicine demands a better quality of analysis increasing the amount of data collected during checkups, and simultaneously decreasing the invasiveness of a procedure. Thus it becomes urgent not only to develop advanced modern hardware, but also to implement special software infrastructure for using it in everyday clinical practice, so-called Picture Archiving and Communication Systems (PACS). Developing distributed PACS is a challenging task for nowadays medical informatics. The paper discusses the architecture of distributed PACS server for processing large high-quality medical images, with respect to technical specifications of modern medical imaging hardware, as well as international standards in medical imaging software. The MapReduce paradigm is proposed for image reconstruction by server, and the details of utilizing the Hadoop framework for this task are being discussed in order to provide the design of distributed PACS as ergonomic and adapted to the needs of end users as possible.

Multivendor nuclear medicine PACS provide fully digital clinical operation at the University of Miami/Jackson Memorial Hospital

NASA Astrophysics Data System (ADS)

Georgiou, Mike F.; Sfakianakis, George N.; Johnson, Gary; Douligeris, Christos; Scandar, Silvia; Eisler, E.; Binkley, B.

1994-05-01

In an effort to improve patient care while considering cost-effectiveness, we developed a Picture Archiving and Communication System (PACS), which combines imaging cameras, computers and other peripheral equipment from multiple nuclear medicine vectors. The PACS provides fully-digital clinical operation which includes acquisition and automatic organization of patient data, distribution of the data to all networked units inside the department and other remote locations, digital analysis and quantitation of images, digital diagnostic reading of image studies and permanent data archival with the ability for fast retrieval. The PACS enabled us to significantly reduce the amount of film used, and we are currently proceeding with implementing a film-less laboratory. Hard copies are produced on paper or transparent sheets for non-digitally connected parts of the hospital. The PACS provides full-digital operation which is faster, more reliable, better organized and managed, and overall more efficient than a conventional film-based operation. In this paper, the integration of the various PACS components from multiple vendors is reviewed, and the impact of PACS, with its advantages and limitations on our clinical operation is analyzed.

Differential expression of glutamate transporters EAAT1 and EAAT2 in mice deficient for PACAP-type I receptor.

PubMed

Zink, M; Schmitt, A; Henn, F A; Gass, P

2004-12-01

Pituitary adenylate cyclase-activating polypeptide (PACAP) modulates glutamatergic neurotransmission and induces the expression of glutamate transporters EAAT1 and EAAT2 in newborn mouse astroglial cell cultures. Since nanomolar concentrations of PACAP exert this effect, signal transduction via the high affinity PACAP-type I-receptor PAC1 was assumed. To test this hypothesis and to assess the importance of PAC1-signalling in vivo, we analyzed glutamate transporter expression in mice with a PAC1 knockout. EAAT1 and EAAT2 expression was investigated in the hippocampus and the cerebral cortex of PAC1 mutant mice and wildtype littermates by semiquantitative in-situ-hybridization. PAC1-knockout mice show a subtle but significant reduction of EAAT1 expression in the dentate gyrus. In contrast, reduced expression levels of EAAT1 in the cerebral cortex did not reach statistical significance and EAAT2 expression was unchanged in CA3 and cerebral cortex of PAC1 mutant mice. Our data confirm the previously reported in-vitro-regulation of EAAT1 in the adult nervous system in vivo. EAAT2 expression, however, is unchanged in PAC1 knockout mice, most likely due to counterbalancing factors.

Impact of PACS in hospital management

NASA Astrophysics Data System (ADS)

Hur, Gham; Cha, Soon-Joo; Kim, Yong H.; Hwang, Yoon J.; Kim, Soo Y.

2002-05-01

Since the low-cost, NT-based, full PACS was successfully implemented in a large-scale hospital at the end of 1999, many hospital administrators have rushed to purchase the system competitively. It is now a worldwide trend to implement the technology, but Korea has several unique environments for the fast spread of the full PACS. Since hospitals in Korea operate inpatient and outpatient clinics in the same building and use identical OCS, full integration of PACS with the OCS was relatively easy and highly efficient. The simple governing structures of the hospitals also made the decision-making process short and effective. In addition, the national health insurance reimbursement policy that started pay in the beginning of 2000 has also played a catalytic role for the swift propagation of PACS. The recent appearance of the affordable PACS gave hospital administrators the opportunity to learn and understand the role of digital imaging in the areas that are directly related to the efficiency and quality of medical services, as well as cost containment. Furthermore, PACS provided them with windows to the 'all-digital hospital,' which will lead them to realign policies in the management of the hospitals in order to compete successfully in the fast-changing world of health care.

Analysis and Control of Pulse-Width Modulated AC to DC Voltage Source Converters.

NASA Astrophysics Data System (ADS)

Wu, Rusong

The pulse width modulated AC to DC voltage source converter is comprehensively analyzed in the thesis. A general mathematical model of the converter is first established, which is discontinuous, time-variant and non-linear. The following three techniques are used to obtain closed form solutions: Fourier analysis, transformation of reference frame and small signal linearization. Three models, namely, a steady-state DC model, a low frequency small signal AC model and a high frequency model, are consequently developed. Finally, three solution sets, namely, the steady-state solution, various dynamic transfer functions and the high frequency harmonic components, are obtained from the three models. Two control strategies, the Phase and Amplitude Control (PAC) and a new proposed strategy, Predicted Current Control with a Fixed Switching Frequency (PCFF), are investigated. Based on the transfer functions derived from the above mentioned analysis, regulators for a closed-loop control are designed. A prototype circuit is built to experimentally verify the theoretical predictions. The analysis and experimental results show that both strategies produce nearly sinusoidal line current with unity power factor on the utility side in both rectifying and regenerating operations and concurrently provide a regulated DC output voltage on the load side. However the proposed PCFF control has a faster and improved dynamic response over the PAC control. Moreover it is also easier to be implemented. Therefore, the PCFF control is preferable to the PAC control. As an example of application, a configuration of variable DC supply under PCFF control is proposed. The quasi-optimal dynamic response obtained shows that the PWM AC to DC converter lays the foundation for building a four-quadrant, fast-dynamic system, and the PCFF control is an effective strategy for improving dynamic performances not only as applied to the AC to DC converter, but also as applied to the DC to DC chopper or other circuits.

Monitoring system for the study of autotrophic biofilms in bioremediation of polyaromatic compounds

NASA Astrophysics Data System (ADS)

Alarie, Jean P.; Bruttig, A.; Miller, Gordon H.; Hill, Walter; Vo-Dinh, Tuan

1999-02-01

Bacterial and other natural materials such as plants and algae have received increasing interest for bioremediation efforts. The identificatIon of materials capable of biodegrading or sequestering environmental pollutants offers an attractive alternative to chemical or physical means of remediation. A number of bacteria capable of biodegrAding organic or reducing metal pollutants have received great interest. Similarly, the use of natural plants to absorb pollutants from soil anD liquid samples is another potential approach. Our interest lies in identification of naturally occurring algae and their ability to absorb polyaromatic compounds (PAC) from groundwater sources (i.e. streams). These algae could serve as natural water filters for streams contaminated with Polyaromatic hydrocarbons. Polycyclic aromatic compounds, which comprise a complex class of condensed multi-ring benzenoid compounds, are important environmental pollutants originating from a wide variety of natural and anthropogenic sources. PACs are generally formed during incomplete combustion or pyrolysis of organic matter containing carbon and hydrogen. Because combustion of organic materials is involved in countless natural processes or human activities, PACs are omnipresent and abundant pollutants in air, soil and water. Among energy-related products, fossil fuels are the major sources of PACs. The primary sources of airborne PACs are associated with combustion, coal coking, and petroleum catalytic cracking. Coal and shale conversion also contribute to production of PACs. Production, transportation and, use of synthetic fuels and petroleum products provide emission sources for PACs. In urban environments an significant source of PACs is diesel exhaust. Food cooking and cigarette smoking activities contribute to PAC occurrence in indoor environments. Chemical analysis of PACs is of great environmental and toxicological interest because many of them have been shown to be mutagens and/or potent carcinogens in laboratory animal assays. The parent homocyclic species, which contain only carbon and hydrogen, are the familiar polyaromatic hydrocarbon (PAH) compounds. In addition to the PAH compounds, there are thousands of substituted compounds that could have various substituent groups, such as alkyl, amino, chloro, cyano, hydroxy, oxy, or thio groups. In this study we investigate anthracene and pyrene as PAH model systems. A portable fiberoptic instrument capable of real-time measurements has been developed for field screening these PAHs in surface water and natural algae systems. Our preliminary studies investigated the detection limits of anthracene and pyrene and the adsorption properties of two algae using fluorescence monitoring. An exposure study of the algae to 5 ppb anthracene was performed to investigate the ability of the algae to adsorb PAHs.

Adaptation of industry standards to PACS

NASA Astrophysics Data System (ADS)

Lee, Joseph K.; Yin, Lloyd; Huang, H. K.; Wong, Albert W. K.

1994-05-01

Imagery and textual communications among healthcare information systems, medical imaging equipment, and picture archiving and communication systems (PACS) have always been difficult as each of these components varies with platforms, modalities, and manufacturers. With the emerging of industry standards, it become feasible to integrate all these heterogeneous, disparate medical images and textual data. This paper describes two such major industry standards: Health Level 7 (HL7) and ACR/NEMA. In conforming to the HL7 standard, we are able to share medical information between the hospital information systems, radiology information systems, and PACS. By adapting the ACR/NEMA 2.0 standard, we also can convert medical images generated from a variety of modalities and manufacturers to its standardized data format. The conversion is based on the data dictionary defined in the ACR/NEMA 2.0 document.

Medical information, communication, and archiving system (MICAS): Phase II integration and acceptance testing

NASA Astrophysics Data System (ADS)

Smith, Edward M.; Wandtke, John; Robinson, Arvin E.

1999-07-01

The Medical Information, Communication and Archive System (MICAS) is a multi-modality integrated image management system that is seamlessly integrated with the Radiology Information System (RIS). This project was initiated in the summer of 1995 with the first phase being installed during the first half of 1997 and the second phase installed during the summer of 1998. Phase II enhancements include a permanent archive, automated workflow including modality worklist, study caches, NT diagnostic workstations with all components adhering to Digital Imaging and Communications in Medicine (DICOM) standards. This multi-vendor phased approach to PACS implementation is designed as an enterprise-wide PACS to provide images and reports throughout our healthcare network. MICAS demonstrates that aa multi-vendor open system phased approach to PACS is feasible, cost-effective, and has significant advantages over a single vendor implementation.

Assessing post-abortion care in health facilities in Afghanistan: a cross-sectional study.

PubMed

Ansari, Nasratullah; Zainullah, Partamin; Kim, Young Mi; Tappis, Hannah; Kols, Adrienne; Currie, Sheena; Haver, Jaime; van Roosmalen, Jos; Broerse, Jacqueline E W; Stekelenburg, Jelle

2015-02-03

Complications of abortion are one of the leading causes of maternal mortality worldwide, along with hemorrhage, sepsis, and hypertensive diseases of pregnancy. In Afghanistan little data exist on the capacity of the health system to provide post-abortion care (PAC). This paper presents findings from a national emergency obstetric and neonatal care needs assessment related to PAC, with the aim of providing insight into the current situation and recommendations for improvement of PAC services. A national Emergency Obstetric and Neonatal Care Needs Assessment was conducted from December 2009 through February 2010 at 78 of the 127 facilities designated to provide emergency obstetric and neonatal care services in Afghanistan. Research tools were adapted from the Averting Maternal Death and Disability Program Needs Assessment Toolkit and national midwifery education assessment tools. Descriptive statistics were used to summarize facility characteristics, and linear regression models were used to assess the factors associated with providers' PAC knowledge and skills. The average number of women receiving PAC in the past year in each facility was 244, with no significant difference across facility types. All facilities had at least one staff member who provided PAC services. Overall, 70% of providers reported having been trained in PAC and 68% felt confident in their ability to perform these services. On average, providers were able to identify 66% of the most common complications of unsafe or incomplete abortion and 57% of the steps to take in examining and managing women with these complications. Providers correctly demonstrated an average of 31% of the tasks required for PAC during a simulated procedure. Training was significantly associated with PAC knowledge and skills in multivariate regression models, but other provider and facility characteristics were not. While designated emergency obstetric facilities in Afghanistan generally have most supplies and equipment for PAC, the capacity of healthcare providers to deliver PAC is limited. Therefore, we strongly recommend training all skilled birth attendants in PAC services. In addition, a PAC training package should be integrated into pre-service medical education.

Preparation for the solar system observations with Herschel: Simulation of Jupiter observations with PACS

NASA Astrophysics Data System (ADS)

Sagawa, Hideo; Hartogh, Paul; Rengel, Miriam; de Lange, Arno; Cavalié, Thibault

2010-11-01

Observations of the water inventory as well as other chemically important species on Jupiter will be performed in the frame of the guaranteed time key project of the Herschel Space Observatory entitled "Water and related chemistry in the Solar system". Among other onboard instruments, PACS (Photodetector Array Camera and Spectrometer) will provide new data of the spectral atlas in a wide region covering the far-infrared and submillimetre domains, with an improved spectral resolution and a higher sensitivity compared to previous observations carried out by Cassini/CIRS (Composite InfraRed Spectrometer) and by ISO (Infrared Space Observatory). In order to optimise the observational plan and to prepare for the data analysis, we have simulated the expected spectra of PACS Jupiter observations. Our simulation shows that PACS will promisingly detect several H 2O emission lines. As PACS is capable of spatially resolving the Jovian disk, we will be able to discern the external oxygen sources in the giant planets by exploring the horizontal distribution of water. In addition to H 2O lines, some absorption lines due to tropospheric CH 4, HD, PH 3 and NH 3 lines will be observed with PACS. Furthermore, owing to the high sensitivity of the instrument, the current upper limit on the abundance of hydrogen halides such as HCl will be also improved.

The data storage grid: the next generation of fault-tolerant storage for backup and disaster recovery of clinical images

NASA Astrophysics Data System (ADS)

King, Nelson E.; Liu, Brent; Zhou, Zheng; Documet, Jorge; Huang, H. K.

2005-04-01

Grid Computing represents the latest and most exciting technology to evolve from the familiar realm of parallel, peer-to-peer and client-server models that can address the problem of fault-tolerant storage for backup and recovery of clinical images. We have researched and developed a novel Data Grid testbed involving several federated PAC systems based on grid architecture. By integrating a grid computing architecture to the DICOM environment, a failed PACS archive can recover its image data from others in the federation in a timely and seamless fashion. The design reflects the five-layer architecture of grid computing: Fabric, Resource, Connectivity, Collective, and Application Layers. The testbed Data Grid architecture representing three federated PAC systems, the Fault-Tolerant PACS archive server at the Image Processing and Informatics Laboratory, Marina del Rey, the clinical PACS at Saint John's Health Center, Santa Monica, and the clinical PACS at the Healthcare Consultation Center II, USC Health Science Campus, will be presented. The successful demonstration of the Data Grid in the testbed will provide an understanding of the Data Grid concept in clinical image data backup as well as establishment of benchmarks for performance from future grid technology improvements and serve as a road map for expanded research into large enterprise and federation level data grids to guarantee 99.999 % up time.

The Internet as a Medium of Training for Picture Archival and Communication Systems (PACS).

ERIC Educational Resources Information Center

Majid, Shaheen; Misra, Ramesh Kumar

2002-01-01

Explores the potential of Web-based training for PACS (Picture Archival and Communication Systems) used in radiology departments for the storage and archiving of patients' medical images. Reports results of studies in three hospitals in Malaysia, Singapore and the Philippines that showed that the Internet can be used effectively for training.…

Secure vendor environment (SVE) for PACS

NASA Astrophysics Data System (ADS)

Honeyman-Buck, Janice; Frost, Meryll

2005-04-01

A Secure Vendor Environment (SVE) was created to protect radiology modalities from network intrusion, worms, viruses, and other forms of damaging attacks. Many vendors do not attempt any form of network security and if an institution demands a non-standard and secure installation, a future system upgrade could and frequently does eliminate any security measures installed during the initial installation. The SVE isolates the vendor equipment behind a virtual firewall on a private network that is invisible to the outside world. All interactions must go though a device containing two network interface cards called an Application Processor that acts as a store-and forward router, performs DICOM repair, proxies modality worklist, and isolates the vendor modalities. A small VPN appliance can open the device temporarily for remote access by vendor engineers. Prior to the routine installation of the SVE, vendor equipment was often attacked by hostile network intruders and viruses or worms, sometimes rendering the equipment unusable until the vendor could reload the system. The resulted in considerable clinical downtime and loss of revenue. Since the relatively low cost SVE solution has routinely been installed with all new equipment, no intrusions have occurred, although our network sniffers and intrusion detectors indicate that we are constantly being scanned for vulnerability. Purpose: To provide a secure network for vendor equipment in a PACS environment while allowing vendor access for upgrades and system repairs. Method: The network administrators at our university believe that network security should be implemented at the machine level rather than relying on a firewall. A firewall solution could conceivably block unwanted intrusion from outside the university network, but would still allow literally thousands of potential network users to get through to the PACS network. All the PACS archive, display and routing systems are individually protected from intrusion, but vendors of image producing modalities such as CT, MRI, and CR typically do not protect their equipment from network intrusion. Most vendors use the same user-ids and passwords for their service and administrative accounts which makes it easy for them to get to their systems for remote repairs and upgrades, but also makes it easy for hackers and other unwelcome intruders to gain access. We use a device with two network interface cards to isolate the vendor network from the main PACS / university / hospital network. This device is a store and forward PACS routing device, a DICOM repair device, a modality worklist proxy device, and a de-facto firewall. This device is named an Application Processor (AP). In addition, a small virtual private network (VPN) device is placed on the system that can be controlled only by the PACS administration. If a vendor engineer needs remote access to upgrade or service the equipment, a temporary connection is enabled for only the computer the engineer is using at the time, then is closed when he/she has completed their work. Results: The secure vendor environment (SVE) consists of a computer and a VPN appliance and costs approximately 2,000 USD to build. With software, the total system costs approximately 2800 - $3500. The SVE is typically deployed as part of every equipment installation. Since the SVE has been used, we have had no intrusion and no downtime due to hackers, viruses, worms, etc. This is now a part of every project plan for equipment that will become part of the PACS. New work: The SVE is a unique and new work by our group, developed as a solution totally within our group. Conclusions: Our results have convinced our administration that this small cost to protect vendor equipment is well worth the investment. Prior to developing this solution, there were numerous occasions where intruders invaded our equipment and rendered it unusable until the software could be reloaded, sometimes resulting in the loss of a day or more of clinical use.

The 3-dimensional structure of isolated and small foci of prostatic adenocarcinoma: the morphologic relationship between prostatic adenocarcinoma and prostatic intraepithelial neoplasia.

PubMed

Mai, Kien T; Burns, Bruce F; Stinson, William A; Morash, Christopher

2007-03-01

Transitional histopathologic changes from high-grade prostatic intraepithelial neoplasia (HGPIN) into early prostatic adenocarcinoma (PAC) have not been well studied to date. To investigate the histogenesis of PAC, we examined isolated and small foci of PAC (ISPAC) found in prostatectomy specimens and the 3-dimensional structure of these foci. Twelve consecutive radical prostatectomy specimens having ISPAC, performed for peripheral zone PAC (10 cases) and for transitional zone PAC (2 cases), of Gleason score were studied. One to 2 tissue blocks with representative sections were used. Eight ISPAC, with Gleason score 3 + 3 had complete serial sections of the entire lesion. PAC consisted of continuous, tortuous and branching tubules and acini arising from benign ducts displaying: (a) HGPIN in 5 ISPAC and (b) no HGPIN in 3 ISAPC. At the junctions between benign epithelia with or without HGPIN and malignant epithelia, there were transitional lesions with HGPIN involving small ducts and acini. PAC develops as a result of multiple outpouchings of the epithelium with formation of small ducts and acini showing cytologic atypia and gradual or abrupt loss of basal cells. Grade 3 ISPAC consists of a system of continuous duct pushing into the stroma. There is also evidence suggestive of HGPIN as being both a precursor lesion and an accompanying lesion of PAC.

Accuracy and reliability of tablet computer as an imaging console for detection of radiological signs of acute appendicitis using PACS workstation as reference standard.

PubMed

Awais, Muhammad; Khan, Dawar Burhan; Barakzai, Muhammad Danish; Rehman, Abdul; Baloch, Noor Ul-Ain; Nadeem, Naila

2018-05-01

To ascertain the accuracy and reliability of tablet as an imaging console for detection of radiological signs of acute appendicitis [on focused appendiceal computed tomography (FACT)] using Picture Archiving and Communication System (PACS) workstation as reference standard. From January, 2014 to June, 2015, 225 patients underwent FACT at our institution. These scans were blindly re-interpreted by an independent consultant radiologist, first on PACS workstation and, two weeks later, on tablet. Scans were interpreted for the presence of radiological signs of acute appendicitis. Accuracy of tablet was calculated using PACS as reference standard. Kappa (κ) statistics were calculated as a measure of reliability. Of 225 patients, 99 had radiological evidence of acute appendicitis on PACS workstation. Tablet was 100% accurate in detecting radiological signs of acute appendicitis. Appendicoliths, free fluid, lymphadenopathy, phlegmon/abscess, and perforation were identified on PACS in 90, 43, 39, 10, and 12 scans, respectively. There was excellent agreement between tablet and PACS for detection of appendicolith (к = 0.924), phlegmon/abscess (к = 0.904), free fluid (к = 0.863), lymphadenopathy (к = 0.879), and perforation (к = 0.904). Tablet computer, as an imaging console, was highly reliable and was as accurate as PACS workstation for the radiological diagnosis of acute appendicitis.

Armored Long RNA Controls or Standards for Branched DNA Assay for Detection of Human Immunodeficiency Virus Type 1▿

PubMed Central

Zhan, Sien; Li, Jinming; Xu, Ruihuan; Wang, Lunan; Zhang, Kuo; Zhang, Rui

2009-01-01

The branched DNA (bDNA) assay is a reliable method for quantifying the RNA of human immunodeficiency virus type 1 (HIV-1). The positive controls and standards for this assay for the detection of HIV-1 consist of naked RNA, which is susceptible to degradation by RNase. Armored RNA is a good candidate for an RNase-resistant positive control or standard. However, its use has been limited by the maximal length of the exogenous RNA packaged into virus-like particles by routine armored RNA technology. In the present study, we produced armored long RNA (armored L-RNA) controls or standards (AR-HIV-pol-3034b) for a bDNA assay of HIV-1 by increasing the amount and affinity of the pac sites (the pac site is a specific 19-nucleotide stem-loop region located at the 5′ terminus of the MS2 bacteriophage replicase gene) by a one-plasmid double-expression system. AR-HIV-pol-3034b was completely resistant to DNase and RNase, was stable in normal human EDTA-preserved plasma at 4°C for at least 6 months, and produced reproducible, linear results in the Versant HIV-1 RNA 3.0 assay. In conclusion, AR-HIV-pol-3034b could act as a positive control or standard in a bDNA assay for the detection of HIV-1. In addition, the one-plasmid double-expression system can be used as a better platform than the one-plasmid expression system and the two-plasmid coexpression system for expressing armored L-RNA. PMID:19494069

Armored long RNA controls or standards for branched DNA assay for detection of human immunodeficiency virus type 1.

PubMed

Zhan, Sien; Li, Jinming; Xu, Ruihuan; Wang, Lunan; Zhang, Kuo; Zhang, Rui

2009-08-01

The branched DNA (bDNA) assay is a reliable method for quantifying the RNA of human immunodeficiency virus type 1 (HIV-1). The positive controls and standards for this assay for the detection of HIV-1 consist of naked RNA, which is susceptible to degradation by RNase. Armored RNA is a good candidate for an RNase-resistant positive control or standard. However, its use has been limited by the maximal length of the exogenous RNA packaged into virus-like particles by routine armored RNA technology. In the present study, we produced armored long RNA (armored L-RNA) controls or standards (AR-HIV-pol-3034b) for a bDNA assay of HIV-1 by increasing the amount and affinity of the pac sites (the pac site is a specific 19-nucleotide stem-loop region located at the 5' terminus of the MS2 bacteriophage replicase gene) by a one-plasmid double-expression system. AR-HIV-pol-3034b was completely resistant to DNase and RNase, was stable in normal human EDTA-preserved plasma at 4 degrees C for at least 6 months, and produced reproducible, linear results in the Versant HIV-1 RNA 3.0 assay. In conclusion, AR-HIV-pol-3034b could act as a positive control or standard in a bDNA assay for the detection of HIV-1. In addition, the one-plasmid double-expression system can be used as a better platform than the one-plasmid expression system and the two-plasmid coexpression system for expressing armored L-RNA.

Scalable Fabrication of Natural-Fiber Reinforced Composites with Electromagnetic Interference Shielding Properties by Incorporating Powdered Activated Carbon

PubMed Central

Xia, Changlei; Zhang, Shifeng; Ren, Han; Shi, Sheldon Q.; Zhang, Hualiang; Cai, Liping; Li, Jianzhang

2015-01-01

Kenaf fiber—polyester composites incorporated with powdered activated carbon (PAC) were prepared using the vacuum-assisted resin transfer molding (VARTM) process. The product demonstrates the electromagnetic interference (EMI) shielding function. The kenaf fibers were retted in a pressured reactor to remove the lignin and extractives in the fiber. The PAC was loaded into the freshly retted fibers in water. The PAC loading effectiveness was determined using the Brunauer-Emmett-Teller (BET) specific surface area analysis. A higher BET value was obtained with a higher PAC loading. The transmission energies of the composites were measured by exposing the samples to the irradiation of electromagnetic waves with a variable frequency from 8 GHz to 12 GHz. As the PAC content increased from 0% to 10.0%, 20.5% and 28.9%, the EMI shielding effectiveness increased from 41.4% to 76.0%, 87.9% and 93.0%, respectively. Additionally, the EMI absorption increased from 21.2% to 31.7%, 44.7% and 64.0%, respectively. The ratio of EMI absorption/shielding of the composite at 28.9% of PAC loading was increased significantly by 37.1% as compared with the control sample. It was indicated that the incorporation of PAC into the composites was very effective for absorbing electromagnetic waves, which resulted in a decrease in secondary electromagnetic pollution. PMID:28787808

Effects of polyaluminum chloride and lanthanum-modified bentonite on the growth rates of three Cylindrospermopsis raciborskii strains

PubMed Central

van Oosterhout, Frank; Becker, Vanessa; Attayde, José Luiz; Lürling, Miquel

2018-01-01

In tropical and subtropical lakes, eutrophication often leads to nuisance blooms of Cylindrospermopsis raciborskii. In laboratory experiments, we tested the combined effects of flocculant polyaluminum chloride (PAC) and lanthanum-modified bentonite (LMB) on the sinking and growth rates of three C. raciborskii strains. We tested the hypothesis that the combination of PAC and LMB would (1) effectively sink C. raciborskii in a test tube experiment and (2) impair C. raciborskii growth, irrespective of the biomass of the inoculum (bloom) and the strain in the growth experiment. We tested the recommended (LMB1) and a three-times higher dose of LMB (LMB3). The combined addition of PAC and LMB enhanced the sedimentation of all C. raciborskii strains. Moreover, both the PAC and LMB doses decreased the phosphate concentration. PAC and LMB1 decreased the growth rate of all strains, but the efficacy depended on the biomass and strain. The combined addition of PAC and LMB3 inhibited the growth of all strains independently of the biomass and strain. We conclude that a low dose of PAC in combination with the recommended dose of LMB decreases C. raciborskii blooms and that the efficiency of the technique depends on the biomass of the bloom. A higher dose of LMB is needed to obtain a more efficient control of C. raciborskii blooms. PMID:29614118

Effects of polyaluminum chloride and lanthanum-modified bentonite on the growth rates of three Cylindrospermopsis raciborskii strains.

PubMed

Araújo, Fabiana; van Oosterhout, Frank; Becker, Vanessa; Attayde, José Luiz; Lürling, Miquel

2018-01-01

In tropical and subtropical lakes, eutrophication often leads to nuisance blooms of Cylindrospermopsis raciborskii. In laboratory experiments, we tested the combined effects of flocculant polyaluminum chloride (PAC) and lanthanum-modified bentonite (LMB) on the sinking and growth rates of three C. raciborskii strains. We tested the hypothesis that the combination of PAC and LMB would (1) effectively sink C. raciborskii in a test tube experiment and (2) impair C. raciborskii growth, irrespective of the biomass of the inoculum (bloom) and the strain in the growth experiment. We tested the recommended (LMB1) and a three-times higher dose of LMB (LMB3). The combined addition of PAC and LMB enhanced the sedimentation of all C. raciborskii strains. Moreover, both the PAC and LMB doses decreased the phosphate concentration. PAC and LMB1 decreased the growth rate of all strains, but the efficacy depended on the biomass and strain. The combined addition of PAC and LMB3 inhibited the growth of all strains independently of the biomass and strain. We conclude that a low dose of PAC in combination with the recommended dose of LMB decreases C. raciborskii blooms and that the efficiency of the technique depends on the biomass of the bloom. A higher dose of LMB is needed to obtain a more efficient control of C. raciborskii blooms.

Blueberry proanthocyanidins against human norovirus surrogates in model foods and under simulated gastric conditions.

PubMed

Joshi, Snehal; Howell, Amy B; D'Souza, Doris H

2017-05-01

Blueberry proanthocyanidins (B-PAC) are known to decrease titers of human norovirus surrogates in vitro. The application of B-PAC as therapeutic or preventive options against foodborne viral illness needs to be determined using model foods and simulated gastric conditions in vitro. The objective of this study was to evaluate the antiviral effect of B-PAC in model foods (apple juice (AJ) and 2% reduced fat milk) and simulated gastrointestinal fluids against cultivable human norovirus surrogates (feline calicivirus; FCV-F9 and murine norovirus; MNV-1) over 24 h at 37 °C. Equal amounts of each virus (5 log PFU/ml) was mixed with B-PAC (1, 2 and 5 mg/ml) prepared either in AJ, or 2% milk, or simulated gastric fluids and incubated over 24 h at 37 °C. Controls included phosphate buffered saline, malic acid (pH 7.2), AJ, 2% milk or simulated gastric and intestinal fluids incubated with virus over 24 h at 37 °C. The tested viruses were reduced to undetectable levels within 15 min with B-PAC (1, 2 and 5 mg/ml) in AJ (pH 3.6). However, antiviral activity of B-PAC was reduced in milk. FCV-F9 was reduced by 0.4 and 1.09 log PFU/ml with 2 and 5 mg/ml B-PAC in milk, respectively and MNV-1 titers were reduced by 0.81 log PFU/ml with 5 mg/ml B-PAC in milk after 24 h. B-PAC at 5 mg/ml in simulated intestinal fluid reduced titers of the tested viruses to undetectable levels within 30 min. Overall, these results show the potential of B-PAC as preventive and therapeutic options for foodborne viral illnesses. Copyright © 2016. Published by Elsevier Ltd.

PACS strategy for imaging centers.

PubMed

Bedel, Victoria; Zdanowicz, Mark

2004-01-01

Picture archiving and communications systems (PACS) have been available in imaging centers for many years, but they often were less functional, were not well integrated into patient information systems, and lacked the network backbone to implement a system. As modalities are replaced and technology improves, the ability and time for an imaging center to acquire, integrate, and utilize PACS has arrived. However, each imaging center must determine why it should invest in PACS. A business plan is the fundamental need. Each imaging center must understand its target market, growth rate, and staffing plans. Additional considerations lie in current and future modality availability, the need for offsite delivery of images and reports, and the potential need for remote transmission of images. These issues must be identified and prioritized. A multidisciplinary team is essential. The most successful PACS implementation begins with complete involvement from all levels. The team should be comprised of people with complementary skills who are committed to a common purpose, set of performance goals, and approach for which they hold themselves mutually accountable. The team must jointly decide on the project's objectives. These objectives fall under 4 categories: clinical, service, financial, and performance. PACS must be considered a tool to help accomplish each objective. The imaging center must determine its top priorities, then translate them into a technology "wish list." The center can then list those pieces of technology that are most important and prioritize them. There are even more considerations for connecting multiple imaging centers. The team must create a comprehensive request for proposal (RFP) and determine the vendors that will receive the document. Once the RFP responses have been received and the vendor has been selected, an effective training plan must be executed. Training plans should be competency-based, ensuring comfort and competency among all staff. Upon the project's completion, it is essential for the imaging center to evaluate PACS' effect upon its services and relationships with patients, staff, and referring physicians. Marketing and demonstrating the latest technology can positively impact all these areas.

Using an image-extended relational database to support content-based image retrieval in a PACS.

PubMed

Traina, Caetano; Traina, Agma J M; Araújo, Myrian R B; Bueno, Josiane M; Chino, Fabio J T; Razente, Humberto; Azevedo-Marques, Paulo M

2005-12-01

This paper presents a new Picture Archiving and Communication System (PACS), called cbPACS, which has content-based image retrieval capabilities. The cbPACS answers range and k-nearest- neighbor similarity queries, employing a relational database manager extended to support images. The images are compared through their features, which are extracted by an image-processing module and stored in the extended relational database. The database extensions were developed aiming at efficiently answering similarity queries by taking advantage of specialized indexing methods. The main concept supporting the extensions is the definition, inside the relational manager, of distance functions based on features extracted from the images. An extension to the SQL language enables the construction of an interpreter that intercepts the extended commands and translates them to standard SQL, allowing any relational database server to be used. By now, the system implemented works on features based on color distribution of the images through normalized histograms as well as metric histograms. Metric histograms are invariant regarding scale, translation and rotation of images and also to brightness transformations. The cbPACS is prepared to integrate new image features, based on texture and shape of the main objects in the image.

Development of the regional EPR and PACS sharing system on the infrastructure of cloud computing technology controlled by patient identifier cross reference manager.

PubMed

Kondoh, Hiroshi; Teramoto, Kei; Kawai, Tatsurou; Mochida, Maki; Nishimura, Motohiro

2013-01-01

A Newly developed Oshidori-Net2, providing medical professionals with remote access to electronic patient record systems (EPR) and PACSs of four hospitals, of different venders, using cloud computing technology and patient identifier cross reference manager. The operation was started from April 2012. The patients moved to other hospital were applied. Objective is to show the merit and demerit of the new system.

An examination of the first 30 days after patients are discharged to the community from hip fracture post-acute care

PubMed Central

Leland, Natalie; Gozalo, Pedro; Christian, TJ; Bynum, Julie; Mor, Vince; Wetle, Terrie Fox; Teno, Joan

2015-01-01

Background Post-acute care (PAC) rehabilitation aims to maximize independence and facilitate a safe community transition. Yet little is known about PAC patients’ success in staying home post-discharge or differences on this outcome across PAC providers. Objectives Examine the percentage of PAC patients who remain in the community at least 30 days after discharge (i.e., successful community discharge) following hip fracture rehabilitation and describe differences among PAC facilities based on this outcome. Research Design Retrospective observational study. Subjects Community-dwelling, Medicare fee-for-service beneficiaries 75 years of age and older who experienced their first hip fracture between 1999–2007 (n=880,779). PAC facilities admitting hip fracture patients in 2006. Measures Successful community discharge, sites of readmission after PAC discharge. Results Between 1999 and 2007, 57% of patients achieved successful community discharge. Black were less likely (adjusted odds ratios=0.84, 95% confidence interval 0.82–0.86) than similar whites to achieve successful community discharge. Among all who re-entered the community (n=581,095), 14% remained in the community fewer than 30 days. Acute hospitals (67.5%) and institutional PAC (16.8%) were the most common sites of re-entry. The median proportion of successful community discharge among facilities was 49% (IQR: 33%–66%). Lowest-quartile facilities admitted older (85.9 vs. 84.1 years of age), sicker patients (e.g., higher rates of hospital complications 6.0% vs. 4.6%), but admitted fewer annually (7.1 vs. 19.3), compared to the highest quartile. Conclusions Re-entry into the healthcare system after PAC community discharge is common. Due to the distinct care needs of the PAC population there is a need for a quality measure that complements the current 30-day hospital readmission outcome and captures the objectives of PAC rehabilitation. PMID:26340664

The Effect of a Novel Movement Strategy in Decreasing ACL Risk Factors in Female Adolescent Soccer Players: A Randomized Controlled Trial

PubMed Central

Celebrini, Richard G.; Eng, Janice J.; Miller, William C.; Ekegren, Christina L.; Johnston, James D.; Depew, Thomas A.; MacIntyre, Donna L.

2015-01-01

Objective To determine the effect of a novel movement strategy incorporated within a soccer warm-up on biomechanical risk factors for ACL injury during three sport-specific movement tasks. Design Single-blind, randomized controlled clinical trial. Setting Laboratory setting. Participants 20 top-tier female teenage soccer players. Interventions Subjects were randomized to the Core Position and Control movement strategy (Core-PAC) warm-up or standard warm-up which took place prior to their regular soccer practice over a 6-week period. The Core-PAC focuses on getting the centre of mass closer to the plant foot or base of support. Main Outcome Measures Peak knee flexion angle and abduction moments during a side-hop (SH), side-cut (SC) and unanticipated side-cut (USC) task after the 6-weeks with (intervention group only) and without a reminder to use the Core-PAC strategy. Results The Core-PAC group increased peak flexion angles during the SH task (Mean difference = 6.2°, 95% CI: 1.9–10.5°, effect size = 1.01, P = 0.034) after the 6-week warm-up program without a reminder. In addition, the Core-PAC group demonstrated increased knee flexion angles for the side-cut (Mean difference = 8.5°, 95% CI: 4.8–12.2°, ES = 2.02, P = 0.001) and side-hop (Mean difference = 10.0°, 95% CI: 5.7–14.3°, ES = 1.66, P = 0.001) task after a reminder. No changes in abduction moments were found. Conclusions The results of this study suggest that the Core-PAC may be one method of modifying high-risk soccer-specific movements and can be implemented within a practical, team-based soccer warm-up. The results should be interpreted with caution due to the small sample size. PMID:24184850

Very Facile Polarity Umpolung and Noncovalent Functionalization of Inorganic Nanoparticles: A Tool Kit for Supramolecular Materials Chemistry.

PubMed

Zeininger, Lukas; Petzi, Stefanie; Schönamsgruber, Jörg; Portilla, Luis; Halik, Marcus; Hirsch, Andreas

2015-09-28

The facile assembly of shell-by-shell (SbS)-coated nanoparticles [TiO2-PAC16]@shell 1-7 (PAC16 = hexadecylphosphonic acid), which are soluble in water and can be isolated as stable solids, is reported. In these functional architectures, an umpolung of dispersibility (organic apolar versus water) was accomplished by the noncovalent binding of ligands 1-7 to titania nanoparticles [TiO2-PAC16] containing a first covalent coating with PAC16. Ligands 1-7 are amphiphilic and form the outer second shell of [TiO2-PAC16]@shell 1-7. The tailor-designed dendritic building blocks 3-5 contain negative and positive charges in the same molecule, and ligands 6 and 7 contain a perylenetetracarboxylic acid dimide (PDI) core (6/7) as a photoactive reporter component. In the redox and photoactive system [TiO2-PAC16]@shell 7, electronic communication between the inorganic core to the PDI ligands was observed. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

PACS project management utilizing web-based tools

NASA Astrophysics Data System (ADS)

Patel, Sunil; Levin, Brad; Gac, Robert J., Jr.; Harding, Douglas, Jr.; Chacko, Anna K.; Radvany, Martin; Romlein, John R.

2000-05-01

As Picture Archiving and Communications Systems (PACS) implementations become more widespread, the management of deploying large, multi-facility PACS will become a more frequent occurrence. The tools and usability of the World Wide Web to disseminate project management information obviates time, distance, participant availability, and data format constraints, allowing for the effective collection and dissemination of PACS planning, implementation information, for a potentially limitless number of concurrent PACS sites. This paper will speak to tools, such as (1) a topic specific discussion board, (2) a 'restricted' Intranet, within a 'project' Intranet. We will also discuss project specific methods currently in use in a leading edge, regional PACS implementation concerning the sharing of project schedules, physical drawings, images of implementations, site-specific data, point of contacts lists, project milestones, and a general project overview. The individual benefits realized for the end user from each tool will also be covered. These details will be presented, balanced with a spotlight on communication as a critical component of any project management undertaking. Using today's technology, the web arguably provides the most cost and resource effective vehicle to facilitate the broad based, interactive sharing of project information.

infoRAD: computers for clinical practice and education in radiology. Teleradiology, information transfer, and PACS: implications for diagnostic imaging in the 1990s.

PubMed

Schilling, R B

1993-05-01

Picture archiving and communication systems (PACS) provide image viewing at diagnostic, reporting, consultation, and remote workstations; archival on magnetic or optical media by means of short- or long-term storage devices; communications by means of local or wide area networks or public communication services; and integrated systems with modality interfaces and gateways to health care facilities and departmental information systems. Research indicates three basic needs for image and report management: (a) improved communication and turnaround time between radiologists and other imaging specialists and referring physicians, (b) fast reliable access to both current and previously obtained images and reports, and (c) space-efficient archival support. Although PACS considerations are much more complex than those associated with single modalities, the same basic purchase criteria apply. These criteria include technical leadership, image quality, throughput, life cost (eg, initial cost, maintenance, upgrades, and depreciation), and total service. Because a PACS takes much longer to implement than a single modality, the customer and manufacturer must develop a closer working relationship than has been necessary in the past.

'It's a very complicated issue here': understanding the limited and declining use of manual vacuum aspiration for postabortion care in Malawi: a qualitative study.

PubMed

Cook, Sinead; de Kok, Bregje; Odland, Maria Lisa

2017-04-01

Malawi has one of the highest maternal mortality ratios in the world. Unsafe abortions are an important contributor to Malawi's maternal mortality and morbidity, where abortion is illegal except to save the woman's life. Postabortion care (PAC) aims to reduce adverse consequences of unsafe abortions, in part by treating incomplete abortions. Although global and national PAC policies recommend manual vacuum aspiration (MVA) for treatment of incomplete abortion, usage in Malawi is low and appears to be decreasing, with sharp curettage being used in preference. There is limited evidence regarding what influences rejection of recommended PAC innovations. Hence, drawing on Greenhalgh et al. 's (2004. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Quarterly 82: 581-629.) diffusion of healthcare innovation framework, this qualitative study aimed to investigate factors contributing to the limited and declining use of MVA in Malawi. Semi-structured interviews with 17 PAC providers in a central hospital and a district hospital indicate that a range of factors coalesce and influence PAC and MVA use in Malawi. Factors pertain to four main domains: the system (shortages of material and human resources; lack of training, supervision and feedback), relationships (power dynamics; expected job roles), the health workers (attitudes towards abortion and PAC; prioritization of PAC) and the innovation (perceived risks and benefits of MVA use). Effective and sustainable PAC policy must adopt a broader people-centred health systems approach which considers all these factors, their interactions and the wider socio-cultural, legal and political context of abortion and PAC. The study showed the value of using Greenhalgh et al. 's (2004. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Quarterly 82: 581-629.) framework to consider the complex interaction of factors surrounding innovation use (or lack of), but provided more insights into rejections of innovations and, particularly, a low- and middle-income country perspective. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Adoption of alternative financing strategies to increase the diffusion of picture archiving and communication systems into the radiology marketplace.

PubMed

Reiner, B; Siegel, E; McKay, P

2000-05-01

The objective of the study was to evaluate current marketplace conditions and strategies employed by major picture archiving and communication systems (PACS) vendors in the creation of alternative financing strategies, to enhance the diffusion of filmless imaging. Data were collected from the major PACS vendors in the forms of survey questionnaires and review of existing leases. Topics evaluated in the survey included current financing options available, foreseeable changes in PACS financing, role of third-party financiers, and creation of risk-sharing arrangements. Generic leases were also reviewed evaluating the presence or absence of several key variables including technology obsolescence protection, hardware/software upgrades, end-of-term options, determination of fair market value, functionality/acceptance testing, uptime guarantees, and workflow management consulting. Eight of the 10 PACS vendors surveyed participated in the data collection. The vast majority of current PACS implementations (60% to 90%) occur through direct purchase, with conventional leasing (operating or capital) accounting for only 5% to 30% of PACS installations. The majority of respondents view fee-for-lease arrangements and other forms of risk sharing as increasing importance for future PACS financing. The specific targets for such risk-sharing arrangements consist of small hospital and privately owned imaging centers. Leases currently offered range in duration from 3 to 5 years and frequently offer technology obsolescence protection with upgrades, multiple end-of-term options, and some form of acceptance testing. A number of important variables frequently omitted from leases include uptime guarantees, flexibility in changing financing or vendors, and incorporation of expected productivity/operational efficiency gains. As vendors strive to increase the penetration of PACS into the radiology marketplace, there will be a shift from conventional financing (loan or purchase) to leasing. Fee-for-use leasing and other forms of risk sharing have the greatest potential in smaller hospitals, which do not have the financial resources to pursue conventional financing options. Potential PACS customers must be cautious when entering into these alternative financing strategies, to ensure that appropriate safeguards are incorporated, in order to minimize downside risk.

The Potential of Dark Septate Endophytes to Form Root Symbioses with Ectomycorrhizal and Ericoid Mycorrhizal Middle European Forest Plants

PubMed Central

Lukešová, Tereza; Kohout, Petr; Větrovský, Tomáš; Vohník, Martin

2015-01-01

The unresolved ecophysiological significance of Dark Septate Endophytes (DSE) may be in part due to existence of morphologically indistinguishable cryptic species in the most common Phialocephala fortinii s. l.—Acephala applanata species complex (PAC). We inoculated three middle European forest plants (European blueberry, Norway spruce and silver birch) with 16 strains of eight PAC cryptic species and other DSE and ectomycorrhizal/ericoid mycorrhizal fungi and focused on intraradical structures possibly representing interfaces for plant-fungus nutrient transfer and on host growth response. The PAC species Acephala applanata simultaneously formed structures resembling ericoid mycorrhiza (ErM) and DSE microsclerotia in blueberry. A. macrosclerotiorum, a close relative to PAC, formed ectomycorrhizae with spruce but not with birch, and structures resembling ErM in blueberry. Phialocephala glacialis, another close relative to PAC, formed structures resembling ErM in blueberry. In blueberry, six PAC strains significantly decreased dry shoot biomass compared to ErM control. In birch, one A. macrosclerotiorum strain increased root biomass and the other shoot biomass in comparison with non-inoculated control. The dual mycorrhizal ability of A. macrosclerotiorum suggested that it may form mycorrhizal links between Ericaceae and Pinaceae. However, we were unable to detect this species in Ericaceae roots growing in a forest with presence of A. macrosclerotiorum ectomycorrhizae. Nevertheless, the diversity of Ericaceae mycobionts was high (380 OTUs) with individual sites often dominated by hitherto unreported helotialean and chaetothyrialean/verrucarialean species; in contrast, typical ErM fungi were either absent or low in abundance. Some DSE apparently have a potential to form mycorrhizae with typical middle European forest plants. However, except A. applanata, the tested representatives of all hitherto described PAC cryptic species formed typical DSE colonization without specific structures necessary for mycorrhizal nutrient transport. A. macrosclerotiorum forms ectomycorrhiza with conifers but not with broadleaves and probably does not form common mycorrhizal networks between conifers with Ericaceae. PMID:25905493

PAC1- and VPAC2 receptors in light regulated behavior and physiology: Studies in single and double mutant mice

PubMed Central

Georg, Birgitte; Fahrenkrug, Jan

2017-01-01

The two sister peptides, pituitary adenylate cyclase activating polypeptide (PACAP) and vasoactive intestinal polypeptide (VIP) and their receptors, the PAC1 –and the VPAC2 receptors, are involved in regulation of the circadian timing system. PACAP as a neurotransmitter in the retinohypothalamic tract (RHT) and VIP as a neurotransmitter, involved in synchronization of SCN neurons. Behavior and physiology in VPAC2 deficient mice are strongly regulated by light most likely as a result of masking. Consequently, we used VPAC2 and PAC1/VPAC2 double mutant mice in comparison with PAC1 receptor deficient mice to further elucidate the role of PACAP in the light mediated regulation of behavior and physiology of the circadian system. We compared circadian rhythms in mice equipped with running wheels or implanted radio-transmitter measuring core body temperature kept in a full photoperiod ((FPP)(12:12 h light dark-cycles (LD)) and skeleton photo periods (SPP) at high and low light intensity. Furthermore, we examined the expression of PAC1- and VPAC2 receptors in the SCN of the different genotypes in combination with visualization of PACAP and VIP and determined whether compensatory changes in peptide and/or receptor expression in the reciprocal knockouts (KO) (PAC1 and VPAC2) had occurred. Our data demonstrate that in although being closely related at both ligand and receptor structure/sequence, PACAP/PAC1 receptor signaling are independent of VIP/VPAC2 receptor signaling and vice versa. Furthermore, lack of either of the receptors does not result in compensatory changes at neither the physiological or anatomical level. PACAP/PAC1 signaling is important for light regulated behavior, VIP/VPAC2signaling for stable clock function and both signaling pathways may play a role in shaping diurnality versus nocturnality. PMID:29155851

Data protection and security issues of PACS

NASA Astrophysics Data System (ADS)

Bakker, Albert R.

1992-07-01

It is observed that the dataprotection aspects of PACS have hardly been explored, while for Hospital Information Systems (HIS) considerable attention has been paid to these aspects. In the dataprotection domain around HIS we distinguish the aspects data integrity (safety), usage integrity (confidentiality, privacy) and availability. A wide range of measures (dealing with hardware, software or organization/procedures) has been suggested to achieve adequate protection. For each system a selection of the suggested measures has to be made, where risk is balanced against costs. It seems that it is taken for granted that the usual measures as implemented for HIS will also be adequate for PACS. In this paper dataprotection aspects for PACS are discussed. Apart from similarities with the HIS situation also differences will be identified. In particular safeguarding the image databank requires special measured. Dataprotection should not be an add-on of the system, it should be taken into account in the design phase. As an illustration two alternatives for the organization of the image databank will be considered from the point of view of dataprotection. The one being consecutive historical storage of images, the other the clustering of images of the same patient on the same volume in the storage system.

Protecting clinical data in PACS, teleradiology systems, and research environments

NASA Astrophysics Data System (ADS)

Meissner, Marion C.; Collmann, Jeff R.; Tohme, Walid G.; Mun, Seong K.

1997-05-01

As clinical data is more widely stored in electronic patient record management systems and transmitted over the Internet and telephone lines, it becomes more accessible and therefore more useful, but also more vulnerable. Computer systems such as PACS, telemedicine applications, and medical research networks must protect against accidental or deliberate modification, disclosure, and violation of patient confidentiality in order to be viable. Conventional wisdom in the medical field and among lawmakers legislating the use of electronic medical records suggests that, although it may improve access to information, an electronic medical record cannot be as secure as a traditional paper record. This is not the case. Information security is a well-developed field in the computer and communications industry. If medical information systems, such as PACS, telemedicine applications, and research networks, properly apply information security techniques, they can ensure the accuracy and confidentiality of their patient information and even improve the security of their data over a traditional paper record. This paper will elaborate on some of these techniques and discuss how they can be applied to medical information systems. The following systems will be used as examples for the analysis: a research laboratory at Georgetown University Medical Center, the Deployable Radiology system installed to support the US Army's peace- keeping operation in Bosnia, a kidney dialysis telemedicine system in Washington, D.C., and various experiences with implementing and integrating PACS.

A comparison between digital images viewed on a picture archiving and communication system diagnostic workstation and on a PC-based remote viewing system by emergency physicians.

PubMed

Parasyn, A; Hanson, R M; Peat, J K; De Silva, M

1998-02-01

Picture Archiving and Communication Systems (PACS) make possible the viewing of radiographic images on computer workstations located where clinical care is delivered. By the nature of their work this feature is particularly useful for emergency physicians who view radiographic studies for information and use them to explain results to patients and their families. However, the high cost of PACS diagnostic workstations with fuller functionality places limits on the number of and therefore the accessibility to workstations in the emergency department. This study was undertaken to establish how well less expensive personal computer-based workstations would work to support these needs of emergency physicians. The study compared the outcome of observations by 5 emergency physicians on a series of radiographic studies containing subtle abnormalities displayed on both a PACS diagnostic workstation and on a PC-based workstation. The 73 digitized radiographic studies were randomly arranged on both types of workstation over four separate viewing sessions for each emergency physician. There was no statistical difference between a PACS diagnostic workstation and a PC-based workstation in this trial. The mean correct ratings were 59% on the PACS diagnostic workstations and 61% on the PC-based workstations. These findings also emphasize the need for prompt reporting by a radiologist.

Costs of postabortion care in public sector health facilities in Malawi: a cross-sectional survey.

PubMed

Benson, Janie; Gebreselassie, Hailemichael; Mañibo, Maribel Amor; Raisanen, Keris; Johnston, Heidi Bart; Mhango, Chisale; Levandowski, Brooke A

2015-12-17

Health systems could obtain substantial cost savings by providing safe abortion care rather than providing expensive treatment for complications of unsafely performed abortions. This study estimates current health system costs of treating unsafe abortion complications and compares these findings with newly-projected costs for providing safe abortion in Malawi. We conducted in-depth surveys of medications, supplies, and time spent by clinical personnel dedicated to postabortion care (PAC) for three treatment categories (simple, severe non-surgical, and severe surgical complications) and three uterine evacuation (UE) procedure types (manual vacuum aspiration (MVA), dilation and curettage (D&C) and misoprostol-alone) at 15 purposively-selected public health facilities. Per-case treatment costs were calculated and applied to national, annual PAC caseload data. The median cost per D&C case ($63) was 29% higher than MVA treatment ($49). Costs to treat severe non-surgical complications ($63) were almost five times higher than those of a simple PAC case ($13). Severe surgical complications were especially costly to treat at $128. PAC treatment in public facilities cost an estimated $314,000 annually. Transition to safe, legal abortion would yield an estimated cost reduction of 20%-30%. The method of UE and severity of complications have a large impact on overall costs. With a liberalized abortion law and implementation of induced abortion services with WHO-recommended UE methods, current PAC costs to the health system could markedly decrease.

Renoprotective RAAS inhibition does not affect the association between worse renal function and higher plasma aldosterone levels.

PubMed

Gant, Christina M; Laverman, Gozewijn D; Vogt, Liffert; Slagman, Maartje C J; Heerspink, Hiddo J L; Waanders, Femke; Hemmelder, Marc H; Navis, Gerjan

2017-12-20

Aldosterone is elevated in chronic kidney disease (CKD) and may be involved in hypertension. Surprisingly, the determinants of the plasma aldosterone concentration (PAC) and its role in hypertension are not well studied in CKD. Therefore, we studied the determinants of aldosterone and its association with blood pressure in CKD patients. We also studied this during renin-angiotensin-aldosterone system inhibition (RAASi) to establish clinical relevance, as RAASi is the treatment of choice in CKD with albuminuria. We performed a post-hoc analysis on data from a randomized controlled double blind cross-over trial in non-diabetic CKD patients (n = 33, creatinine clearance (CrCl) 85 (75-95) ml/min, proteinuria 3.2 (2.5-4.0) g/day). Patients were treated with losartan 100 mg (ARB), and ARB + hydrochlorothiazide 25 mg (HCT), during both a regular (200 ± 10 mmol Na + /day) and low (89 ± 8 mmol Na + /day) dietary sodium intake, in 6-week study periods. PAC data at the end of each study period were analyzed. The association between PAC and blood pressure was analyzed continuously, and according to PAC above or below the median. Lower CrCl was correlated with higher PAC during placebo as well as during ARB (β = -1.213, P = 0.008 and β = -1.090, P = 0.010). Higher PAC was not explained by high renin, illustrated by a comparable association between CrCl and the aldosterone-to-renin ratio. The association between lower CrCl and higher PAC was also found in a second study with single RAASi with ACE inhibition (ACEi; lisinopril 40 mg/day), and dual RAASi (lisinopril 40 mg/day + valsartan 320 mg/day). Higher PAC was associated with a higher systolic blood pressure (P = 0.010) during different study periods. Only during maximal treatment with ARB + HCT + dietary sodium restriction, blood pressure was no longer different in subjects with a PAC above and below the median. In CKD patients with a standardized regular sodium intake, worse renal function is associated with a higher aldosterone, untreated and during RAASi with either ARB, ACEi, or both. Furthermore, higher aldosterone is associated with higher blood pressure, which can be treated with the combination of RAASi, HCT and dietary sodium restriction. The first study was performed before it was standard to register trials and the study was not retrospectively registered. The second study was registered in the Netherlands Trial Register on the 5th of May 2006 (NTR675).

An Exploratory Analysis of Functional Staging Using an Item Response Theory Approach

PubMed Central

Tao, Wei; Haley, Stephen M.; Coster, Wendy J.; Ni, Pengsheng; Jette, Alan M.

2009-01-01

Objectives To develop and explore the feasibility of a functional staging system (defined as the process of assigning subjects, according to predetermined standards, into a set of hierarchical levels with regard to their functioning performance in mobility, daily activities, and cognitive skills) based on item response theory (IRT) methods using short-forms of the Activity Measure for Post-Acute Care (AM-PAC); and to compare the criterion validity and sensitivity of the IRT-based staging system to a non-IRT-based staging system developed for the FIM instrument. Design Prospective, longitudinal cohort study of patients interviewed at hospital discharge and 1, 6, and 12 months after inpatient rehabilitation. Setting Follow-up interviews conducted in patients’ homes. Participants Convenience sample of 516 patients (47% men; sample mean age, 68.3y) at baseline (retention at the final follow-up, 65%) with neurologic, lower-extremity orthopedic, or complex medical conditions. Interventions Not applicable Main Outcome Measures AM-PAC basic mobility, daily activity, and applied cognitive activity stages; FIM executive control, mobility, activities of daily living, and sphincter stages. Stages refer to the hierarchical levels assigned to patient’s functioning performance. Results We were able to define IRT-based staging definitions and create meaningful cut scores based on the 3 AM-PAC short-forms. The IRT stages correlated as well or better to the criterion items than the FIM stages. Both the IRT-based stages and the FIM stages were sensitive to changes throughout the 6-month follow-up period. The FIM stages were more sensitive in detecting changes between baseline and 1-month follow-up visit. The AM-PAC stages were more discriminant in the follow-up visits. Conclusions An IRT-based staging approach appeared feasible and effective in classifying patients throughout long-term follow-up. Although these stages were developed from short-forms, this staging methodology could also be applied to improve the meaning of scores generated from IRT-based computerized adaptive testing in future work. PMID:18503798

Pilot-scale study of powdered activated carbon recirculation for micropollutant removal.

PubMed

Meinel, F; Sperlich, A; Jekel, M

Adsorption onto powdered activated carbon (PAC) is a promising technique for the removal of organic micropollutants (OMPs) from treated wastewater. To enhance the adsorption efficiency, PAC is recycled back into the adsorption stage. This technique was examined in pilot scale in comparison to a reference without recirculation. Coagulation with Fe(3+) was carried out simultaneously to adsorption. Extensive OMP measurements showed that recirculation significantly increased OMP eliminations. Thus, significant PAC savings were feasible. The PAC concentration in the contact reactor proved to be an important operating parameter that can be surrogated by the easily measurable total suspended solids (TSS) concentration. OMP eliminations increased with increasing TSS concentrations. At 20 mg PAC L(-1) and 2.8 g TSS L(-1) in the contact reactor, well-adsorbable carbamazepine was eliminated by 97%, moderately adsorbable diclofenac was eliminated by 92% and poorly-adsorbable acesulfame was eliminated by 54% in comparison to 49%, 35% and 18%, respectively, without recirculation. The recirculation system represents an efficient technique, as the PAC's adsorption capacity is practically completely used. Small PAC dosages yield high OMP eliminations. Poorly-adsorbable gabapentin was eliminated to an unexpectedly high degree. A laboratory-scale biomass inhibition study showed that aerobic biodegradation removed gabapentin in addition to adsorption.

Does use of a PACS increase the number of images per study? A case study in ultrasound.

PubMed

Horii, Steven; Nisenbaum, Harvey; Farn, James; Coleman, Beverly; Rowling, Susan; Langer, Jill; Jacobs, Jill; Arger, Peter; Pinheiro, Lisa; Klein, Wendy; Reber, Michele; Iyoob, Christopher

2002-03-01

The purpose of this study was to determine if the use of a picture archiving and communications system (PACS) in ultrasonography increased the number of images acquired per examination. The hypothesis that such an increase does occur was based on anecdotal information; this study sought to test the hypothesis. A random sample of all ultrasound examination types was drawn from the period 1998 through 1999. The ultrasound PACS in use (ACCESS; Kodak Health Information Systems, Dallas, TX) records the number of grayscale and color images saved as part of each study. Each examination in the sample was checked in the ultrasound PACS database,.and the number of grayscale and color images was recorded. The comparison film-based sample was drawn from the period 1994 through 1995. The number of examinations of each type selected was based on the overall statistics of the section; that is, the sample was designed to represent the approximate frequency with which the various examination types are done. For film-based image counts, the jackets were retrieved, and the number of grayscale and color images were counted. The number of images obtained per examination (for most examinations) in ultrasound increased with PACS use. This was more evident with some examination types (eg, pelvis). This result, however, has to be examined for possible systematic biases because ultrasound practice has changed over the time since the authors stopped using film routinely. The use of PACS in ultrasonography was not associated with an increase in the number of images per examination based solely on the use of PACS, with the exception of neonatal head studies. Increases in the number of images per study was otherwise associated with examinations for which changes in protocols resulted in the increased image counts.

Content-based image retrieval in medical applications for picture archiving and communication systems

NASA Astrophysics Data System (ADS)

Lehmann, Thomas M.; Guld, Mark O.; Thies, Christian; Fischer, Benedikt; Keysers, Daniel; Kohnen, Michael; Schubert, Henning; Wein, Berthold B.

2003-05-01

Picture archiving and communication systems (PACS) aim to efficiently provide the radiologists with all images in a suitable quality for diagnosis. Modern standards for digital imaging and communication in medicine (DICOM) comprise alphanumerical descriptions of study, patient, and technical parameters. Currently, this is the only information used to select relevant images within PACS. Since textual descriptions insufficiently describe the great variety of details in medical images, content-based image retrieval (CBIR) is expected to have a strong impact when integrated into PACS. However, existing CBIR approaches usually are limited to a distinct modality, organ, or diagnostic study. In this state-of-the-art report, we present first results implementing a general approach to content-based image retrieval in medical applications (IRMA) and discuss its integration into PACS environments. Usually, a PACS consists of a DICOM image server and several DICOM-compliant workstations, which are used by radiologists for reading the images and reporting the findings. Basic IRMA components are the relational database, the scheduler, and the web server, which all may be installed on the DICOM image server, and the IRMA daemons running on distributed machines, e.g., the radiologists" workstations. These workstations can also host the web-based front-ends of IRMA applications. Integrating CBIR and PACS, a special focus is put on (a) location and access transparency for data, methods, and experiments, (b) replication transparency for methods in development, (c) concurrency transparency for job processing and feature extraction, (d) system transparency at method implementation time, and (e) job distribution transparency when issuing a query. Transparent integration will have a certain impact on diagnostic quality supporting both evidence-based medicine and case-based reasoning.

Remote consultation and diagnosis in medical imaging using a global PACS backbone network

NASA Astrophysics Data System (ADS)

Martinez, Ralph; Sutaria, Bijal N.; Kim, Jinman; Nam, Jiseung

1993-10-01

A Global PACS is a national network which interconnects several PACS networks at medical and hospital complexes using a national backbone network. A Global PACS environment enables new and beneficial operations between radiologists and physicians, when they are located in different geographical locations. One operation allows the radiologist to view the same image folder at both Local and Remote sites so that a diagnosis can be performed. The paper describes the user interface, database management, and network communication software which has been developed in the Computer Engineering Research Laboratory and Radiology Research Laboratory. Specifically, a design for a file management system in a distributed environment is presented. In the remote consultation and diagnosis operation, a set of images is requested from the database archive system and sent to the Local and Remote workstation sites on the Global PACS network. Viewing the same images, the radiologists use pointing overlay commands, or frames to point out features on the images. Each workstation transfers these frames, to the other workstation, so that an interactive session for diagnosis takes place. In this phase, we use fixed frames and variable size frames, used to outline an object. The data pockets for these frames traverses the national backbone in real-time. We accomplish this feature by using TCP/IP protocol sockets for communications. The remote consultation and diagnosis operation has been tested in real-time between the University Medical Center and the Bowman Gray School of Medicine at Wake Forest University, over the Internet. In this paper, we show the feasibility of the operation in a Global PACS environment. Future improvements to the system will include real-time voice and interactive compressed video scenarios.

MediLink: a wearable telemedicine system for emergency and mobile applications.

PubMed

Koval, T; Dudziak, M

1999-01-01

The practical needs of the medical professional faced with critical care or emergency situations differ from those working in many environments where telemedicine and mobile computing have been introduced and tested. One constructive criticism of the telemedicine initiative has been to question what positive benefits are gained from videoconferencing, paperless transactions, and online access to patient record. With a goal of producing a positive answer to such questions an architecture for multipurpose mobile telemedicine applications has been developed. The core technology is based upon a wearable personal computer with a smart-card interface coupled with speech, pen, video input and wireless intranet connectivity. The TransPAC system with the MedLink software system is designed to provide an integrated solution for a broad range of health care functions where mobile and hands-free or limited-access systems are preferred or necessary and where the capabilities of other mobile devices are insufficient or inappropriate. Structured and noise-resistant speech-to-text interfacing plus the use of a web browser-like display, accessible through either a flatpanel, standard, or headset monitor, gives the beltpack TransPAC computer the functions of a complete desktop including PCMCIA card interfaces for internet connectivity and a secure smartcard with 16-bit microprocessor and upwards of 64K memory. The card acts to provide user access control for security, user custom configuration of applications and display and vocabulary, and memory to diminish the need for PC-server communications while in an active session. TransPAC is being implemented for EMT and ER staff usage.

76 FR 336 - Intent To Prepare a Supplemental Environmental Impact Statement (SEIS) for PacRim Coal's Proposed...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-04

... Environmental Impact Statement (SEIS) for PacRim Coal's Proposed Chuitna Coal Project AGENCY: U.S. Army Corps of... Chuitna Coal Project. It is anticipated that the Environmental Protection Agency (EPA), the Native Village... the Alaska Surface Coal Mining Control and Reclamation Act (ASCMCRA) permit, which governs all aspects...

Performance evaluation of powdered activated carbon for removing 28 types of antibiotics from water.

PubMed

Zhang, Xinbo; Guo, Wenshan; Ngo, Huu Hao; Wen, Haitao; Li, Nan; Wu, Wei

2016-05-01

Currently, the occurrence and fate of antibiotics in the aquatic environment has become a very serious problem in that they can potentially and irreversibly damage the ecosystem and human health. For this reason, interest has increased in developing strategies to remove antibiotics from water. This study evaluated the performance of powdered activated carbon (PAC) in removing from water 6 representative groups of 28 antibiotics, namely Tetracyclines (TCs), Macrolides (MCs), Chloramphenicols (CPs), Penicillins (PNs), Sulfonamides (SAs) and Quinolones (QNs). Results indicate that PAC demonstrated superior adsorption capacity for all selected antibiotics. The removal efficiency was up to 99.9% in deionized water and 99.6% in surface water at the optimum conditions with PAC dosage of 20 mg/L and contact time of 120 min. According to the Freundlich model's adsorption isotherm, the values of n varied among these antibiotics and most were less than 1, suggesting that the adsorption of antibiotics onto PAC was nonlinear. Adsorption of antibiotics followed well the pseudo-second-order kinetic model (R(2) = 0.99). Analysis using the Weber-Morris model revealed that the intra-particle diffusion was not the only rate-controlling step. Overall, the findings in this study confirm that PAC is a feasible and viable option for removing antibiotics from water in terms of water quality improvement and urgent antibiotics pollution control. Further research is essential on the following subjects: (i) removing more types of antibiotics by PAC; (ii) the adsorption process; and (iii) the mechanism of the competitive adsorption existing between natural organic matters (NOMs) and antibiotics. Copyright © 2016 Elsevier Ltd. All rights reserved.

Toshiba General Hospital PACS for routine in- and outpatient clinics

NASA Astrophysics Data System (ADS)

Toshimitsu, Akihiro; Okazaki, Nobuo; Kura, Hiroyuki; Nishihara, Eitaro; Tsubura, Shinichi

1996-05-01

The Toshiba General Hospital introduced a departmental RIS/PACS (Radiology Information System/Picture Archiving and Communication System) in the radiology department in May, 1993. It has been used routinely since that time. In order to provide efficient means for clinicians to find and read many images, the system has been expanded to the neurosurgery and urology clinics and wards since May, 1995, and five image referring workstations now provide digital images to clinicians. In this paper we discuss an algorithm for image migration, one of the key issues to accomplish the expansion to outpatient clinics successfully, and propose the WYWIWYG (what you want is what you get) image transfer logic. This is the logic used to transfer images that physicians require refer without increasing the traffic between the image server and referring workstations. We accomplish the WYWIWYG logic by prioritizing exams the physicians have not yet viewed and by finding historical exams according to the modality, anatomy, and marking. Clinicians gave us comments from their first use of the system and suggested that the PACS enables clinicians to review images more efficiently compared to a film-based system. Our experience suggests that it is a key to the effective application of PACS in outpatient clinics to incorporate consideration patterns of clinicians on the migration algorithm.

Planning and cost analysis of digital radiography services for a network of hospitals (the Veterans Integrated Service Network).

PubMed

Duerinckx, A J; Kenagy, J J; Grant, E G

1998-01-01

This study analysed the design and cost of a picture archiving and communications system (PACS), computerized radiography (CR) and a wide-area network for teleradiology. The Desert Pacific Healthcare Network comprises 10 facilities, including four tertiary medical centres and one small hospital. Data were collected on radiologists' workloads, and patient and image flow within and between these medical centres. These were used to estimate the size and cash flows associated with a system-wide implementation of PACS, CR and teleradiology services. A cost analysis model was used to estimate the potential cost savings in a filmless radiology environment. ATM technology was selected as the communications medium between the medical centres. A strategic plan and business plan were successfully developed. The cost model predicted the cost-effectiveness of the proposed PACS/CR configuration within four to six years, if the base costs were kept low. The experience gained in design and cost analysis of a PACS/teleradiology network will serve as a model for similar projects.

Impact of PAC Fines in Fouling of Polymeric and Ceramic Low-Pressure Membranes for Drinking Water Treatment

PubMed Central

Oligny, Laurent; Bérubé, Pierre R.; Barbeau, Benoit

2016-01-01

This study assessed the issue of membrane fouling in a Hybrid Membrane Process (HMP) due to the export of powdered activated carbon (PAC) fines from a pretreatment contactor. Two parallel pilot-scale ceramic and polymeric membranes were studied. Reversible and irreversible foulings were measured following three cleaning procedures: Physical backwashing (BW), chemically enhanced backwashing (CEB) and Clean-in-Place (CIP). The impacts on fouling of membrane type, operation flux increase and the presence/absence of the PAC pretreatment were investigated. Membranes without pretreatment were operated in parallel as a control. In addition, CIP washwaters samples were analyzed to measure organic and inorganic foulants removed from the membranes. It was observed that for the polymeric membranes, fouling generally increased with the presence of the PAC pretreatment because of the export of fines. On the contrary, the ceramic membranes were not significantly impacted by their presence. The analysis of CIP washwaters showed a greater total organic carbon (TOC) content on membranes with a PAC pretreatment while no similar conclusion could be made for inorganic foulants. PMID:27399788

Impact of PAC Fines in Fouling of Polymeric and Ceramic Low-Pressure Membranes for Drinking Water Treatment.

PubMed

Oligny, Laurent; Bérubé, Pierre R; Barbeau, Benoit

2016-07-07

This study assessed the issue of membrane fouling in a Hybrid Membrane Process (HMP) due to the export of powdered activated carbon (PAC) fines from a pretreatment contactor. Two parallel pilot-scale ceramic and polymeric membranes were studied. Reversible and irreversible foulings were measured following three cleaning procedures: Physical backwashing (BW), chemically enhanced backwashing (CEB) and Clean-in-Place (CIP). The impacts on fouling of membrane type, operation flux increase and the presence/absence of the PAC pretreatment were investigated. Membranes without pretreatment were operated in parallel as a control. In addition, CIP washwaters samples were analyzed to measure organic and inorganic foulants removed from the membranes. It was observed that for the polymeric membranes, fouling generally increased with the presence of the PAC pretreatment because of the export of fines. On the contrary, the ceramic membranes were not significantly impacted by their presence. The analysis of CIP washwaters showed a greater total organic carbon (TOC) content on membranes with a PAC pretreatment while no similar conclusion could be made for inorganic foulants.

The cost of post-abortion care in developing countries: a comparative analysis of four studies

PubMed Central

Vlassoff, Michael; Singh, Susheela; Onda, Tsuyoshi

2016-01-01

Over the last five years, comprehensive national surveys of the cost of post-abortion care (PAC) to national health systems have been undertaken in Ethiopia, Uganda, Rwanda and Colombia using a specially developed costing methodology—the Post-abortion Care Costing Methodology (PACCM). The objective of this study is to expand the research findings of these four studies, making use of their extensive datasets. These studies offer the most complete and consistent estimates of the cost of PAC to date, and comparing their findings not only provides generalizable implications for health policies and programs, but also allows an assessment of the PACCM methodology. We find that the labor cost component varies widely: in Ethiopia and Colombia doctors spend about 30–60% more time with PAC patients than do nurses; in Uganda and Rwanda an opposite pattern is found. Labor costs range from I$42.80 in Uganda to I$301.30 in Colombia. The cost of drugs and supplies does not vary greatly, ranging from I$79 in Colombia to I$115 in Rwanda. Capital and overhead costs are substantial amounting to 52–68% of total PAC costs. Total costs per PAC case vary from I$334 in Rwanda to I$972 in Colombia. The financial burden of PAC is considerable: the expense of treating each PAC case is equivalent to around 35% of annual per capita income in Uganda, 29% in Rwanda and 11% in Colombia. Providing modern methods of contraception to women with an unmet need would cost just a fraction of the average expenditure on PAC: one year of modern contraceptive services and supplies cost only 3–12% of the average cost of treating a PAC patient. PMID:27045001

Association of iris crypts with acute primary angle closure.

PubMed

Koh, Victor; Chua, Jacqueline; Shi, Yuan; Thakku, Sri Gowtham; Lee, Ryan; Nongpiur, Monisha E; Baskaran, Mani; Kumar, Rajesh S; Perera, Shamira; Aung, Tin; Cheng, Ching-Yu

2017-10-01

To determine the relationship between iris surface features and acute primary angle closure (APAC) in eyes with angle closure. Case-control study involving Asian patients diagnosed with previous APAC, primary angle closure suspect (PACS), primary angle closure (PAC) and primary angle closure glaucoma (PACG) at an eye centre in Singapore between August 2012 and January 2015. Participants underwent ophthalmic examination and digital slit-lamp iris photography. Iris surface features were graded based on crypts, furrows and colour. Fellow eyes of APAC were compared with PACS and PAC/PACG eyes with regard to their iris surface features. Occurrence of APAC. A total of 309 patients (71 APAC, 139 PACS, 47 PAC and 52 PACG) were included (mean age: 67.7±7.2 years and 36.6% male). Compared with PACS, higher crypt grade was significantly associated with lower odds of APAC (OR=0.58 for one grade higher in crypt grade; p=0.027, adjusted for age, gender, ethnicity and pupil diameter). The results remained similar when compared with PAC/PACG group (OR=0.58 for one grade higher in crypt grade; p=0.043). We did not observe any significant associations between iris furrows or colour with presence of APAC. Our study comprising Asian eyes with angle closure suggests that the presence of a higher crypt grading may be protective for APAC. As such, assessing iris surface architecture for crypts could be a new measure for risk stratification of developing APAC in eyes with angle closure. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Differential pharmacodynamic effects of paclitaxel formulations in an intracranial rat brain tumor model.

PubMed

Zhou, Rong; Mazurchuk, Richard V; Tamburlin, Judith H; Harrold, John M; Mager, Donald E; Straubinger, Robert M

2010-02-01

Nano- and microparticulate carriers can exert a beneficial impact on the pharmacodynamics of anticancer agents. To investigate the relationships between carrier and antitumor pharmacodynamics, paclitaxel incorporated in liposomes (L-pac) was compared with the clinical standard formulated in Cremophor-EL/ethanol (Cre-pac) in a rat model of advanced primary brain cancer. Three maximum-tolerated-dose regimens given by intravenous administration were investigated: 50 mg/kg on day 8 (d8) after implantation of 9L gliosarcoma tumors; 40 mg/kg on d8 and d15; 20 mg/kg on d8, d11, and d15. Body weight change and neutropenia were assessed as pharmacodynamic markers of toxicity. The pharmacodynamic markers of antitumor efficacy were increase in lifespan (ILS) and tumor volume progression, measured noninvasively by magnetic resonance imaging. At equivalent doses, neutropenia was similar for both formulations, but weight loss was more severe for Cre-pac. No regimen of Cre-pac extended survival, whereas L-pac at 40 mg/kg x2 doses was well tolerated and mediated 26% ILS (p < 0.0002) compared with controls. L-pac at a lower cumulative dose (20 mg/kg x3) was even more effective (40% ILS; p < 0.0001). In striking contrast, the identical regimen of Cre-pac was lethal. Development of a novel semimechanistic pharmacodynamic model permitted quantitative hypothesis testing with the tumor volume progression data, and suggested the existence of a transient treatment effect that was consistent with sensitization or "priming" of tumors by more frequent L-pac dosing schedules. Therefore, improved antitumor responses of carrier-based paclitaxel formulations can arise both from dose escalation, because of reduced toxicity, and from novel carrier-mediated alterations of antitumor pharmacodynamic effects.

Characterizing differences in the phosphorus activation coefficient of three typical cropland soils and the influencing factors under long-term fertilization.

PubMed

Wu, Qihua; Zhang, Shuxiang; Zhu, Ping; Huang, Shaomin; Wang, Boren; Zhao, LinPing; Xu, Minggang

2017-01-01

The phosphorus activation coefficient (PAC, the ratio of available P to total P) is an important indicator of soil P availability and the transformation of P fractions. Understanding the details of the PAC is useful to estimate soil available P status and to provide P management guidance. In this research, soils from five long-term (23 years) fertilization treatments in three croplands were selected to examine the relationships between the PAC and P fractions and to analyse the influencing factors. PAC was affected by both soil types and fertilization treatments. Compared to the unfertilized control (CK) treatment, long-term P application significantly increased the PAC, all of the inorganic P (Pi) fractions and most of the organic P (Po) fractions in all the three soils, particularly in chemical fertilizer combined with manure treatment (NPKM). The PAC was significantly correlated to all of the Pi fractions proportions (P<0.05) except for Dil. HCl-Pi and Conc. HCl-Pi. Compared with CK, the chemical P and chemical P combined with manure treatments increased the ratio of total Pi fractions to total Po fractions (Pit/Pot); furthermore, NPKM significantly increased the organic C (Co) content and decreased the Co/Pot ratio. Stepwise multiple regressions showed that PAC = 0.93 Co+0.69 Pit/Pot-0.07 Co/Pot-0.27CaCO3-3.79 (R2 = 0.924, P<0.001). In addition, the variance partitioning analysis showed that more variance of PAC is explained by soil factors (29.53%) than by P input (0.19%) and climate (0.25%) factors. Our findings demonstrate that P application increased the PAC by changing the Co content and the proportion of P fractions. Moreover, soil factors were the most important drivers of P transformations, and NPKM was optimal for improving soil fertility in Chinese croplands.

Characterizing differences in the phosphorus activation coefficient of three typical cropland soils and the influencing factors under long-term fertilization

PubMed Central

Wu, Qihua; Zhang, Shuxiang; Zhu, Ping; Huang, Shaomin; Wang, Boren; Zhao, LinPing; Xu, Minggang

2017-01-01

The phosphorus activation coefficient (PAC, the ratio of available P to total P) is an important indicator of soil P availability and the transformation of P fractions. Understanding the details of the PAC is useful to estimate soil available P status and to provide P management guidance. In this research, soils from five long-term (23 years) fertilization treatments in three croplands were selected to examine the relationships between the PAC and P fractions and to analyse the influencing factors. PAC was affected by both soil types and fertilization treatments. Compared to the unfertilized control (CK) treatment, long-term P application significantly increased the PAC, all of the inorganic P (Pi) fractions and most of the organic P (Po) fractions in all the three soils, particularly in chemical fertilizer combined with manure treatment (NPKM). The PAC was significantly correlated to all of the Pi fractions proportions (P<0.05) except for Dil. HCl-Pi and Conc. HCl-Pi. Compared with CK, the chemical P and chemical P combined with manure treatments increased the ratio of total Pi fractions to total Po fractions (Pit/Pot); furthermore, NPKM significantly increased the organic C (Co) content and decreased the Co/Pot ratio. Stepwise multiple regressions showed that PAC = 0.93 Co+0.69 Pit/Pot-0.07 Co/Pot-0.27CaCO3-3.79 (R2 = 0.924, P<0.001). In addition, the variance partitioning analysis showed that more variance of PAC is explained by soil factors (29.53%) than by P input (0.19%) and climate (0.25%) factors. Our findings demonstrate that P application increased the PAC by changing the Co content and the proportion of P fractions. Moreover, soil factors were the most important drivers of P transformations, and NPKM was optimal for improving soil fertility in Chinese croplands. PMID:28467425

Contribution retribution. Health system, CEO must pay excise taxes after pressuring workers to help fund state association's PAC through payroll deductions.

PubMed

Taylor, Mark

2004-11-22

The IRS wants not-for-profit health systems to remember to keep their distance from politics--it's taxing the payroll contributions at one system that went to a state hospital association's PAC. Kenneth Robbins, left, says hospitals should always be conscious of activities that could jeopardize their tax-exempt status. "It's an issue we've been concerned with as long as I can remember," he says.

Integration, acceptance testing, and clinical operation of the Medical Information, Communication and Archive System, phase II.

PubMed

Smith, E M; Wandtke, J; Robinson, A

1999-05-01

The Medical Information, Communication and Archive System (MICAS) is a multivendor incremental approach to picture archiving and communications system (PACS). It is a multimodality integrated image management system that is seamlessly integrated with the radiology information system (RIS). Phase II enhancements of MICAS include a permanent archive, automated workflow, study caches, Microsoft (Redmond, WA) Windows NT diagnostic workstations with all components adhering to Digital Information Communications in Medicine (DICOM) standards. MICAS is designed as an enterprise-wide PACS to provide images and reports throughout the Strong Health healthcare network. Phase II includes the addition of a Cemax-Icon (Fremont, CA) archive, PACS broker (Mitra, Waterloo, Canada), an interface (IDX PACSlink, Burlington, VT) to the RIS (IDXrad) plus the conversion of the UNIX-based redundant array of inexpensive disks (RAID) 5 temporary archives in phase I to NT-based RAID 0 DICOM modality-specific study caches (ImageLabs, Bedford, MA). The phase I acquisition engines and workflow management software was uninstalled and the Cemax archive manager (AM) assumed these functions. The existing ImageLabs UNIX-based viewing software was enhanced and converted to an NT-based DICOM viewer. Installation of phase II hardware and software and integration with existing components began in July 1998. Phase II of MICAS demonstrates that a multivendor open-system incremental approach to PACS is feasible, cost-effective, and has significant advantages over a single-vendor implementation.

Reduction of Enteric Viruses by Blueberry Juice and Blueberry Proanthocyanidins.

PubMed

Joshi, Snehal S; Howell, Amy B; D'Souza, Doris H

2016-12-01

Blueberry and blueberry extracts are known for their health benefits and antimicrobial properties. Natural therapeutic or preventive options to decrease the incidences of foodborne viral illnesses are becoming popular and being researched. This study aimed to determine the antiviral effects of blueberry juice (BJ) and blueberry proanthocyanidins (BB-PAC, B-type PAC structurally different from A-type PAC found in cranberries) against the infectivity of hepatitis A virus (HAV) and human norovirus surrogates (feline calicivirus (FCV-F9) and murine norovirus (MNV-1)) at 37 °C over 24 h using standard plaque assays. Viruses at ~5 log PFU/ml were mixed with equal volumes of BJ (pH 2.8), neutralized BJ (pH 7.0), BB-PAC (1, 2, 4, and 10 mg/ml), malic acid (pH 3.0), or phosphate-buffered saline (pH 7.2) and incubated over 24 h at 37 °C. Each experiment was carried out in duplicate and replicated thrice. FCV-F9 titers were found to be reduced to undetectable levels with 1 and 2 mg/ml BB-PAC after 5 min, with 0.5 mg/ml BB-PAC after 1-h, and with BJ after 3-h. MNV-1 titers were reduced to undetectable levels after 3 h with 1, 2, and 5 mg/ml BB-PAC and after 6 h with BJ. HAV titers were reduced to undetectable levels after 30 min with 2 and 5 mg/ml BB-PAC, after 3 h with 1 mg/ml BB-PAC, and by ~2 log PFU/ml with BJ after 24-h. BB-PAC shows preventive potential against infection by the tested enteric viruses in a dose- and time-dependent manner, although further in vitro studies in model food systems and in vivo studies using animal models are warranted.

Local area networks in an imaging environment.

PubMed

Noz, M E; Maguire, G Q; Erdman, W A

1986-01-01

There is great interest at present in incorporating image-management systems popularly referred to as picture archiving and communication systems (PACS) into imaging departments. This paper will describe various aspects of local area networks (LANs) for medical images and will give a definition of terms and classification of devices by describing a possible system which links various digital image sources through a high-speed data link and a common image format, allows for viewing and processing of all images produced within the complex, and eliminates the transport of films. The status of standards governing LAN and particularly PACS systems along with a proposed image exchange format will be given. Prototype systems, particularly a system for nuclear medicine images, will be presented, as well as the prospects for the immediate future in terms of installations started and commercial products available. A survey of the many questions that arise in the development of a PACS for medical images and also a survey of the presently suggested/adopted answers will be given.

Planning factors for developing an enterprise-wide picture archiving and communication system maintenance program.

PubMed

Staley, S; Romlein, J; Chacko, A K; Wider, R

2000-05-01

Picture archiving and communication system (PACS) maintenance on an individual site basis has historically been a complex and costly challenge. With the advent of enterprise-wide PACS projects such as the Virtual Radiology Environment (VRE) project, the challenge of a maintenance program with even more complexities has presented itself. The approach of the project management team for the VRE project is not one of reactive maintenance, but one of highly proactive planning and negotiations, in hopes of capitalizing on the economies of scale of an enterprise-wide PACS maintenance program. A proactive maintenance program is one aspect of life-cycle management. As with any capital acquisition, life-cycle management may be used to manage the specific project aspects related to PACS. The purpose of an enterprise-wide warranty and maintenance life-cycle management approach is to maintain PACS at its maximum operational efficiency and utilization levels through a flexible, shared, yet symbiotic relationship between local, regional, and vendor resources. These goals include providing maximum operational performance levels on a local, regional, and enterprise basis, while maintaining acceptable costs and resource utilization levels. This goal must be achieved without negatively impacting point of care activities, regardless of changes to the clinical business environment.

Image management within a PACS

NASA Astrophysics Data System (ADS)

Glicksman, Robert A.; Prior, Fred W.; Wilson, Dennis L.

1993-09-01

The full benefits of a PACS system cannot be achieved by a departmental system, as films must still be made to service referring physicians and clinics. Therefore, a full hospital PACS must provide workstations throughout the hospital which are connected to the central file server and database, but which present `clinical' views of radiological data. In contrast to the radiologist, the clinician needs to select examinations from a `patient list' which presents the results of his/her radiology referrals. The most important data for the clinician is the radiology report, which must be immediately available upon selection of the examination. The images themselves, perhaps with annotations provided by the reading radiologist, must also be available in a few seconds from selection. Furthermore, the ability to display radiologist selected relevant historical images along with the new examination is necessary in those instances where the radiologist felt that certain historical images were important in the interpretation and diagnosis of the patient. Therefore, views of the new and historical data along clinical lines, conference preparation features, and modality and body part specific selections are also required to successfully implement a full hospital PACS. This paper describes the concepts for image selection and presentation at PACS workstations, both `diagnostic' workstations within the radiology department and `clinical' workstations which support the rest of the hospital and outpatient clinics.

Cost-effectiveness prospects of picture archiving and communication systems.

PubMed

Hindel, R; Preger, W

1988-01-01

PAC (picture archiving and communication) systems are widely discussed and promoted as the organizational solution to digital image management in a radiology department. For approximately two decades digital imaging has increasingly been used for such diagnostic modalities as CT, DSA, MRI, DR (Digital Radiography) and others. PACS are seen as a step toward high technology integration and more efficient management. Although the acquisition of such technology is investment intensive, there are well-founded projections that prolonged operation will prove cost justified. Such justification can only partly be derived from cost reduction through PAC with respect to present department management--the major justification is preparation for future economic pressures which could make survival of a department without modern technology difficult. Especially in the United States the political climate favors 'competitive medicine' and reduced government support. Seen in this context PACS promises to speed the transition of Health Care Services into a business with tight resource management, cost accounting and marketing. The following paper analyzes cost and revenue in a typical larger Radiology Department, projects various scenarios of cost reduction by means of digital technology and concludes with cautious optimism that the investment expenses for a PACS will be justified in the near future by prudent utilization of high technology.

Passive Immunization with Milk Produced from an Immunized Cow Prevents Oral Recolonization by Streptococcus mutans

PubMed Central

Shimazaki, Yoshihiro; Mitoma, Morihide; Oho, Takahiko; Nakano, Yoshio; Yamashita, Yoshihisa; Okano, Kaoru; Nakano, Yutaka; Fukuyama, Masataka; Fujihara, Noboru; Nada, Youichi; Koga, Toshihiko

2001-01-01

Cell surface protein antigen (PAc) and water-insoluble glucan-synthesizing enzyme (GTF-I) produced by cariogenic Streptococcus mutans are two major factors implicated in the colonization of the human oral cavity by this bacterium. We examined the effect of bovine milk, produced after immunization with a fusion protein of functional domains of these proteins, on the recolonization of S. mutans. To prepare immune milk, a pregnant Holstein cow was immunized with the fusion protein PAcA-GB, a fusion of the saliva-binding alanine-rich region (PAcA) of PAc and the glucan-binding (GB) domain of GTF-I. After eight adult subjects received cetylpyridinium chloride (CPC) treatment, one subgroup (n = 4) rinsed their mouths with immune milk and a control group (n = 4) rinsed with nonimmune milk. S. mutans levels in saliva and dental plaque decreased after CPC treatment in both groups. Mouth rinsing with immune milk significantly inhibited recolonization of S. mutans in saliva and plaque. On the other hand, the numbers of S. mutans cells in saliva and plaque in the control group increased immediately after the CPC treatment and surpassed the baseline level 42 and 28 days, respectively, after the CPC treatment. The ratios of S. mutans to total streptococci in saliva and plaque in the group that received immune milk were lower than those in the control group. These results suggest that milk produced from immunized cow may be useful for controlling S. mutans in the human oral cavity. PMID:11687453

Peer consultation on relationship between PAC profile and toxicity of petroleum substances.

PubMed

Patterson, Jacqueline; Maier, Andrew; Kohrman-Vincent, Melissa; Dourson, Michael L

2013-11-01

An expert peer consultation panel reviewed a report by the PAC Analysis Task Group, which hypothesized that systemic, developmental, and reproductive toxicity observed in repeated-dose dermal toxicity studies was related to polycyclic aromatic compound (PAC) content. Peer consultations seek to solicit scientific and technical input from experts on the scientific basis and merits of the subject report. This peer consultation panel included nine scientists with expertise in petroleum chemistry, biostatistics, toxicology, risk assessment, structure activity, and reproductive and developmental toxicology. The panel evaluated the technical quality of the PAC report and provided recommendations for improving the statistical and biological approaches. The PAC report authors revised their methods and documentation, which are published elsewhere in this supplement. A review of the post peer consultation manuscripts confirmed that many of the key suggestions from expert panel members were considered and incorporated. In cases where the PAC report authors did not fully incorporate panel suggestions from the peer consultation, they have provided an explanation and support for their decision. This peer consultation demonstrates the value of formal engagement of peers in development of new scientific methods and approaches. Copyright © 2012 Elsevier Inc. All rights reserved.

PACS photometer calibration block analysis

NASA Astrophysics Data System (ADS)

Moór, A.; Müller, T. G.; Kiss, C.; Balog, Z.; Billot, N.; Marton, G.

2014-07-01

The absolute stability of the PACS bolometer response over the entire mission lifetime without applying any corrections is about 0.5 % (standard deviation) or about 8 % peak-to-peak. This fantastic stability allows us to calibrate all scientific measurements by a fixed and time-independent response file, without using any information from the PACS internal calibration sources. However, the analysis of calibration block observations revealed clear correlations of the internal source signals with the evaporator temperature and a signal drift during the first half hour after the cooler recycling. These effects are small, but can be seen in repeated measurements of standard stars. From our analysis we established corrections for both effects which push the stability of the PACS bolometer response to about 0.2 % (stdev) or 2 % in the blue, 3 % in the green and 5 % in the red channel (peak-to-peak). After both corrections we still see a correlation of the signals with PACS FPU temperatures, possibly caused by parasitic heat influences via the Kevlar wires which connect the bolometers with the PACS Focal Plane Unit. No aging effect or degradation of the photometric system during the mission lifetime has been found.

A Benchmark Study on Error Assessment and Quality Control of CCS Reads Derived from the PacBio RS

PubMed Central

Jiao, Xiaoli; Zheng, Xin; Ma, Liang; Kutty, Geetha; Gogineni, Emile; Sun, Qiang; Sherman, Brad T.; Hu, Xiaojun; Jones, Kristine; Raley, Castle; Tran, Bao; Munroe, David J.; Stephens, Robert; Liang, Dun; Imamichi, Tomozumi; Kovacs, Joseph A.; Lempicki, Richard A.; Huang, Da Wei

2013-01-01

PacBio RS, a newly emerging third-generation DNA sequencing platform, is based on a real-time, single-molecule, nano-nitch sequencing technology that can generate very long reads (up to 20-kb) in contrast to the shorter reads produced by the first and second generation sequencing technologies. As a new platform, it is important to assess the sequencing error rate, as well as the quality control (QC) parameters associated with the PacBio sequence data. In this study, a mixture of 10 prior known, closely related DNA amplicons were sequenced using the PacBio RS sequencing platform. After aligning Circular Consensus Sequence (CCS) reads derived from the above sequencing experiment to the known reference sequences, we found that the median error rate was 2.5% without read QC, and improved to 1.3% with an SVM based multi-parameter QC method. In addition, a De Novo assembly was used as a downstream application to evaluate the effects of different QC approaches. This benchmark study indicates that even though CCS reads are post error-corrected it is still necessary to perform appropriate QC on CCS reads in order to produce successful downstream bioinformatics analytical results. PMID:24179701

A Benchmark Study on Error Assessment and Quality Control of CCS Reads Derived from the PacBio RS.

PubMed

Jiao, Xiaoli; Zheng, Xin; Ma, Liang; Kutty, Geetha; Gogineni, Emile; Sun, Qiang; Sherman, Brad T; Hu, Xiaojun; Jones, Kristine; Raley, Castle; Tran, Bao; Munroe, David J; Stephens, Robert; Liang, Dun; Imamichi, Tomozumi; Kovacs, Joseph A; Lempicki, Richard A; Huang, Da Wei

2013-07-31

PacBio RS, a newly emerging third-generation DNA sequencing platform, is based on a real-time, single-molecule, nano-nitch sequencing technology that can generate very long reads (up to 20-kb) in contrast to the shorter reads produced by the first and second generation sequencing technologies. As a new platform, it is important to assess the sequencing error rate, as well as the quality control (QC) parameters associated with the PacBio sequence data. In this study, a mixture of 10 prior known, closely related DNA amplicons were sequenced using the PacBio RS sequencing platform. After aligning Circular Consensus Sequence (CCS) reads derived from the above sequencing experiment to the known reference sequences, we found that the median error rate was 2.5% without read QC, and improved to 1.3% with an SVM based multi-parameter QC method. In addition, a De Novo assembly was used as a downstream application to evaluate the effects of different QC approaches. This benchmark study indicates that even though CCS reads are post error-corrected it is still necessary to perform appropriate QC on CCS reads in order to produce successful downstream bioinformatics analytical results.

Evaluation on simultaneous removal of particles and off-flavors using population balance for application of powdered activated carbon in dissolved air flotation process.

PubMed

Kwak, D H; Yoo, S J; Lee, E J; Lee, J W

2010-01-01

Most of the water treatment plants applying the DAF process are faced with off-flavors control problems. For simultaneous control of particles of impurities and dissolved organics that cause pungent taste and odor in water, an effective method would be the simple application of powdered activated carbon (PAC) in the DAF process. A series of experiments were carried out to explore the feasibility for simultaneous removal of kaolin particles and organic compounds that produce off-flavors (2-MIB and geosmin). In addition, the flotation efficiency of kaolin and PAC particles adsorbing organics in the DAF process was evaluated by employing the population balance theory. The removal efficiency of 2-MIB and geosmin under the treatment condition with kaolin particles for simultaneous treatment was lower than that of the individual treatment. The decrease in the removal efficiency was probably caused by 2-MIB and geosmin remaining in the PAC particle in the treated water of DAF after bubble flotation. Simulation results obtained by the population balance model indicate, that the initial collision-attachment efficiency of PAC particles was lower than that of kaolin particles.

Control and communication co-design: analysis and practice on performance improvement in distributed measurement and control system based on fieldbus and Ethernet.

PubMed

Liang, Geng

2015-01-01

In this paper, improving control performance of a networked control system by reducing DTD in a different perspective was investigated. Two different network architectures for system implementation were presented. Analysis and improvement dealing with DTD for the experimental control system were expounded. Effects of control scheme configuration on DTD in the form of FB were investigated and corresponding improvements by reallocation of FB and re-arrangement of schedule table are proposed. Issues of DTD in hybrid network were investigated and corresponding approaches to improve performance including (1) reducing DTD in PLC or PAC by way of IEC61499 and (2) cascade Smith predictive control with BPNN-based identification were proposed and investigated. Control effects under the proposed methodologies were also given. Experimental and field practices validated these methodologies. Copyright © 2014 ISA. Published by Elsevier Ltd. All rights reserved.

Effects of anchoring and arc structure on the control authority of a rail plasma actuator

NASA Astrophysics Data System (ADS)

Choi, Young-Joon; Gray, Miles; Sirohi, Jayant; Raja, Laxminarayan L.

2017-09-01

Experiments were conducted on a rail plasma actuator (RailPAc) with different electrode cross sections (rails or rods) to assess methods to improve the actuation authority, defined as the impulse generated for a given electrical input. The arc was characterized with electrical measurements and high-speed images, while impulse measurements quantified the actuation authority. A RailPAc power supply capable of delivering  ∼1 kA of current at  ∼100 V was connected to rod electrodes (free-floating with circular cross-section) and rail electrodes (flush-mounted in a flat plate with rectangular cross-section). High-speed images show that the rail electrodes cause the arc to anchor itself to the anode electrode and transit in discrete jumps, while rod electrodes permit the arc to transit smoothly without anchoring. The impulse measurements reveal that the anchoring reduces the actuation authority by  ∼21% compared to a smooth transit, and the effect of anchoring can be suppressed by reducing the gap between the rails to 2 mm. The study further demonstrates that if a smooth transit is achieved, the control authority can be increased with a larger gap and larger arc current. In conclusion, the actuation authority of a RailPAc can be maximized by carefully choosing a gap width that prevents anchoring. Further study is warranted to increase the RailPAc actuation authority by introducing multiple turns of wires beneath the RailPAc to augment the induced magnetic field.

A Medical Image Backup Architecture Based on a NoSQL Database and Cloud Computing Services.

PubMed

Santos Simões de Almeida, Luan Henrique; Costa Oliveira, Marcelo

2015-01-01

The use of digital systems for storing medical images generates a huge volume of data. Digital images are commonly stored and managed on a Picture Archiving and Communication System (PACS), under the DICOM standard. However, PACS is limited because it is strongly dependent on the server's physical space. Alternatively, Cloud Computing arises as an extensive, low cost, and reconfigurable resource. However, medical images contain patient information that can not be made available in a public cloud. Therefore, a mechanism to anonymize these images is needed. This poster presents a solution for this issue by taking digital images from PACS, converting the information contained in each image file to a NoSQL database, and using cloud computing to store digital images.

Modulating the Release Kinetics of Paclitaxel from Membrane-Covered Stents Using Different Loading Strategies

PubMed Central

Sydow-Plum, Georg; Haidar, Ziyad S.; Merhi, Yahye; Tabrizian, Maryam

2008-01-01

Membrane-covered Express2TM Monorail® stents composed of chitosan (CH) blended with polyethylene oxide (PEO) in 70:30% wt (CH-PEO) were coated with a monolayer of hyaluronic acid (HA). This significantly improved the resistance to platelet adhesion and demonstrated excellent mechanical properties, resisting the harsh conditions during stent crimping and subsequent inflation. CH-PEO/HA membrane was then combined with a paclitaxel (Pac) delivery system via three different approaches for comparison of release profiles of Pac. The activity of Pac in these systems was confirmed since its presence in the membrane significantly decreased cell viability of U937 macrophages. Presented results are promising for applications requiring different release patterns of hydrophobic drugs.

User acceptability--a critical success factor for picture archiving and communication system implementation.

PubMed

Crivianu-Gaita, D; Babyn, P; Gilday, D; O'Brien, B; Charkot, E

2000-05-01

The Department of Diagnostic Imaging at the Hospital for Sick Children (HSC), Toronto, implemented a picture archiving and communication system (PACS) during the last year. This report describes our experience from the point of view of user acceptability. Based on objective data, the following key success factors were identified: user involvement in PACS planning, training, technical support, and rollout of pilot projects. Although technical factors are critical and must be addressed, the main conclusion of our study is that other nontechnical factors need to be recognized and resolved. Recognition of the importance of these factors to user acceptance and clear communication and consultation will help reduce negative user attitudes and increase the chance of a successful PACS implementation.

COMPENDEX/TEXT-PAC: RETROSPECTIVE SEARCH.

ERIC Educational Resources Information Center

Standera, Oldrich

The Text-Pac System is capable of generating indexes and bulletins to provide a current information service without the selectivity feature. Indexes of the accumulated data base may also be used as a basis for manual retrospective searching. The manual search involves searching computer-prepared indexes from a machine readable data base produced…

A demanding web-based PACS supported by web services technology

NASA Astrophysics Data System (ADS)

Costa, Carlos M. A.; Silva, Augusto; Oliveira, José L.; Ribeiro, Vasco G.; Ribeiro, José

2006-03-01

During the last years, the ubiquity of web interfaces have pushed practically all PACS suppliers to develop client applications in which clinical practitioners can receive and analyze medical images, using conventional personal computers and Web browsers. However, due to security and performance issues, the utilization of these software packages has been restricted to Intranets. Paradigmatically, one of the most important advantages of digital image systems is to simplify the widespread sharing and remote access of medical data between healthcare institutions. This paper analyses the traditional PACS drawbacks that contribute to their reduced usage in the Internet and describes a PACS based on Web Services technology that supports a customized DICOM encoding syntax and a specific compression scheme providing all historical patient data in a unique Web interface.

Interoperative fundus image and report sharing in compliance with integrating the healthcare enterprise conformance and web access to digital imaging and communication in medicine persistent object protocol.

PubMed

Wu, Hui-Qun; Lv, Zheng-Min; Geng, Xing-Yun; Jiang, Kui; Tang, Le-Min; Zhou, Guo-Min; Dong, Jian-Cheng

2013-01-01

To address issues in interoperability between different fundus image systems, we proposed a web eye-picture archiving and communication system (PACS) framework in conformance with digital imaging and communication in medicine (DICOM) and health level 7 (HL7) protocol to realize fundus images and reports sharing and communication through internet. Firstly, a telemedicine-based eye care work flow was established based on integrating the healthcare enterprise (IHE) Eye Care technical framework. Then, a browser/server architecture eye-PACS system was established in conformance with the web access to DICOM persistent object (WADO) protocol, which contains three tiers. In any client system installed with web browser, clinicians could log in the eye-PACS to observe fundus images and reports. Multipurpose internet mail extensions (MIME) type of a structured report is saved as pdf/html with reference link to relevant fundus image using the WADO syntax could provide enough information for clinicians. Some functions provided by open-source Oviyam could be used to query, zoom, move, measure, view DICOM fundus images. Such web eye-PACS in compliance to WADO protocol could be used to store and communicate fundus images and reports, therefore is of great significance for teleophthalmology.

Pattern mining of user interaction logs for a post-deployment usability evaluation of a radiology PACS client.

PubMed

Jorritsma, Wiard; Cnossen, Fokie; Dierckx, Rudi A; Oudkerk, Matthijs; van Ooijen, Peter M A

2016-01-01

To perform a post-deployment usability evaluation of a radiology Picture Archiving and Communication System (PACS) client based on pattern mining of user interaction log data, and to assess the usefulness of this approach compared to a field study. All user actions performed on the PACS client were logged for four months. A data mining technique called closed sequential pattern mining was used to automatically extract frequently occurring interaction patterns from the log data. These patterns were used to identify usability issues with the PACS. The results of this evaluation were compared to the results of a field study based usability evaluation of the same PACS client. The interaction patterns revealed four usability issues: (1) the display protocols do not function properly, (2) the line measurement tool stays active until another tool is selected, rather than being deactivated after one use, (3) the PACS's built-in 3D functionality does not allow users to effectively perform certain 3D-related tasks, (4) users underuse the PACS's customization possibilities. All usability issues identified based on the log data were also found in the field study, which identified 48 issues in total. Post-deployment usability evaluation based on pattern mining of user interaction log data provides useful insights into the way users interact with the radiology PACS client. However, it reveals few usability issues compared to a field study and should therefore not be used as the sole method of usability evaluation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Comparison of the Anti-Adhesion Activity of Three Different Cranberry Extracts on Uropathogenic P-fimbriated Escherichia coli: a Randomized, Double-blind, Placebo Controlled, Ex Vivo, Acute Study.

PubMed

Howell, Amy; Souza, Dan; Roller, Marc; Fromentin, Emilie

2015-07-01

Research suggests that cranberry (Vaccinium macrocarpon) helps maintain urinary tract health. Bacterial adhesion to the uroepithelium is the initial step in the progression to development of a urinary tract infection. The bacterial anti-adhesion activity of cranberry proanthocyanidins (PACs) has been demonstrated in vitro. Three different cranberry extracts were developed containing a standardized level of 36 mg of PACs. This randomized, double-blind, placebo controlled, ex vivo, acute study was designed to compare the anti-adhesion activity exhibited by human urine following consumption of three different cranberry extracts on uropathogenic P-fimbriated Escherichia coli in healthy men and women. All three cranberry extracts significantly increased anti-adhesion activity in urine. from 6 to 12 hours after intake of a single dose standardized to deliver 36 mg of PACs (as measured by the BL-DMAC method), versus placebo.

PACS development in Asia.

PubMed

Inamura, Kiyonari; Kousaka, Susumu; Yamamoto, Yuichiro; Sukenobu, Yoshiharu; Okura, Yasuhiko; Matsumura, Yasushi; Takeda, Hiroshi

2003-01-01

First, history of PACS in Japan from 1982 to 2002 has been investigated. By 2002 total of 1468 PACS units have been installed. Of these, 1174 are small-size PACS with less than four image display terminals, 203 are medium-size with 5-14 terminals, and 91 are large-size with 15 up to 1300 terminals. The main nine large-size PACS of 91 have been retrospectively investigated from 1984 for PACS experiments and from 1989 for PACS operation. Most of these nine hospitals have increased the number of PACS terminals by installing additional PACS units, instead of reinforcing the existing single PACS. The use of DICOM interfaces has increased the number of modalities connected to PACS and influenced the spreading of PACS installations in Japan. The status of HIS and RIS coupling to PACS, and the use of PACS in primary diagnosis or in image referral are discussed. Assessment of PACS is now in an early stage. Baseline studies of HIS/RIS/PACS effectiveness have been carried out to assess quantitatively the PACS merit. Second, history of PACS development in Korea is described. Very acute climbing up of filmless PACS diffusion was observed from 2000 to 2002. The reasons seem to be lack of domestic X-ray film industry, economic crisis in 1997 and PACS Reimbursement Act in health insurance in Korea. Third, the Hong Kong Wide Area Image Distribution/PACS Project is reported. It is now under phase 1 of design and partial implementation employing the latest and the highest ends of advanced technology such as failure resilience. Copyright 2002 Elsevier Science Ltd.

A cryptologic based trust center for medical images.

PubMed

Wong, S T

1996-01-01

To investigate practical solutions that can integrate cryptographic techniques and picture archiving and communication systems (PACS) to improve the security of medical images. The PACS at the University of California San Francisco Medical Center consolidate images and associated data from various scanners into a centralized data archive and transmit them to remote display stations for review and consultation purposes. The purpose of this study is to investigate the model of a digital trust center that integrates cryptographic algorithms and protocols seamlessly into such a digital radiology environment to improve the security of medical images. The timing performance of encryption, decryption, and transmission of the cryptographic protocols over 81 volumetric PACS datasets has been measured. Lossless data compression is also applied before the encryption. The transmission performance is measured against three types of networks of different bandwidths: narrow-band Integrated Services Digital Network, Ethernet, and OC-3c Asynchronous Transfer Mode. The proposed digital trust center provides a cryptosystem solution to protect the confidentiality and to determine the authenticity of digital images in hospitals. The results of this study indicate that diagnostic images such as x-rays and magnetic resonance images could be routinely encrypted in PACS. However, applying encryption in teleradiology and PACS is a tradeoff between communications performance and security measures. Many people are uncertain about how to integrate cryptographic algorithms coherently into existing operations of the clinical enterprise. This paper describes a centralized cryptosystem architecture to ensure image data authenticity in a digital radiology department. The system performance has been evaluated in a hospital-integrated PACS environment.

A cryptologic based trust center for medical images.

PubMed Central

Wong, S T

1996-01-01

OBJECTIVE: To investigate practical solutions that can integrate cryptographic techniques and picture archiving and communication systems (PACS) to improve the security of medical images. DESIGN: The PACS at the University of California San Francisco Medical Center consolidate images and associated data from various scanners into a centralized data archive and transmit them to remote display stations for review and consultation purposes. The purpose of this study is to investigate the model of a digital trust center that integrates cryptographic algorithms and protocols seamlessly into such a digital radiology environment to improve the security of medical images. MEASUREMENTS: The timing performance of encryption, decryption, and transmission of the cryptographic protocols over 81 volumetric PACS datasets has been measured. Lossless data compression is also applied before the encryption. The transmission performance is measured against three types of networks of different bandwidths: narrow-band Integrated Services Digital Network, Ethernet, and OC-3c Asynchronous Transfer Mode. RESULTS: The proposed digital trust center provides a cryptosystem solution to protect the confidentiality and to determine the authenticity of digital images in hospitals. The results of this study indicate that diagnostic images such as x-rays and magnetic resonance images could be routinely encrypted in PACS. However, applying encryption in teleradiology and PACS is a tradeoff between communications performance and security measures. CONCLUSION: Many people are uncertain about how to integrate cryptographic algorithms coherently into existing operations of the clinical enterprise. This paper describes a centralized cryptosystem architecture to ensure image data authenticity in a digital radiology department. The system performance has been evaluated in a hospital-integrated PACS environment. PMID:8930857

Accuracy of apparent diffusion coefficient value measurement on PACS workstation: A comparative analysis.

PubMed

El Kady, Reem M; Choudhary, Arabinda Kumar; Tappouni, Rafel

2011-03-01

The purpose of this article is to evaluate the accuracy of apparent diffusion coefficient (ADC) measurements made with a PACS workstation compared with measurements made with a dedicated workstation, which is currently considered the reference standard. A retrospective review was performed in liver lesions from 79 patients using three MRI platforms. The final diagnosis was established by liver biopsy in 31 patients and by dynamic MRI and follow-up, both clinical and radiologic as indicated, in 48 patients. Each lesion that was clearly demonstrable on the ADC map was measured with a commercial dedicated postprocessing workstation and again with a PACS system. A two-sample t test was used to determine the statistically significant differences between the two ADC measurements. A total of 79 patients with 120 liver lesions were included. ADC values measured on the workstation were 0.4-4.38 × 10(-3) mm(2)/s. The ADC values measured on the PACS were 0.42-4.35 × 10(-3) mm(2)/s. The T value was -1.113, with 119 degrees of freedom, and the significance level was 0.268, which implies no significant difference between the two different measuring systems for all pathologic abnormalities and MRI scanners used. ADC values measured on a routine PACS workstation are as accurate as the values obtained on a dedicated specialized workstation. ADC value measurement on the routine PACS will save time and lead to increased utilization, which, in turn, will lead to an improved understanding of the different disease processes and their clinical management.

PACS and teleradiology for on-call support of abdominal imaging

NASA Astrophysics Data System (ADS)

Horii, Steven C.; Garra, Brian S.; Mun, Seong K.; Zeman, Robert K.; Levine, Betty A.; Fielding, Robert

1991-07-01

One aspect of the Georgetown image management and communications system (IMACS or PACS) is a built-in capability to support teleradiology. Unlike many dedicated teleradiology systems, the support of this capability as a part of PACS means that any acquired images are remotely accessible, not just those specifically input for transmission. Over the past one and one-half years, two radiologists (SCH, BSG) in the abdominal imaging division of the department of radiology have been accumulating experience with teleradiology for on-call support of emergency abdominal imaging, chiefly in ultrasound. As of the time of this writing, use of the system during on-call (one of these attending radiologists primarily responsible) or back-up call (the attending responsible for the Fellow on primary call) has resulted in a marked reduction in the number of times one of them has to drive to the hospital at night or over the weekend. Approximately 80% of the time, use of the teleradiology system obviates having to go in to review a case. The remainder of the time, the radiologist has to perform a procedure (e.g., abscess drainage) or a scan (e.g., complex Doppler study) himself. This paper reviews the system used for teleradiology, how it is electronically and operationally integrated with the PACS, the clinical benefits and disadvantages of this use, and radiologist and referring physician acceptance.

A modular method for evaluating the performance of picture archiving and communication systems.

PubMed

Sanders, W H; Kant, L A; Kudrimoti, A

1993-08-01

Modeling can be used to predict the performance of picture archiving and communication system (PACS) configurations under various load conditions at an early design stage. This is important because choices made early in the design of a system can have a significant impact on the performance of the resulting implementation. Because PACS consist of many types of components, it is important to do such evaluations in a modular manner, so that alternative configurations and designs can be easily investigated. Stochastic activity networks (SANs) and reduced base model construction methods can aid in doing this. SANs are a model type particularly suited to the evaluation of systems in which several activities may be in progress concurrently, and each activity may affect the others through the results of its completion. Together with SANs, reduced base model construction methods provide a means to build highly modular models, in which models of particular components can be easily reused. In this article, we investigate the use of SANs and reduced base model construction techniques in evaluating PACS. Construction and solution of the models is done using UltraSAN, a graphic-oriented software tool for model specification, analysis, and simulation. The method is illustrated via the evaluation of a realistically sized PACS for a typical United States hospital of 300 to 400 beds, and the derivation of system response times and component utilizations.

PACS technologies and reliability: are we making things better or worse?

NASA Astrophysics Data System (ADS)

Horii, Steven C.; Redfern, Regina O.; Kundel, Harold L.; Nodine, Calvin F.

2002-05-01

In the process of installing picture archiving and communications (PACS) and speech recognition equipment, upgrading it, and working with previously stored digital image information, the authors encountered a number of problems. Examination of these difficulties illustrated the complex nature of our existing systems and how difficult it is, in many cases, to predict the behavior of these systems. This was found to be true even for our relatively small number of interconnected systems. The purpose of this paper is to illustrate some of the principles of understanding complex system interaction through examples from our experience. The work for this paper grew out of a number of studies we had carried out on our PACS over several years. The complex nature of our systems was evaluated through comparison of our operations with known examples of systems in other industries. Three scenarios: a network failure, a system software upgrade, and attempting to read media from an old archive showed that the major systems used in the radiology departments of many healthcare facilities (HIS, RIS, PACS, and speed recognition) are likely to interact in complex and often unpredictable ways. These interactions may be very difficult or impossible to predict, so that some plans should be made to overcome the negative aspects of the problems that result. Failures and problems, often unpredictable ones, are a likely side effect of having multiple information handling and processing systems interconnected and interoperating. Planning to avoid, or at least not be so vulnerable, to such difficulties is an important aspect of systems planning.

Utilizing data grid architecture for the backup and recovery of clinical image data.

PubMed

Liu, Brent J; Zhou, M Z; Documet, J

2005-01-01

Grid Computing represents the latest and most exciting technology to evolve from the familiar realm of parallel, peer-to-peer and client-server models. However, there has been limited investigation into the impact of this emerging technology in medical imaging and informatics. In particular, PACS technology, an established clinical image repository system, while having matured significantly during the past ten years, still remains weak in the area of clinical image data backup. Current solutions are expensive or time consuming and the technology is far from foolproof. Many large-scale PACS archive systems still encounter downtime for hours or days, which has the critical effect of crippling daily clinical operations. In this paper, a review of current backup solutions will be presented along with a brief introduction to grid technology. Finally, research and development utilizing the grid architecture for the recovery of clinical image data, in particular, PACS image data, will be presented. The focus of this paper is centered on applying a grid computing architecture to a DICOM environment since DICOM has become the standard for clinical image data and PACS utilizes this standard. A federation of PACS can be created allowing a failed PACS archive to recover its image data from others in the federation in a seamless fashion. The design reflects the five-layer architecture of grid computing: Fabric, Resource, Connectivity, Collective, and Application Layers. The testbed Data Grid is composed of one research laboratory and two clinical sites. The Globus 3.0 Toolkit (Co-developed by the Argonne National Laboratory and Information Sciences Institute, USC) for developing the core and user level middleware is utilized to achieve grid connectivity. The successful implementation and evaluation of utilizing data grid architecture for clinical PACS data backup and recovery will provide an understanding of the methodology for using Data Grid in clinical image data backup for PACS, as well as establishment of benchmarks for performance from future grid technology improvements. In addition, the testbed can serve as a road map for expanded research into large enterprise and federation level data grids to guarantee CA (Continuous Availability, 99.999% up time) in a variety of medical data archiving, retrieval, and distribution scenarios.

Cyanobacteriochrome-based photoswitchable adenylyl cyclases (cPACs) for broad spectrum light regulation of cAMP levels in cells.

PubMed

Blain-Hartung, Matthew; Rockwell, Nathan C; Moreno, Marcus V; Martin, Shelley S; Gan, Fei; Bryant, Donald A; Lagarias, J Clark

2018-06-01

Class III adenylyl cyclases generate the ubiquitous second messenger cAMP from ATP often in response to environmental or cellular cues. During evolution, soluble adenylyl cyclase catalytic domains have been repeatedly juxtaposed with signal-input domains to place cAMP synthesis under the control of a wide variety of these environmental and endogenous signals. Adenylyl cyclases with light-sensing domains have proliferated in photosynthetic species depending on light as an energy source, yet are also widespread in nonphotosynthetic species. Among such naturally occurring light sensors, several flavin-based photoactivated adenylyl cyclases (PACs) have been adopted as optogenetic tools to manipulate cellular processes with blue light. In this report, we report the discovery of a cyanobacteriochrome-based photoswitchable adenylyl cyclase (cPAC) from the cyanobacterium Microcoleus sp. PCC 7113. Unlike flavin-dependent PACs, which must thermally decay to be deactivated, cPAC exhibits a bistable photocycle whose adenylyl cyclase could be reversibly activated and inactivated by blue and green light, respectively. Through domain exchange experiments, we also document the ability to extend the wavelength-sensing specificity of cPAC into the near IR. In summary, our work has uncovered a cyanobacteriochrome-based adenylyl cyclase that holds great potential for the design of bistable photoswitchable adenylyl cyclases to fine-tune cAMP-regulated processes in cells, tissues, and whole organisms with light across the visible spectrum and into the near IR.

Metformin improves circulating endothelial cells and endothelial progenitor cells in type 1 diabetes: MERIT study.

PubMed

Ahmed, Fahad W; Rider, Rachel; Glanville, Michael; Narayanan, Kilimangalam; Razvi, Salman; Weaver, Jolanta U

2016-08-26

Type 1 diabetes is associated with increased cardiovascular disease (CVD). Decreased endothelial progenitor cells (EPCs) number plays a pivotal role in reduced endothelial repair and development of CVD. We aimed to determine if cardioprotective effect of metformin is mediated by increasing circulating endothelial progenitor cells (cEPCs), pro-angiogenic cells (PACs) and decreasing circulating endothelial cells (cECs) count whilst maintaining unchanged glycemic control. This study was an open label and parallel standard treatment study. Twenty-three type 1 diabetes patients without overt CVD were treated with metformin for 8 weeks (treatment group-TG). They were matched with nine type 1 diabetes patients on standard treatment (SG) and 23 age- and sex-matched healthy volunteers (HC). Insulin dose was adjusted to keep unchanged glycaemic control. cEPCs and cECs counts were determined by flow cytometry using surface markers CD45(dim)CD34(+)VEGFR-2(+) and CD45(dim)CD133(-)CD34(+)CD144(+) respectively. Peripheral blood mononuclear cells were cultured to assess changes in PACs number, function and colony forming units (CFU-Hill's colonies). At baseline TG had lower cEPCs, PACs, CFU-Hills' colonies and PACs adhesion versus HC (p < 0.001-all variables) and higher cECs versus HC (p = 0.03). Metformin improved cEPCs, PACs, CFU-Hill's colonies number, cECs and PACs adhesion (p < 0.05-all variables) to levels seen in HC whilst HbA1c (one-way ANOVA p = 0.78) and glucose variability (average glucose, blood glucose standard deviation, mean amplitude of glycaemic excursion, continuous overall net glycaemic action and area under curve) remained unchanged. No changes were seen in any variables in SG. There was an inverse correlation between CFU-Hill's colonies with cECs. Metformin has potential cardio-protective effect through improving cEPCs, CFU-Hill's colonies, cECs, PACs count and function independently of hypoglycaemic effect. This finding needs to be confirmed by long term cardiovascular outcome studies in type 1 diabetes. Trial registration ISRCTN26092132.

Integration of digital gross pathology images for enterprise-wide access.

PubMed

Amin, Milon; Sharma, Gaurav; Parwani, Anil V; Anderson, Ralph; Kolowitz, Brian J; Piccoli, Anthony; Shrestha, Rasu B; Lauro, Gonzalo Romero; Pantanowitz, Liron

2012-01-01

Sharing digital pathology images for enterprise- wide use into a picture archiving and communication system (PACS) is not yet widely adopted. We share our solution and 3-year experience of transmitting such images to an enterprise image server (EIS). Gross pathology images acquired by prosectors were integrated with clinical cases into the laboratory information system's image management module, and stored in JPEG2000 format on a networked image server. Automated daily searches for cases with gross images were used to compile an ASCII text file that was forwarded to a separate institutional Enterprise Digital Imaging and Communications in Medicine (DICOM) Wrapper (EDW) server. Concurrently, an HL7-based image order for these cases was generated, containing the locations of images and patient data, and forwarded to the EDW, which combined data in these locations to generate images with patient data, as required by DICOM standards. The image and data were then "wrapped" according to DICOM standards, transferred to the PACS servers, and made accessible on an institution-wide basis. In total, 26,966 gross images from 9,733 cases were transmitted over the 3-year period from the laboratory information system to the EIS. The average process time for cases with successful automatic uploads (n=9,688) to the EIS was 98 seconds. Only 45 cases (0.5%) failed requiring manual intervention. Uploaded images were immediately available to institution- wide PACS users. Since inception, user feedback has been positive. Enterprise- wide PACS- based sharing of pathology images is feasible, provides useful services to clinical staff, and utilizes existing information system and telecommunications infrastructure. PACS-shared pathology images, however, require a "DICOM wrapper" for multisystem compatibility.

Integration of digital gross pathology images for enterprise-wide access

PubMed Central

Amin, Milon; Sharma, Gaurav; Parwani, Anil V.; Anderson, Ralph; Kolowitz, Brian J; Piccoli, Anthony; Shrestha, Rasu B.; Lauro, Gonzalo Romero; Pantanowitz, Liron

2012-01-01

Background: Sharing digital pathology images for enterprise- wide use into a picture archiving and communication system (PACS) is not yet widely adopted. We share our solution and 3-year experience of transmitting such images to an enterprise image server (EIS). Methods: Gross pathology images acquired by prosectors were integrated with clinical cases into the laboratory information system's image management module, and stored in JPEG2000 format on a networked image server. Automated daily searches for cases with gross images were used to compile an ASCII text file that was forwarded to a separate institutional Enterprise Digital Imaging and Communications in Medicine (DICOM) Wrapper (EDW) server. Concurrently, an HL7-based image order for these cases was generated, containing the locations of images and patient data, and forwarded to the EDW, which combined data in these locations to generate images with patient data, as required by DICOM standards. The image and data were then “wrapped” according to DICOM standards, transferred to the PACS servers, and made accessible on an institution-wide basis. Results: In total, 26,966 gross images from 9,733 cases were transmitted over the 3-year period from the laboratory information system to the EIS. The average process time for cases with successful automatic uploads (n=9,688) to the EIS was 98 seconds. Only 45 cases (0.5%) failed requiring manual intervention. Uploaded images were immediately available to institution- wide PACS users. Since inception, user feedback has been positive. Conclusions: Enterprise- wide PACS- based sharing of pathology images is feasible, provides useful services to clinical staff, and utilizes existing information system and telecommunications infrastructure. PACS-shared pathology images, however, require a “DICOM wrapper” for multisystem compatibility. PMID:22530178

Integration of healthcare information: from enterprise PACS to patient centered multimedia health record.

PubMed

Soriano, Enrique; Plazzotta, Fernando; Campos, Fernando; Kaminker, Diego; Cancio, Alfredo; Aguilera Díaz, Jerónimo; Luna, Daniel; Seehaus, Alberto; Carcía Mónaco, Ricardo; de Quirós, Fernán González Bernaldo

2010-01-01

Every single piece of healthcare information should be fully integrated and transparent within the electronic health record. The Italian Hospital of Buenos Aires initiated the project Multimedia Health Record with the goal to achieve this integration while maintaining a holistic view of current structure of the systems of the Hospital, where the axis remains are the patient and longitudinal history, commencing with section Computed Tomography. Was implemented DICOM standard for communication and image storage and bought a PACS. It was necessary adapt our generic reporting system for live up to the commercial RIS. The Computerized Tomography (CT) Scanners of our hospital were easily integrated into the DICOM network and all the CT Scans generated by our radiology service were stored in the PACS, reported using the Structured Reporting System (we installed diagnostic terminals equipped with 3 monitors) and displayed in the EHR at any point of HIBA's healthcare network.

Modeling the Impact of Motivation, Personality, and Emotion on Social Behavior

NASA Astrophysics Data System (ADS)

Miller, Lynn C.; Read, Stephen J.; Zachary, Wayne; Rosoff, Andrew

Models seeking to predict human social behavior must contend with multiple sources of individual and group variability that underlie social behavior. One set of interrelated factors that strongly contribute to that variability - motivations, personality, and emotions - has been only minimally incorporated in previous computational models of social behavior. The Personality, Affect, Culture (PAC) framework is a theory-based computational model that addresses this gap. PAC is used to simulate social agents whose social behavior varies according to their personalities and emotions, which, in turn, vary according to their motivations and underlying motive control parameters. Examples involving disease spread and counter-insurgency operations show how PAC can be used to study behavioral variability in different social contexts.

ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT, C. LEE COOK DIV., DOVER CORP., STATIC PAC SYSTEM, PHASE I REPORT

EPA Science Inventory

The Static Pac was verified at a natural gas compressor station operated by ANR Pipeline Company. The test was carried out on two engines (8-cylinder, 2000 hp), each with two reciprocating compressors operating in parallel (4 in. rods). The evaluation focused on two shutdown proc...

Performance of biological magnetic powdered activated carbon for drinking water purification.

PubMed

Lompe, Kim Maren; Menard, David; Barbeau, Benoit

2016-06-01

Combining the high adsorption capacity of powdered activated carbon (PAC) with magnetic properties of iron oxide nanoparticles (NPs) leads to a promising composite material, magnetic PAC or MPAC, which can be separated from water using magnetic separators. We propose MPAC as an alternative adsorbent in the biological hybrid membrane process and demonstrate that PAC covered with magnetic NPs is suitable as growth support for heterotrophic and nitrifying bacteria. MPAC with mass fractions of 0; 23; 38 and 54% maghemite was colonized in small bioreactors for over 90 days. Although the bacterial community composition (16s rRNA analysis) was different on MPAC compared to PAC, NPs neither inhibited dissolved organic carbon and ammonia biological removals nor contributed to significant adsorption of these compounds. The same amount of active heterotrophic biomass (48 μg C/cm(3)) developed on MPAC with a mass fraction of 54% NPs as on the non-magnetic PAC control. While X-ray diffraction confirmed that size and type of iron oxides did not change over the study period, a loss in magnetization between 10% and 34% was recorded. Copyright © 2016 Elsevier Ltd. All rights reserved.

Integration of implant planning workflows into the PACS infrastructure

NASA Astrophysics Data System (ADS)

Gessat, Michael; Strauß, Gero; Burgert, Oliver

2008-03-01

The integration of imaging devices, diagnostic workstations, and image servers into Picture Archiving and Communication Systems (PACS) has had an enormous effect on the efficiency of radiology workflows. The standardization of the information exchange between the devices with the DICOM standard has been an essential precondition for that development. For surgical procedures, no such infrastructure exists. With the increasingly important role computerized planning and assistance systems play in the surgical domain, an infrastructure that unifies the communication between devices becomes necessary. In recent publications, the need for a modularized system design has been established. A reference architecture for a Therapy Imaging and Model Management System (TIMMS) has been proposed. It was accepted by the DICOM Working Group 6 as the reference architecture for DICOM developments for surgery. In this paper we propose the inclusion of implant planning systems into the PACS infrastructure. We propose a generic information model for the patient specific selection and positioning of implants from a repository according to patient image data. The information models are based on clinical workflows from ENT, cardiac, and orthopedic surgery as well as technical requirements derived from different use cases and systems. We show an exemplary implementation of the model for application in ENT surgery: the selection and positioning of an ossicular implant in the middle ear. An implant repository is stored in the PACS. It makes use of an experimental implementation of the Surface Mesh Module that is currently being developed as extension to the DICOM standard.

Fine particulate air pollution and premature atrial contractions: The REasons for Geographic And Racial Differences in Stroke study.

PubMed

O'Neal, Wesley T; Soliman, Elsayed Z; Efird, Jimmy T; Judd, Suzanne E; Howard, Virginia J; Howard, George; McClure, Leslie A

2017-05-01

Several reports have suggested that particulate matter (PM) exposure increases the risk for atrial arrhythmias. However, data from large-scale epidemiologic studies supporting this hypothesis are lacking. We examined the association of PM <2.5 μm in diameter (PM 2.5 ) concentration with premature atrial contractions (PACs) in 26,609 (mean age=65±9.4 years; 55% female; 41% black) participants from the REGARDS (REasons for Geographic And Racial Differences in Stroke) study. Estimates of short- (2 weeks) and long-term (1 year) PM 2.5 exposure were computed before each participant's baseline visit using geographic information system data on the individual level at the coordinates of study participants' residences. PACs were identified from baseline electrocardiograms. A total of 2140 (8.2%) participants had evidence of PACs on the baseline electrocardiogram. Short-term PM 2.5 (per 10 μg/m 3 ) exposure was not associated with PACs (OR=1.09, 95% CI=0.98, 1.23). Increases in long-term PM 2.5 (per 10 μg/m 3 ) were associated with PACs (OR=1.40, 95% CI=1.10, 1.78). Interactions were not detected for short- and long-term PM 2.5 exposure by age, sex, or race. Long- but not short-term PM 2.5 exposure is associated with PACs. This suggests a role for long-term PM 2.5 exposure in initiating supraventricular arrhythmias that are triggered by PACs.

IBM Application System/400 as the foundation of the Mayo Clinic/IBM PACS project

NASA Astrophysics Data System (ADS)

Rothman, Melvyn L.; Morin, Richard L.; Persons, Kenneth R.; Gibbons, Patricia S.

1990-08-01

An IBM Application System/400 (AS/400) anchors the Mayo Clinic/IBM joint development PACS project. This paper highlights some of the AS/400's features and the resulting benefits which make it a strong foundation for a medical image archival and review system. Among the AS/400's key features are: 1. A high-level machine architecture 2. Object orientation 3. Relational data base and other functions integrated into the system's architecture 4. High-function interfaces to IBM Personal Computers and IBM Personal System/2s' (pS/2TM).

Whole-slide imaging in pathology: the potential impact on PACS

NASA Astrophysics Data System (ADS)

Horii, Steven C.

2007-03-01

Pathology, the medical specialty charged with the evaluation of macroscopic and microscopic aspects of disease, is increasingly turning to digital imaging. While the conventional tissue blocks and glass slides form an "archive" that pathology departments must maintain, digital images acquired from microscopes or digital slide scanners are increasingly used for telepathology, consultation, and intra-facility communication. Since many healthcare facilities are moving to "enterprise PACS" with departments in addition to radiology using the infrastructure of such systems, some understanding of the potential of whole-slide digital images is important. Network and storage designers, in particular, are very likely to be impacted if a significant number of such images are to be moved on, or stored (even temporarily) in, enterprise PACS. As an example, a typical commercial whole-slide imaging system typically generates 15 gigabytes per slide scanned (per focal plane). Many of these whole-slide scanners have a throughput of 1000 slides per day. If that full capacity is used and all the resulting digital data is moved to the enterprise PACS, it amounts to 15 terabytes per day; the amount of data a large radiology department might generate in a year or two. This paper will review both the clinical scenarios of whole-slide imaging as well as the resulting data volumes. The author will emphasize the potential PACS infrastructure impact of such huge data volumes.

Method of Individual Adjustment for 3D CT Analysis: Linear Measurement.

PubMed

Kim, Dong Kyu; Choi, Dong Hun; Lee, Jeong Woo; Yang, Jung Dug; Chung, Ho Yun; Cho, Byung Chae; Choi, Kang Young

2016-01-01

Introduction . We aim to regularize measurement values in three-dimensional (3D) computed tomography (CT) reconstructed images for higher-precision 3D analysis, focusing on length-based 3D cephalometric examinations. Methods . We measure the linear distances between points on different skull models using Vernier calipers (real values). We use 10 differently tilted CT scans for 3D CT reconstruction of the models and measure the same linear distances from the picture archiving and communication system (PACS). In both cases, each measurement is performed three times by three doctors, yielding nine measurements. The real values are compared with the PACS values. Each PACS measurement is revised based on the display field of view (DFOV) values and compared with the real values. Results . The real values and the PACS measurement changes according to tilt value have no significant correlations ( p > 0.05). However, significant correlations appear between the real values and DFOV-adjusted PACS measurements ( p < 0.001). Hence, we obtain a correlation expression that can yield real physical values from PACS measurements. The DFOV value intervals for various age groups are also verified. Conclusion . Precise confirmation of individual preoperative length and precise analysis of postoperative improvements through 3D analysis is possible, which is helpful for facial-bone-surgery symmetry correction.

Experience with high-performance PACS

NASA Astrophysics Data System (ADS)

Wilson, Dennis L.; Goldburgh, Mitchell M.; Head, Calvin

1997-05-01

Lockheed Martin (Loral) has installed PACS with associated teleradiology in several tens of hospitals. The PACS that have been installed have been the basis for a shift to filmless radiology in many of the hospitals. the basic structure for the PACS and the teleradiology that is being used is outlined. The way that the PACS are being used in the hospitals is instructive. The three most used areas for radiology in the hospital are the wards including the ICU wards, the emergency room, and the orthopedics clinic. The examinations are mostly CR images with 20 percent to 30 percent of the examinations being CT, MR, and ultrasound exams. The PACS are being used to realize improved productivity for radiology and for the clinicians. For radiology the same staff is being used for 30 to 50 percent more workload. For the clinicians 10 to 20 percent of their time is being saved in dealing with radiology images. The improved productivity stems from the high performance of the PACS that has been designed and installed. Images are available on any workstation in the hospital within less than two seconds, even during the busiest hour of the day. The examination management functions to restrict the attention of any one user to the examinations that are of interest. The examination management organizes the workflow through the radiology department and the hospital, improving the service of the radiology department by reducing the time until the information from a radiology examination is available. The remaining weak link in the PACS system is transcription. The examination can be acquired, read, an the report dictated in much less than ten minutes. The transcription of the dictated reports can take from a few hours to a few days. The addition of automatic transcription services will remove this weak link.

Pacific kids DASH for health (PacDASH) randomized, controlled trial with DASH eating plan plus physical activity improves fruit and vegetable intake and diastolic blood pressure in children.

PubMed

Novotny, Rachel; Nigg, Claudio R; Li, Fenfang; Wilkens, Lynne R

2015-04-01

Pacific Kids DASH for Health (PacDASH) aimed to improve child diet and physical activity (PA) level and prevent excess weight gain and elevation in blood pressure (BP) at 9 months. PacDASH was a two-arm, randomized, controlled trial (ClinicalTrials.gov: NCT00905411). Eighty-five 5- to 8-year-olds in the 50th-99th percentile for BMI were randomly assigned to treatment (n=41) or control (n=44) groups; 62 completed the 9-month trial. Sixty-two percent were female. Mean age was 7.1±0.95 years. Race/ethnicity was Asian (44%), Native Hawaiian or Other Pacific Islander (28%), white (21%), or other race/ethnicity (7%). Intervention was provided at baseline and 3, 6 and 9 months, with monthly supportive mailings between intervention visits, and a follow-up visit at 15 months to observe maintenance. Diet and PA were assessed by 2-day log. Body size, composition, and BP were measured. The intervention effect on diet and PA, body size and composition, and BP by the end of the intervention was tested using an F test from a mixed regression model, after adjustment for sex, age, and ethnic group. Fruit and vegetable (FV) intake decreased less in the treatment than control group (p=0.04). Diastolic BP (DBP) was 12 percentile units lower in the treatment than control group after 9 months of intervention (p=0.01). There were no group differences in systolic BP (SBP) or body size/composition. The PacDASH trial enhanced FV intake and DBP, but not SBP or body size/composition.

Development of the User Interface for AIR-Spec

NASA Astrophysics Data System (ADS)

Cervantes Alcala, E.; Guth, G.; Fedeler, S.; Samra, J.; Cheimets, P.; DeLuca, E.; Golub, L.

2016-12-01

The airborne infrared spectrometer (AIR-Spec) is an imaging spectrometer that will observe the solar corona during the 2017 total solar eclipse. This eclipse will provide a unique opportunity to observe infrared emission lines in the corona. Five spectral lines are of particular interest because they may eventually be used to measure the coronal magnetic field. To avoid infrared absorption from atmospheric water vapor, AIR-Spec will be placed on an NSF Gulfstream aircraft flying above 14.9 km. AIR-Spec must be capable of taking stable images while the plane moves. The instrument includes an image stabilization system, which uses fiber-optic gyroscopes to determine platform rotation, GPS to calculate the ephemeris of the sun, and a voltage-driven mirror to correct the line of sight. An operator monitors a white light image of the eclipse and manually corrects for residual drift. The image stabilization calculation is performed by a programmable automatic controller (PAC), which interfaces with the gyroscopes and mirror controller. The operator interfaces with a separate computer, which acquires images and computes the solar ephemeris. To ensure image stabilization is successful, a human machine interface (HMI) was developed to allow connection between the client and PAC. In order to make control of the instruments user friendly during the short eclipse observation, a graphical user interface (GUI) was also created. The GUI's functionality includes turning image stabilization on and off, allowing the user to input information about the geometric setup, calculating the solar ephemeris, refining estimates of the initial aircraft attitude, and storing data from the PAC on the operator's computer. It also displays time, location, attitude, ephemeris, gyro rates and mirror angles.

The cost of post-abortion care in developing countries: a comparative analysis of four studies.

PubMed

Vlassoff, Michael; Singh, Susheela; Onda, Tsuyoshi

2016-10-01

Over the last five years, comprehensive national surveys of the cost of post-abortion care (PAC) to national health systems have been undertaken in Ethiopia, Uganda, Rwanda and Colombia using a specially developed costing methodology-the Post-abortion Care Costing Methodology (PACCM). The objective of this study is to expand the research findings of these four studies, making use of their extensive datasets. These studies offer the most complete and consistent estimates of the cost of PAC to date, and comparing their findings not only provides generalizable implications for health policies and programs, but also allows an assessment of the PACCM methodology. We find that the labor cost component varies widely: in Ethiopia and Colombia doctors spend about 30-60% more time with PAC patients than do nurses; in Uganda and Rwanda an opposite pattern is found. Labor costs range from I$42.80 in Uganda to I$301.30 in Colombia. The cost of drugs and supplies does not vary greatly, ranging from I$79 in Colombia to I$115 in Rwanda. Capital and overhead costs are substantial amounting to 52-68% of total PAC costs. Total costs per PAC case vary from I$334 in Rwanda to I$972 in Colombia. The financial burden of PAC is considerable: the expense of treating each PAC case is equivalent to around 35% of annual per capita income in Uganda, 29% in Rwanda and 11% in Colombia. Providing modern methods of contraception to women with an unmet need would cost just a fraction of the average expenditure on PAC: one year of modern contraceptive services and supplies cost only 3-12% of the average cost of treating a PAC patient. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Why PACS is no longer a four-letter word.

PubMed

Chopra, R M

2000-01-01

The real value of PACS is not realized until widespread adoption exists among physicians other than interpreting radiologists. Referring physicians at the office level, in the operating room and in other departments must be willing to embrace the reading of images on monitors. That takes time. The payoff for a PACS system is therefore not realized until sometime in the future. Given the huge up-front capital expenditure required of PACS solutions, it is no wonder that the decision has historically been a difficult one to make. Enter the application service provider (ASP). The marriage of the ASP model to PACS seems to be one of the true "killer apps" currently available in the healthcare technology space. An ASP can host and maintain the software inherent in PACS solutions. Images are centrally archived over the short-, medium-, and long-term timeframe, utilizing state-of-art data management facilities. Some ASPs also provide the necessary bandwidth to office sites and the small amount of hardware that is required onsite, such as viewing stations or monitors. Costs for Internet-based image management under the ASP model rely on a pay-as-you-go formula, which may include all software, support, required hardware and bandwidth as part of the service. There may be a minor up-front fee for installation. The ASP pricing model eliminates the huge gamble an organization takes on "big iron" PACS purchases. Those benefits rely on the first rule of finance: a dollar today is worth more than a dollar tomorrow. PACS and ASPs were made for one another. Because the financial benefits of PACS are realized over time, the timing of cash flows is extremely important. Other benefits inherent in the ASP model such as scalability, diminished need for IT personnel, software version integrity and better pricing because of economies of scale are attractive also.

Online Error Reporting for Managing Quality Control Within Radiology.

PubMed

Golnari, Pedram; Forsberg, Daniel; Rosipko, Beverly; Sunshine, Jeffrey L

2016-06-01

Information technology systems within health care, such as picture archiving and communication system (PACS) in radiology, can have a positive impact on production but can also risk compromising quality. The widespread use of PACS has removed the previous feedback loop between radiologists and technologists. Instead of direct communication of quality discrepancies found for an examination, the radiologist submitted a paper-based quality-control report. A web-based issue-reporting tool can help restore some of the feedback loop and also provide possibilities for more detailed analysis of submitted errors. The purpose of this study was to evaluate the hypothesis that data from use of an online error reporting software for quality control can focus our efforts within our department. For the 372,258 radiologic examinations conducted during the 6-month period study, 930 errors (390 exam protocol, 390 exam validation, and 150 exam technique) were submitted, corresponding to an error rate of 0.25 %. Within the category exam protocol, technologist documentation had the highest number of submitted errors in ultrasonography (77 errors [44 %]), while imaging protocol errors were the highest subtype error for computed tomography modality (35 errors [18 %]). Positioning and incorrect accession had the highest errors in the exam technique and exam validation error category, respectively, for nearly all of the modalities. An error rate less than 1 % could signify a system with a very high quality; however, a more likely explanation is that not all errors were detected or reported. Furthermore, staff reception of the error reporting system could also affect the reporting rate.

A model of axonal transport drug delivery

NASA Astrophysics Data System (ADS)

Kuznetsov, Andrey V.

2012-04-01

In this paper a model of targeted drug delivery by means of active (motor-driven) axonal transport is developed. The model is motivated by recent experimental research by Filler et al. (A.G. Filler, G.T. Whiteside, M. Bacon, M. Frederickson, F.A. Howe, M.D. Rabinowitz, A.J. Sokoloff, T.W. Deacon, C. Abell, R. Munglani, J.R. Griffiths, B.A. Bell, A.M.L. Lever, Tri-partite complex for axonal transport drug delivery achieves pharmacological effect, Bmc Neuroscience 11 (2010) 8) that reported synthesis and pharmacological efficiency tests of a tri-partite complex designed for axonal transport drug delivery. The developed model accounts for two populations of pharmaceutical agent complexes (PACs): PACs that are transported retrogradely by dynein motors and PACs that are accumulated in the axon at the Nodes of Ranvier. The transitions between these two populations of PACs are described by first-order reactions. An analytical solution of the coupled system of transient equations describing conservations of these two populations of PACs is obtained by using Laplace transform. Numerical results for various combinations of parameter values are presented and their physical significance is discussed.

Pituitary adenylate cyclase-activating polypeptide type 1 (PAC1) receptor is expressed during embryonic development of the earthworm.

PubMed

Boros, Akos; Somogyi, Ildikó; Engelmann, Péter; Lubics, Andrea; Reglodi, Dóra; Pollák, Edit; Molnár, László

2010-03-01

Pituitary adenylate cyclase activating polypeptide (PACAP)-like molecules have been shown to be present in cocoon albumin and in Eisenia fetida embryos at an early developmental stage (E1) by immunocytochemistry and radioimmunoassay. Here, we focus on detecting the stage at which PAC1 receptor (PAC1R)-like immunoreactivity first appears in germinal layers and structures, e.g., various parts of the central nervous system (CNS), in developing earthworm embryos. PAC1R-like immunoreactivity was revealed by Western blot and Far Western blot as early as the E2 developmental stage, occurring in the ectoderm and later in specific neurons of the developing CNS. Labeled CNS neurons were first seen in the supraesophageal ganglion (brain) and subsequently in the subesophageal and ventral nerve cord ganglia. Ultrastructurally, PAC1Rs were located mainly on plasma membranes and intracellular membranes, especially on cisternae of the endoplasmic reticulum. Therefore, PACAP-like compounds probably influence the differentiation of germinal layers (at least the ectoderm) and of some neurons and might act as signaling molecules during earthworm embryonic development.

Gestures for Picture Archiving and Communication Systems (PACS) operation in the operating room: Is there any standard?

PubMed

Madapana, Naveen; Gonzalez, Glebys; Rodgers, Richard; Zhang, Lingsong; Wachs, Juan P

2018-01-01

Gestural interfaces allow accessing and manipulating Electronic Medical Records (EMR) in hospitals while keeping a complete sterile environment. Particularly, in the Operating Room (OR), these interfaces enable surgeons to browse Picture Archiving and Communication System (PACS) without the need of delegating functions to the surgical staff. Existing gesture based medical interfaces rely on a suboptimal and an arbitrary small set of gestures that are mapped to a few commands available in PACS software. The objective of this work is to discuss a method to determine the most suitable set of gestures based on surgeon's acceptability. To achieve this goal, the paper introduces two key innovations: (a) a novel methodology to incorporate gestures' semantic properties into the agreement analysis, and (b) a new agreement metric to determine the most suitable gesture set for a PACS. Three neurosurgical diagnostic tasks were conducted by nine neurosurgeons. The set of commands and gesture lexicons were determined using a Wizard of Oz paradigm. The gestures were decomposed into a set of 55 semantic properties based on the motion trajectory, orientation and pose of the surgeons' hands and their ground truth values were manually annotated. Finally, a new agreement metric was developed, using the known Jaccard similarity to measure consensus between users over a gesture set. A set of 34 PACS commands were found to be a sufficient number of actions for PACS manipulation. In addition, it was found that there is a level of agreement of 0.29 among the surgeons over the gestures found. Two statistical tests including paired t-test and Mann Whitney Wilcoxon test were conducted between the proposed metric and the traditional agreement metric. It was found that the agreement values computed using the former metric are significantly higher (p < 0.001) for both tests. This study reveals that the level of agreement among surgeons over the best gestures for PACS operation is higher than the previously reported metric (0.29 vs 0.13). This observation is based on the fact that the agreement focuses on main features of the gestures rather than the gestures themselves. The level of agreement is not very high, yet indicates a majority preference, and is better than using gestures based on authoritarian or arbitrary approaches. The methods described in this paper provide a guiding framework for the design of future gesture based PACS systems for the OR.

A bidirectional ACR-NEMA interface between the VA's DHCP Integrated Imaging System and the Siemens-Loral PACS.

PubMed Central

Kuzmak, P. M.; Dayhoff, R. E.

1992-01-01

There is a wide range of requirements for digital hospital imaging systems. Radiology needs very high resolution black and white images. Other diagnostic disciplines need high resolution color imaging capabilities. Images need to be displayed in many locations throughout the hospital. Different imaging systems within a hospital need to cooperate in order to show the whole picture. At the Baltimore VA Medical Center, the DHCP Integrated Imaging System and a commercial Picture Archiving and Communication System (PACS) work in concert to provide a wide-range of departmental and hospital-wide imaging capabilities. An interface between the DHCP and the Siemens-Loral PACS systems enables patient text and image data to be passed between the two systems. The interface uses ACR-NEMA 2.0 Standard messages extended with shadow groups based on draft ACR-NEMA 3.0 prototypes. A Novell file server, accessible to both systems via Ethernet, is used to communicate all the messages. Patient identification information, orders, ADT, procedure status, changes, patient reports, and images are sent between the two systems across the interface. The systems together provide an extensive set of imaging capabilities for both the specialist and the general practitioner. PMID:1482906

A bidirectional ACR-NEMA interface between the VA's DHCP Integrated Imaging System and the Siemens-Loral PACS.

PubMed

Kuzmak, P M; Dayhoff, R E

1992-01-01

There is a wide range of requirements for digital hospital imaging systems. Radiology needs very high resolution black and white images. Other diagnostic disciplines need high resolution color imaging capabilities. Images need to be displayed in many locations throughout the hospital. Different imaging systems within a hospital need to cooperate in order to show the whole picture. At the Baltimore VA Medical Center, the DHCP Integrated Imaging System and a commercial Picture Archiving and Communication System (PACS) work in concert to provide a wide-range of departmental and hospital-wide imaging capabilities. An interface between the DHCP and the Siemens-Loral PACS systems enables patient text and image data to be passed between the two systems. The interface uses ACR-NEMA 2.0 Standard messages extended with shadow groups based on draft ACR-NEMA 3.0 prototypes. A Novell file server, accessible to both systems via Ethernet, is used to communicate all the messages. Patient identification information, orders, ADT, procedure status, changes, patient reports, and images are sent between the two systems across the interface. The systems together provide an extensive set of imaging capabilities for both the specialist and the general practitioner.

Pituitary adenylate cyclase activating polypeptide and PAC1 receptor signaling increase Homer 1a expression in central and peripheral neurons.

PubMed

Girard, Beatrice M; Keller, Emily T; Schutz, Kristin C; May, Victor; Braas, Karen M

2004-12-15

Pituitary adenylate cyclase activating polypeptides (PACAP) and PAC1 receptor signaling have diverse roles in central and peripheral nervous system development and function. In recent microarray analyses for PACAP and PAC1 receptor modulation of neuronal transcripts, the mRNA of Homer 1a (H1a), which encodes the noncrosslinking and immediate early gene product isoform of Homer, was identified to be strongly upregulated in superior cervical ganglion (SCG) sympathetic neurons. Given the prominent roles of Homer in synaptogenesis, synaptic protein complex assembly and receptor/channel signaling, we have examined the ability for PACAP to induce H1a expression in sympathetic, cortical and hippocampal neurons to evaluate more comprehensively the roles of PACAP in synaptic function. In both central and peripheral neuronal cultures, PACAP peptides increased transiently H1a transcript levels approximately 3.5- to 6-fold. From real-time quantitative PCR measurements, the temporal patterns of PACAP-mediated H1a mRNA induction among the different neuronal cultures appeared similar although the onset of sympathetic H1a transcript expression appeared protracted. The increase in H1a transcripts was accompanied by increases in H1a protein levels. Comparative studies with VIP and PACAP(6-38) antagonist demonstrated that the PACAP effects reflected PAC1 receptor activation and signaling. The PAC1 receptor isoforms expressed in central and peripheral neurons can engage diverse intracellular second messenger systems, and studies using selective signaling pathway inhibitors demonstrated that the cyclic AMP/PKA and MEK/ERK cascades are principal mediators of the PACAP-mediated H1a induction response. In modulating H1a transcript and protein expression, these studies may implicate broad roles for PACAP and PAC1 receptor signaling in synaptic development and plasticity.

Medical image security in a HIPAA mandated PACS environment.

PubMed

Cao, F; Huang, H K; Zhou, X Q

2003-01-01

Medical image security is an important issue when digital images and their pertinent patient information are transmitted across public networks. Mandates for ensuring health data security have been issued by the federal government such as Health Insurance Portability and Accountability Act (HIPAA), where healthcare institutions are obliged to take appropriate measures to ensure that patient information is only provided to people who have a professional need. Guidelines, such as digital imaging and communication in medicine (DICOM) standards that deal with security issues, continue to be published by organizing bodies in healthcare. However, there are many differences in implementation especially for an integrated system like picture archiving and communication system (PACS), and the infrastructure to deploy these security standards is often lacking. Over the past 6 years, members in the Image Processing and Informatics Laboratory, Childrens Hospital, Los Angeles/University of Southern California, have actively researched image security issues related to PACS and teleradiology. The paper summarizes our previous work and presents an approach to further research on the digital envelope (DE) concept that provides image integrity and security assurance in addition to conventional network security protection. The DE, including the digital signature (DS) of the image as well as encrypted patient information from the DICOM image header, can be embedded in the background area of the image as an invisible permanent watermark. The paper outlines the systematic development, evaluation and deployment of the DE method in a PACS environment. We have also proposed a dedicated PACS security server that will act as an image authority to check and certify the image origin and integrity upon request by a user, and meanwhile act also as a secure DICOM gateway to the outside connections and a PACS operation monitor for HIPAA supporting information. Copyright 2002 Elsevier Science Ltd.

The color removal of dye wastewater by magnesium chloride/red mud (MRM) from aqueous solution.

PubMed

Wang, Qi; Luan, Zhaokun; Wei, Ning; Li, Jin; Liu, Chengxi

2009-10-30

In this study, the MgCl2/red mud system (MRM) was used to investigate the color removal efficiency of dye solutions. Parameters such as the effect of the dosage of red mud (RM) and MgCl2 have been studied. The effect of pH on the conversion rate of Mg2+ has also been studied. The color removal efficiency of MRM was compared with that of PAC/RM and PAC/NaOH. Meanwhile, the color removal efficiency of RM was compared with that of NaOH. The results show that the MRM system can remove more than 98% of the coloring material at a dosage of 25 g RM/L dye solution and a volume of 1.5 mL MgCl2/L dye solution in the decolorization process of reactive dye, acid dye and direct dye. The color removal efficiency was better than PAC/RM and PAC/NaOH system. The adsorption data have been analyzed using Langmuir and Freundlich isotherms. The results indicated that both models provide the best correlation of the experimental data. The decolorization mechanism of MRM was discussed, too. The MRM system was a viable alternative to some of the more conventional forms of chemical treatment of dye solutions and also provided another way to make use of industrial waste red mud.

Oral microemulsions of paclitaxel: in situ and pharmacokinetic studies.

PubMed

Nornoo, Adwoa O; Zheng, Haian; Lopes, Luciana B; Johnson-Restrepo, Boris; Kannan, Kurunthachalam; Reed, Rachel

2009-02-01

The overall goal of this study was to develop cremophor-free oral microemulsions of paclitaxel (PAC) to enhance its permeability and oral absorption. The mechanism of this enhancement, as well as characteristics of the microemulsions relevant to the increase in permeability and absorption of the low solubility, low permeability PAC was investigated. Phase diagrams were used to determine the macroscopic phase behavior of the microemulsions and to compare the efficiency of different surfactant-oil mixtures to incorporate water. The microemulsion region on the phase diagrams utilizing surfactant-myvacet oil combinations was in decreasing order: lecithin: butanol: myvacet oil (LBM, 48.5%)>centromix CPS: 1-butanol: myvacet oil (CPS, 45.15%)>capmul MCM: polysorbate 80: myvacet oil (CPM, 27.6%)>capryol 90: polysorbate 80: myvacet oil (CP-P80, 23.9%)>capmul: myvacet oil (CM, 20%). Oil-in-water (o/w) microemulsions had larger droplet sizes (687-1010 nm) than the water-in-oil (w/o) microemulsions (272-363 nm) when measured using a Zetasizer nano series particle size analyzer. Utilizing nuclear magnetic resonance spectroscopy (NMR), the self-diffusion coefficient (D) of PAC in CM, LBM and CPM containing 10% of deuterium oxide (D(2)O) was 2.24x10(-11), 1.97x10(-11) and 0.51x10(-11) m(2)/s, respectively. These values indicate the faster molecular mobility of PAC in the two w/o microemulsions (CM and LBM) than the o/w microemulsion--CPM. The in situ permeability of PAC through male CD-IGS rat intestine was 3- and 11-fold higher from LBM and CM, respectively, than that from the control clinical formulation, Taxol (CE, cremophor: ethanol) in a single pass perfusion study. PAC permeability was significantly increased in the presence of the pgp/CYP3A4 inhibitor cyclosporine A (CsA). This enhancement may be attributed to the pgp inhibitory effect of the surfactants, oil and/or the membrane perturbation effect of the surfactants. The oral disposition of PAC in CM, LBM and CPM compared to CE was studied in male CD-IGS rats after a single oral dose (20 mg/kg). The area-under-the-curve of PAC in CM was significantly larger than LBM, CPM and CE. Oral microemulsions of PAC were developed that increased both the permeability and AUC of PAC as compared to CE.

Comparing activated carbon of different particle sizes on enhancing methane generation in upflow anaerobic digester.

PubMed

Xu, Suyun; He, Chuanqiu; Luo, Liwen; Lü, Fan; He, Pinjing; Cui, Lifeng

2015-11-01

Two sizes of conductive particles, i.e. 10-20 mesh granulated activated carbon (GAC) and 80-100 mesh powdered activated carbon (PAC) were added into lab-scale upflow anaerobic sludge blanket reactors, respectively, to testify their enhancement on the syntrophic metabolism of alcohols and volatile fatty acids (VFAs) in 95days operation. When OLR increased to more than 5.8gCOD/L/d, the differences between GAC/PAC supplemented reactors and the control reactor became more significant. The introduction of activated carbon could facilitate the enrichment of methanogens and accelerate the startup of methanogenesis, as indicated by enhanced methane yield and substrate degradation. High-throughput pyrosequencing analysis showed that syntrophic bacteria and Methanosarcina sp. with versatile metabolic capability increased in the tightly absorbed fraction on the PAC surface, leading to the promoted syntrophic associations. Thus PAC prevails over than GAC for methanogenic reactor with heavy load. Copyright © 2015 Elsevier Ltd. All rights reserved.

Software tools for interactive instruction in radiologic anatomy.

PubMed

Alvarez, Antonio; Gold, Garry E; Tobin, Brian; Desser, Terry S

2006-04-01

To promote active learning in an introductory Radiologic Anatomy course through the use of computer-based exercises. DICOM datasets from our hospital PACS system were transferred to a networked cluster of desktop computers in a medical school classroom. Medical students in the Radiologic Anatomy course were divided into four small groups and assigned to work on a clinical case for 45 minutes. The groups used iPACS viewer software, a free DICOM viewer, to view images and annotate anatomic structures. The classroom instructor monitored and displayed each group's work sequentially on the master screen by running SynchronEyes, a software tool for controlling PC desktops remotely. Students were able to execute the assigned tasks using the iPACS software with minimal oversight or instruction. Course instructors displayed each group's work on the main display screen of the classroom as the students presented the rationale for their decisions. The interactive component of the course received high ratings from the students and overall course ratings were higher than in prior years when the course was given solely in lecture format. DICOM viewing software is an excellent tool for enabling students to learn radiologic anatomy from real-life clinical datasets. Interactive exercises performed in groups can be powerful tools for stimulating students to learn radiologic anatomy.

The yeast homologue of the microtubule-associated protein Lis1 interacts with the sumoylation machinery and a SUMO-targeted ubiquitin ligase

PubMed Central

Alonso, Annabel; D'Silva, Sonia; Rahman, Maliha; Meluh, Pam B.; Keeling, Jacob; Meednu, Nida; Hoops, Harold J.; Miller, Rita K.

2012-01-01

Microtubules and microtubule-associated proteins are fundamental for multiple cellular processes, including mitosis and intracellular motility, but the factors that control microtubule-associated proteins (MAPs) are poorly understood. Here we show that two MAPs—the CLIP-170 homologue Bik1p and the Lis1 homologue Pac1p—interact with several proteins in the sumoylation pathway. Bik1p and Pac1p interact with Smt3p, the yeast SUMO; Ubc9p, an E2; and Nfi1p, an E3. Bik1p interacts directly with SUMO in vitro, and overexpression of Smt3p and Bik1p results in its in vivo sumoylation. Modified Pac1p is observed when the SUMO protease Ulp1p is inactivated. Both ubiquitin and Smt3p copurify with Pac1p. In contrast to ubiquitination, sumoylation does not directly tag the substrate for degradation. However, SUMO-targeted ubiquitin ligases (STUbLs) can recognize a sumoylated substrate and promote its degradation via ubiquitination and the proteasome. Both Pac1p and Bik1p interact with the STUbL Nis1p-Ris1p and the protease Wss1p. Strains deleted for RIS1 or WSS1 accumulate Pac1p conjugates. This suggests a novel model in which the abundance of these MAPs may be regulated via STUbLs. Pac1p modification is also altered by Kar9p and the dynein regulator She1p. This work has implications for the regulation of dynein's interaction with various cargoes, including its off-loading to the cortex. PMID:23034179

New trends in radiology workstation design

NASA Astrophysics Data System (ADS)

Moise, Adrian; Atkins, M. Stella

2002-05-01

In the radiology workstation design, the race for adding more features is now morphing into an iterative user centric design with the focus on ergonomics and usability. The extent of the list of features for the radiology workstation used to be one of the most significant factors for a Picture Archiving and Communication System (PACS) vendor's ability to sell the radiology workstation. Not anymore is now very much the same between the major players in the PACS market. How these features work together distinguishes different radiology workstations. Integration (with the PACS/Radiology Information System (RIS) systems, with the 3D tool, Reporting Tool etc.), usability (user specific preferences, advanced display protocols, smart activation of tools etc.) and efficiency (what is the output a radiologist can generate with the workstation) are now core factors for selecting a workstation. This paper discusses these new trends in radiology workstation design. We demonstrate the importance of the interaction between the PACS vendor (software engineers) and the customer (radiologists) during the radiology workstation design. We focus on iterative aspects of the workstation development, such as the presentation of early prototypes to as many representative users as possible during the software development cycle and present the results of a survey of 8 radiologists on designing a radiology workstation.

Cloning and expression profiling of the PacSnRK2 and PacPP2C gene families during fruit development, ABA treatment, and dehydration stress in sweet cherry.

PubMed

Shen, Xinjie; Guo, Xiao; Zhao, Di; Zhang, Qiang; Jiang, Yuzhuang; Wang, Yantao; Peng, Xiang; Wei, Yan; Zhai, Zefeng; Zhao, Wei; Li, Tianhong

2017-10-01

Plant SNF1-related protein kinase 2 (SnRK2) and protein phosphatase 2C (PP2C) family members are core components of the ABA signal transduction pathway. SnRK2 and PP2C proteins have been suggested to play crucial roles in fruit ripening and improving plant tolerance to drought stress, but supporting genetic information has been lacking in sweet cherry (Prunus avium L.). Here, we cloned six full-length SnRK2 genes and three full-length PP2C genes from sweet cherry cv. Hong Deng. Quantitative PCR analysis revealed that PacSnRK2.2, PacSnRK2.3, PacSnRK2.6, and PacPP2C1-3 were negatively regulated in fruits in response to exogenous ABA treatment, PacSnRK2.4 and PacSnRK2.5 were upregulated, and PacSnRK2.1 expression was not affected. The ABA treatment also significantly promoted the accumulation of anthocyanins in sweet cherry fruit. The expression of all PacSnRK2 and PacPP2C genes was induced by dehydration stress, which also promoted the accumulation of drought stress signaling molecules in the sweet cherry fruits, including ABA, soluble sugars, and anthocyanin. Furthermore, a yeast two-hybrid analysis demonstrated that PacPP2C1 interacts with all six PacSnRK2s, while PacPP2C3 does not interact with PacSnRK2.5. PacPP2C2 does not interact with PacSnRK2.1 or PacSnRK2.4. These results indicate that PacSnRK2s and PacPP2Cs may play a variety of roles in the sweet cherry ABA signaling pathway and the fruit response to drought stress. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Enterprise-class Digital Imaging and Communications in Medicine (DICOM) image infrastructure.

PubMed

York, G; Wortmann, J; Atanasiu, R

2001-06-01

Most current picture archiving and communication systems (PACS) are designed for a single department or a single modality. Few PACS installations have been deployed that support the needs of the hospital or the entire Integrated Delivery Network (IDN). The authors propose a new image management architecture that can support a large, distributed enterprise.

Analysis of PAC1 receptor gene variants in Caucasian and African American infants dying of sudden infant death syndrome.

PubMed

Barrett, Karlene T; Rodikova, Ekaterina; Weese-Mayer, Debra E; Rand, Casey M; Marazita, Mary L; Cooper, Margaret E; Berry-Kravis, Elizabeth M; Bech-Hansen, N Torben; Wilson, Richard J A

2013-12-01

Stress peptide, pituitary adenylate cyclase-activating polypeptide (PACAP), has been implicated in sudden infant death syndrome (SIDS). The aim of this exploratory study was to determine whether variants in the gene encoding the PACAP-specific receptor, PAC1, are associated with SIDS in Caucasian and African American infants. Polymerase chain reaction and Sanger DNA sequencing was used to compare variants in the 5'-untranslated region, exons and intron-exon boundaries of the PAC1 gene in 96 SIDS cases and 96 race- and gender-matched controls. The intron 3 variant, A/G: rs758995 (variant 'h'), and the intron 6 variant, C/T: rs10081254 (variant 'n'), were significantly associated with SIDS in Caucasians and African Americans, respectively (p < 0.05). Also associated with SIDS were interactions between the variants rs2302475 (variant 'i') in PAC1 and rs8192597 and rs2856966 in PACAP among Caucasians (p < 0.02) and rs2267734 (variant 'q') in PAC1 and rs1893154 in PACAP among African Americans (p < 0.01). However, none of these differences survived post hoc analysis. Overall, this study does not support a strong association between variants in the PAC1 gene and SIDS; however, a number of potential associations between race-specific variants and SIDS were identified that warrant targeted investigations in future studies. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Requirements for a documentation of the image manipulation processes within PACS

NASA Astrophysics Data System (ADS)

Retter, Klaus; Rienhoff, Otto; Karsten, Ch.; Prince, Hazel E.

1990-08-01

This paper discusses to which extent manipulation functions which have been applied to images handled in PACS should be documented. After postulating an increasing amount of postprocessing features on PACS-consoles, legal, educational and medical reasons for a documentation of image manipulation processes are presented. Besides legal necessities, aspects of storage capacity, response time, and potential uses determine the extent of this documentation. Is there a specific kind of manipulation functions which has to be documented generally? Should the physician decide which parts of the various pathways he tries are recorded by the system? To distinguish, for example, between reversible and irreversible functions or between interactive and non-interactive functions is one step towards a solution. Another step is to establish definitions for terms like "raw" and "final" image. The paper systematizes these questions and offers strategic help. The answers will have an important impact on PACS design and functionality.

Car accidents induced by a bottleneck

NASA Astrophysics Data System (ADS)

Marzoug, Rachid; Echab, Hicham; Ez-Zahraouy, Hamid

2017-12-01

Based on the Nagel-Schreckenberg model (NS) we study the probability of car accidents to occur (Pac) at the entrance of the merging part of two roads (i.e. junction). The simulation results show that the existence of non-cooperative drivers plays a chief role, where it increases the risk of collisions in the intermediate and high densities. Moreover, the impact of speed limit in the bottleneck (Vb) on the probability Pac is also studied. This impact depends strongly on the density, where, the increasing of Vb enhances Pac in the low densities. Meanwhile, it increases the road safety in the high densities. The phase diagram of the system is also constructed.

Ambient pH Controls Glycogen Levels by Regulating Glycogen Synthase Gene Expression in Neurospora crassa. New Insights into the pH Signaling Pathway

PubMed Central

Cupertino, Fernanda Barbosa; Freitas, Fernanda Zanolli; de Paula, Renato Magalhães; Bertolini, Maria Célia

2012-01-01

Glycogen is a polysaccharide widely distributed in microorganisms and animal cells and its metabolism is under intricate regulation. Its accumulation in a specific situation results from the balance between glycogen synthase and glycogen phosphorylase activities that control synthesis and degradation, respectively. These enzymes are highly regulated at transcriptional and post-translational levels. The existence of a DNA motif for the Aspergillus nidulans pH responsive transcription factor PacC in the promoter of the gene encoding glycogen synthase (gsn) in Neurospora crassa prompted us to investigate whether this transcription factor regulates glycogen accumulation. Transcription factors such as PacC in A. nidulans and Rim101p in Saccharomyces cerevisiae play a role in the signaling pathway that mediates adaptation to ambient pH by inducing the expression of alkaline genes and repressing acidic genes. We showed here that at pH 7.8 pacC was over-expressed and gsn was down-regulated in wild-type N. crassa coinciding with low glycogen accumulation. In the pacCKO strain the glycogen levels and gsn expression at alkaline pH were, respectively, similar to and higher than the wild-type strain at normal pH (5.8). These results characterize gsn as an acidic gene and suggest a regulatory role for PACC in gsn expression. The truncated recombinant protein, containing the DNA-binding domain specifically bound to a gsn DNA fragment containing the PacC motif. DNA-protein complexes were observed with extracts from cells grown at normal and alkaline pH and confirmed by ChIP-PCR analysis. The PACC present in these extracts showed equal molecular mass, indicating that the protein is already processed at normal pH, in contrast to A. nidulans. Together, these results show that the pH signaling pathway controls glycogen accumulation by regulating gsn expression and suggest the existence of a different mechanism for PACC activation in N. crassa. PMID:22952943

NASA Dryden Flight Research Center: Unmanned Aircraft Operations

NASA Technical Reports Server (NTRS)

Pestana, Mark

2010-01-01

This slide presentation reviews several topics related to operating unmanned aircraft in particular sharing aspects of unmanned aircraft from the perspective of a pilot. There is a section on the Global Hawk project which contains information about the first Global Hawk science mission, (i.e., Global Hawk Pacific (GloPac). Included in this information is GloPac science highlights, a listing of the GloPac Instruments. The second Global Hawk science mission was Genesis and Rapid Intensification Process (GRIP), for the NASA Hurricane Science Research Team. Information includes the instrumentation and the flights that were undertaken during the program. A section on Ikhana is next. This section includes views of the Ground Control Station (GCS), and a discussion of how the piloting of UAS is different from piloting in a manned aircraft. There is also discussion about displays and controls of aircraft. There is also discussion about what makes a pilot. The last section relates the use of Ikhana in the western states fire mission.

SCAR Radiologic Technologist Survey: analysis of the impact of digital technologies on productivity.

PubMed

Reiner, Bruce I; Siegel, Eliot L; Carrino, John A; Goldburgh, Mitchell M

2002-09-01

As medical reimbursements continue to decline, increasing financial pressures are placed upon medical imaging providers. This burden is exacerbated by the existing radiologic technologist (RT) crisis, which has caused RT salaries to trend upward. One strategy to address these trends is employing technology to improve technologist productivity. While industry-wide RT productivity benchmarks have been established for film-based operation, little to date has been published in the medical literature regarding similar productivity measures for filmless operation using PACS. This study was undertaken to document the complex relationship between technologist productivity and implementation of digital radiography and digital information technologies, including PACS and hospital/radiology information systems (HIS/RIS). A nationwide survey was conducted with 112 participating institutions, in varying degrees of digital technology implementation. Technologist productivity was defined as the number of annual exams performed per technologist full-time equivalent (FTE). Productivity analyses were performed among the different demographic and technology profile groups, with a focus on general radiography, which accounts for 65-70% of imaging department volumes. When evaluating the relationship between technologist productivity and digital technology implementation, improved productivity measures were observed for institutions implementing HIS/RIS, modality worklist, and PACS. The timing of PACS implementation was found to have a significant effect on technologist productivity measures, with an initial 10.8% drop in productivity during the first year of PACS implementation, followed by a 27.8% increase in productivity beyond year one. This suggests there is a "PACS learning curve" phenomenon, which should be considered when institutions are planning for PACS implementation.

Uptake of postabortion care services and acceptance of postabortion contraception in Puntland, Somalia.

PubMed

Chukwumalu, Kingsley; Gallagher, Meghan C; Baunach, Sabine; Cannon, Amy

2017-11-01

Unsafe abortion is responsible for at least 9% of all maternal deaths worldwide; however, in humanitarian emergencies where health systems are weak and reproductive health services are often unavailable or disrupted, this figure is higher. In Puntland, Somalia, Save the Children International (SCI) implemented postabortion care (PAC) services to address the issue of high maternal morbidity and mortality due to unsafe abortion. Abortion is explicitly permitted by Somali law to save the life of a woman, but remains a sensitive topic due to religious and social conservatism that exists in the region. Using a multipronged approach focusing on capacity building, assurance of supplies and infrastructure, and community collaboration and mobilisation, the demand for PAC services increased as did the proportion of women who adopted a method of family planning post-abortion. From January 2013 to December 2015, a total of 1111 clients received PAC services at the four SCI-supported health facilities. The number of PAC clients increased from a monthly average of 20 in 2013 to 38 in 2015. During the same period, 98% (1090) of PAC clients were counselled for postabortion contraception, of which 955 (88%) accepted a contraceptive method before leaving the facility, with 30% opting for long-acting reversible contraception. These results show that comprehensive PAC services can be implemented in politically unstable, culturally conservative settings where abortion and modern contraception are sensitive and stigmatised matters among communities, health workers, and policy makers. However, like all humanitarian settings, large unmet needs exist for PAC services in Somalia.

Effects of recirculation in a three-tank pilot-scale system for pharmaceutical removal with powdered activated carbon.

PubMed

Kårelid, Victor; Larsson, Gen; Björlenius, Berndt

2017-05-15

The removal of pharmaceutically active compounds by powdered activated carbon (PAC) in municipal wastewater is a promising solution to the problem of polluted recipient waters. Today, an efficient design strategy is however lacking with regard to high-level overall, and specific, substance removal in the large scale. The performance of PAC-based removal of pharmaceuticals was studied in pilot-scale with respect to the critical parameters; contact time and PAC dose using one PAC product selected by screening in bench-scale. The goal was a minimum of 95% removal of the pharmaceuticals present in the evaluated municipal wastewater. A set of 21 pharmaceuticals was selected from an initial 100 due to their high occurrence in the effluent water of two selected wastewater treatment plants (WWTPs) in Sweden, whereof candidates discussed for future EU regulation directives were included. By using recirculation of PAC over a treatment system using three sequential contact tanks, a combination of the benefits of powdered and granular carbon performance was achieved. The treatment system was designed so that recirculation could be introduced to any of the three tanks to investigate the effect of recirculation on the adsorption performance. This was compared to use of the setup, but without recirculation. A higher degree of pharmaceutical removal was achieved in all recirculation setups, both overall and with respect to specific substances, as compared to without recirculation. Recirculation was tested with nominal contact times of 30, 60 and 120 min and the goal of 95% removal could be achieved already at the shortest contact times at a PAC dose of 10-15 mg/L. In particular, the overall removal could be increased even to 97% and 99%, at 60 and 120 min, respectively, when the recirculation point was the first tank. Recirculation of PAC to either the first or the second contact tank proved to be comparable, while a slightly lower performance was observed with recirculation to the third tank. With regards to individual substances, clarithromycin and diclofenac were ubiquitously removed according to the set goal and in contrast, a few substances (fluconazole, irbesartan, memantine and venlafaxine) required specific settings to reach an acceptable removal. Copyright © 2017 Elsevier Ltd. All rights reserved.

Design of an image-distribution service from a clinical PACS

NASA Astrophysics Data System (ADS)

Gehring, Dale G.; Persons, Kenneth R.; Rothman, Melvyn L.; Felmlee, Joel P.; Gerhart, D. J.; Hangiandreou, Nicholas J.; Reardon, Frank J.; Shirk, M.; Forbes, Glenn S.; Williamson, Byrn, Jr.

1994-05-01

A PACS system has been developed through a multi-phase collaboration between the Mayo Clinic and IBM/Rochester. The current system has been fully integrated into the clinical practice of the Radiology Department for the primary purpose of digital image archival, retrieval, and networked workstation review. Work currently in progress includes the design and implementation of a gateway device for providing digital image data to third-party workstations, laser printers, and other devices, for users both within and outside of the Radiology Department.

Clinical challenges associated with incorporation of nonradiology images into the electronic medical record

NASA Astrophysics Data System (ADS)

Siegel, Eliot L.; Reiner, Bruce I.

2001-08-01

To date, the majority of Picture Archival and Communication Systems (PACS) have been utilized only for capture, storage, and display of radiology and in some cases, nuclear medicine images. Medical images for other subspecialty areas are currently stored in local, independent systems, which typically are not accessible throughout the healthcare enterprise and do not communicate with other hospital information or image management systems. It is likely that during the next few years, healthcare centers will expand PAC system capability to incorporate these multimedia data or alternatively, hospital-wide electronic patient record systems will be able to provide this function.

Ghrelin system in alcohol-dependent subjects: role of plasma ghrelin levels in alcohol drinking and craving

PubMed Central

Leggio, Lorenzo; Ferrulli, Anna; Cardone, Silvia; Nesci, Antonio; Miceli, Antonio; Malandrino, Noemi; Capristo, Esmeralda; Canestrelli, Benedetta; Monteleone, Palmiero; Kenna, George A.; Swift, Robert M.; Addolorato, Giovanni

2016-01-01

Animal studies suggest that the gut-brain peptide ghrelin plays an important role in the neurobiology of alcohol dependence (AD). Human studies show an effect of alcohol on ghrelin levels and a correlation between ghrelin levels and alcohol craving in alcoholics. This investigation consisted of two studies. Study 1 was a 12-week study with alcohol-dependent subjects, where plasma ghrelin determinations were assessed four times (T0-T3) and related to alcohol intake and craving [Penn Alcohol Craving Score (PACS) and Obsessive Compulsive Drinking Scale (OCDS)]. Serum growth hormone (GH) levels and assessment of the nutritional/metabolic status were also performed. Study 2 was a pilot case-control study to assess ghrelin gene polymorphisms (Arg51Gln and Leu72Met) in alcohol-dependent individuals. Study 1 showed no significant differences in ghrelin levels in the whole sample, while there was a statistical difference for ghrelin between non-abstinent and abstinent subjects. Baseline ghrelin levels were significantly and positively correlated with the PACS score at T1 and with all craving scores both at T2 and T3 (PACS, OCDS, obsessive and compulsive OCDS subscores). In Study 2, although there was a higher frequency of the Leu72Met ghrelin gene polymorphism in alcohol-dependent individuals, the distribution between healthy controls and alcohol dependent individuals was not statistically significant. This investigation suggests that ghrelin is potentially able to affect alcohol-seeking behaviors, such as alcohol drinking and craving, representing a new potential neuropharmacological target for AD. PMID:21392177

Ghrelin system in alcohol-dependent subjects: role of plasma ghrelin levels in alcohol drinking and craving.

PubMed

Leggio, Lorenzo; Ferrulli, Anna; Cardone, Silvia; Nesci, Antonio; Miceli, Antonio; Malandrino, Noemi; Capristo, Esmeralda; Canestrelli, Benedetta; Monteleone, Palmiero; Kenna, George A; Swift, Robert M; Addolorato, Giovanni

2012-03-01

Animal studies suggest that the gut-brain peptide ghrelin plays an important role in the neurobiology of alcohol dependence (AD). Human studies show an effect of alcohol on ghrelin levels and a correlation between ghrelin levels and alcohol craving in alcoholics. This investigation consisted of two studies. Study 1 was a 12-week study with alcohol-dependent subjects, where plasma ghrelin determinations were assessed four times (T0-T3) and related to alcohol intake and craving [Penn Alcohol Craving Score (PACS) and Obsessive Compulsive Drinking Scale (OCDS)]. Serum growth hormone levels and assessment of the nutritional/metabolic status were also performed. Study 2 was a pilot case-control study to assess ghrelin gene polymorphisms (Arg51Gln and Leu72Met) in alcohol-dependent individuals. Study 1 showed no significant differences in ghrelin levels in the whole sample, while there was a statistical difference for ghrelin between non-abstinent and abstinent subjects. Baseline ghrelin levels were significantly and positively correlated with the PACS score at T1 and with all craving scores both at T2 and T3 (PACS, OCDS, obsessive and compulsive OCDS subscores). In Study 2, although there was a higher frequency of the Leu72Met ghrelin gene polymorphism in alcohol-dependent individuals, the distribution between healthy controls and alcohol dependent individuals was not statistically significant. This investigation suggests that ghrelin is potentially able to affect alcohol-seeking behaviors, such as alcohol drinking and craving, representing a new potential neuropharmacological target for AD. © 2011 The Authors, Addiction Biology © 2011 Society for the Study of Addiction.

Physiological responses to cadmium stress in strawberry treated with pomegranate peel-activated carbon.

PubMed

Naderi, Somayeh; Gholami, Mahdiyeh; Baninasab, Bahram; Afyuni, Majid

2018-05-12

Many reports have already been published regarding the removal of heavy metals from aqueous solutions onto activated carbon. However, the biosorbents' effect on the plant response still needs further investigation. In this study, activated carbon derived from the pomegranate peel [pomegranate activated carbons (PAC)] was used to see the effects of the addition of PAC on growing strawberry in Cd-contaminated sand. Cd accumulation and toxicity to strawberry was investigated by measuring the concentration of Cd in plant tissues and various biochemical activities of plant. Our results suggested that PAC had a high sorption capacity for Cd. Strawberry plant tried to deal with the Cd-induced oxidative stress by strengthening its antioxidant competences and decreasing Cd absorption. In comparison with the control, PAC applied to the sand decreased the level of lipid peroxidation and enhanced the carotenoid content. The greater tolerance of strawberry toward the level of Cd due to the application of PAC was associated with improving the physical conditions of the soil, increasing the amounts of some essential elements and decreasing the level of Cd absorption. Gaviota strawberry cultivar exposed to 5 or 10 mg kg -1 Cd was able to adopt a new metabolic equilibrium, allowing the plant to cope with this metal.

Development of a Multi-Centre Clinical Trial Data Archiving and Analysis Platform for Functional Imaging

NASA Astrophysics Data System (ADS)

Driscoll, Brandon; Jaffray, David; Coolens, Catherine

2014-03-01

Purpose: To provide clinicians & researchers participating in multi-centre clinical trials with a central repository for large volume dynamic imaging data as well as a set of tools for providing end-to-end testing and image analysis standards of practice. Methods: There are three main pieces to the data archiving and analysis system; the PACS server, the data analysis computer(s) and the high-speed networks that connect them. Each clinical trial is anonymized using a customizable anonymizer and is stored on a PACS only accessible by AE title access control. The remote analysis station consists of a single virtual machine per trial running on a powerful PC supporting multiple simultaneous instances. Imaging data management and analysis is performed within ClearCanvas Workstation® using custom designed plug-ins for kinetic modelling (The DCE-Tool®), quality assurance (The DCE-QA Tool) and RECIST. Results: A framework has been set up currently serving seven clinical trials spanning five hospitals with three more trials to be added over the next six months. After initial rapid image transfer (+ 2 MB/s), all data analysis is done server side making it robust and rapid. This has provided the ability to perform computationally expensive operations such as voxel-wise kinetic modelling on very large data archives (+20 GB/50k images/patient) remotely with minimal end-user hardware. Conclusions: This system is currently in its proof of concept stage but has been used successfully to send and analyze data from remote hospitals. Next steps will involve scaling up the system with a more powerful PACS and multiple high powered analysis machines as well as adding real-time review capabilities.

User interface customization on Endoscopy Department Mini-PACS and its impact on examination workflow

NASA Astrophysics Data System (ADS)

Osada, Masakazu; Kaise, Mitsuru; Ozeki, Takeshi; Tsunakawa, Hirofumi; Tsunakawa, Kiyoshi; Takayanagi, Takashi; Suzuki, Nobuaki; Miwa, Jun; Ohta, Yasuhiko; Kanai, Koichi

1999-07-01

We have proposed a new user interface with workflow customization, implemented and evaluted in Endoscopy Department Mini-PACS that has been introduced and routinely used for two years at Toshiba General Hospital. We have set some task at endoscopy image acquisition units during examinations for two different types of user interfaces and compared performance. One is a command-button based operation using a remote control, and another is that with eight graphic buttons which are displayed on a CRT monitor and can be customized. Results of the two-year study show that mean number of input diagnosis codes per examination with graphic and customized interface is significantly greater than that with conventional interface. Also, mean time to complete one upper gastric endoscopy examination with new user interface is about 17 percent less than that with conventional interface. These result suggest that systems with the visualized and customized operation and feedback encourages physicians to use more functions and to compete tasks more efficiently than systems with conventional command-button based user interfaces.

Internationalization of healthcare applications: a generic approach for PACS workstations.

PubMed

Hussein, R; Engelmann, U; Schroeter, A; Meinzer, H P

2004-01-01

Along with the revolution of information technology and the increasing use of computers world-wide, software providers recognize the emerging need for internationalized, or global, software applications. The importance of internationalization comes from its benefits such as addressing a broader audience, making the software applications more accessible, easier to use, more flexible to support and providing users with more consistent information. In addition, some governmental agencies, e.g., in Spain, accept only fully localized software. Although the healthcare communication standards, namely, Digital Imaging and Communication in Medicine (DICOM) and Health Level Seven (HL7) support wide areas of internationalization, most of the implementers are still protective about supporting the complex languages. This paper describes a generic internationalization approach for Picture Archiving and Communication System (PACS) workstations. The Unicode standard is used to internationalize the application user interface. An encoding converter was developed to encode and decode the data between the rendering module (in Unicode encoding) and the DICOM data (in ISO 8859 encoding). An integration gateway was required to integrate the internationalized PACS components with the different PACS installations. To introduce a pragmatic example, the described approach was applied to the CHILI PACS workstation. The approach has enabled the application to handle the different internationalization aspects transparently, such as supporting complex languages, switching between different languages at runtime, and supporting multilingual clinical reports. In the healthcare enterprises, internationalized applications play an essential role in supporting a seamless flow of information between the heterogeneous multivendor information systems.

EST-PAC a web package for EST annotation and protein sequence prediction

PubMed Central

Strahm, Yvan; Powell, David; Lefèvre, Christophe

2006-01-01

With the decreasing cost of DNA sequencing technology and the vast diversity of biological resources, researchers increasingly face the basic challenge of annotating a larger number of expressed sequences tags (EST) from a variety of species. This typically consists of a series of repetitive tasks, which should be automated and easy to use. The results of these annotation tasks need to be stored and organized in a consistent way. All these operations should be self-installing, platform independent, easy to customize and amenable to using distributed bioinformatics resources available on the Internet. In order to address these issues, we present EST-PAC a web oriented multi-platform software package for expressed sequences tag (EST) annotation. EST-PAC provides a solution for the administration of EST and protein sequence annotations accessible through a web interface. Three aspects of EST annotation are automated: 1) searching local or remote biological databases for sequence similarities using Blast services, 2) predicting protein coding sequence from EST data and, 3) annotating predicted protein sequences with functional domain predictions. In practice, EST-PAC integrates the BLASTALL suite, EST-Scan2 and HMMER in a relational database system accessible through a simple web interface. EST-PAC also takes advantage of the relational database to allow consistent storage, powerful queries of results and, management of the annotation process. The system allows users to customize annotation strategies and provides an open-source data-management environment for research and education in bioinformatics. PMID:17147782

Synergic effects of renin and aldosterone on right ventricular function in hypertension: a tissue Doppler study.

PubMed

Gregori, Mario; Giammarioli, Benedetta; Tocci, Giuliano; Befani, Alberto; Ciavarella, Giuseppino Massimo; Ferrucci, Andrea; Paneni, Francesco

2015-12-01

Right ventricular dysfunction (RVD) is associated with poor cardiovascular outcome. The renin-angiotensin-aldosterone system is involved in alterations of the left ventricular geometry and function. Detrimental effects of the renin-angiotensin-aldosterone system on the right ventricular function are being postulated, but data supporting this assumption are still lacking. The aim of the study was to assess the impact of hyperreninemia, hyperaldosteronism or their combination on right ventricular function in hypertensive individuals. Plasma renin activity (PRA) and plasma aldosterone concentrations (PACs) were measured in 116 hypertensive patients, divided as follows: normal PRA and PAC (n = 38); high PRA and normal PAC (hypereninemia) (n = 26); normal PRA and high PAC (hyperaldosternism) (n = 27); high PRA and PAC (HRA) (n = 25). Echocardiographic evaluation of the left and right ventricles (RV), including tissue Doppler imaging, was performed. RVD was identified by tissue Doppler Imaging-derived Myocardial Performance Index, calculated with a multisegmental approach. Indices of the right ventricular structure and function, as well as the prevalence of RVD, were higher in hyperreninemia and hyperaldosternism groups as compared with the normal group, and a further increase was observed in the HRA patients. Regression models showed a similar risk of RVD in the hyperreninemia and hyperaldosternism patients, regardless of systemic and pulmonary pressure, as well as left ventricular dysfunction. Notably, patients with both hyperreninemia and hyperaldosternism exhibited the strongest association with RVD as compared with patients with only hyperreninemia or hyperaldosternism. Isolated hyperreninemia or hyperaldosternism determines a similar impairment of the right ventricular function, whereas their combination is further detrimental. Renin and aldosterone may represent early biomarkers of right ventricular dysfunction in hypertension.

Application of Computed Tomography Processed by Picture Archiving and Communication Systems in the Diagnosis of Acute Achilles Tendon Rupture

PubMed Central

Tian, Jing; Xie, Bing; Zhang, Hao

2016-01-01

The applications of CT examination in the diagnosis of the acute Achilles tendon rupture (AATR) were investigated. A total of 36 patients with suspected acute Achilles tendon rupture were tested using physical examination, ultrasound, and 3DCT scanning, respectively. Then, surgery was performed for the patients who showed positive result in at least two of the three tests for AATR. 3DVR, MPR, and the other CT scan image processing and diagnosis were conducted in PACS (picture archiving and communication system). PACS was also used to measure the length of distal broken ends of the Achilles tendon (AT) to tendon calcaneal insertion. Our study indicated that CT has the highest accuracy in diagnosis of acute Achilles tendon complete rupture. The length measurement is matched between PACS and those actually measured in operation. CT not only demonstrates more details directly in three dimensions especially with the rupture involved calcaneal insertion flap but also locates the rupture region for percutaneous suture by measuring the length of distal stump in PACS without the effect of the position of ankle. The accuracy of CT diagnosis for Achilles tendon partial rupture is yet to be studied. PMID:28078295

Automatically measuring brain ventricular volume within PACS using artificial intelligence.

PubMed

Yepes-Calderon, Fernando; Nelson, Marvin D; McComb, J Gordon

2018-01-01

The picture archiving and communications system (PACS) is currently the standard platform to manage medical images but lacks analytical capabilities. Staying within PACS, the authors have developed an automatic method to retrieve the medical data and access it at a voxel level, decrypted and uncompressed that allows analytical capabilities while not perturbing the system's daily operation. Additionally, the strategy is secure and vendor independent. Cerebral ventricular volume is important for the diagnosis and treatment of many neurological disorders. A significant change in ventricular volume is readily recognized, but subtle changes, especially over longer periods of time, may be difficult to discern. Clinical imaging protocols and parameters are often varied making it difficult to use a general solution with standard segmentation techniques. Presented is a segmentation strategy based on an algorithm that uses four features extracted from the medical images to create a statistical estimator capable of determining ventricular volume. When compared with manual segmentations, the correlation was 94% and holds promise for even better accuracy by incorporating the unlimited data available. The volume of any segmentable structure can be accurately determined utilizing the machine learning strategy presented and runs fully automatically within the PACS.

Investment alternative: the status quo or PACS?

NASA Astrophysics Data System (ADS)

Vanden Brink, John A.; Cywinski, Jozef K.

1990-08-01

While the cost of Picture Archiving and Communication Systems (PACS) can be substantial, the cost of continuing with present manual methods may become prohibitive in growing departments as the need for additional space and personnel (both technical and professional) to meet the increasing requirements for all image management activities continues to grow. This will occur simultaneously with increasing pressures on problems of the present system, i.e., lost films, lost revenues, delayed reporting and longer diagnostic cycle times. Present methods of image archiving communication and management i.e. the relationship of procedure volume to VFE requirements for professional and technical personnel, costs of film, film storage space, and other performance factors are analyzed based on the database created by the Technology Marketing Group (TMG) computerized cost analysis model applied to over 50 US hospitals. Also, the model is used to provide the projected cost of present methods of film management for an average US 400 +bed hospital based on ten year growth rate assumptions. TMG PACS Tracking data provides confirmation of staffmg pattern correlation to procedure volume. The data presented in the paper provides a basis for comparing the investment in maintaining the status quo to an investment in PACS.

Chronic stress increases pituitary adenylate cyclase-activating peptide (PACAP) and brain-derived neurotrophic factor (BDNF) mRNA expression in the bed nucleus of the stria terminalis (BNST): roles for PACAP in anxiety-like behavior

PubMed Central

Hammack, Sayamwong E.; Cheung, Joseph; Rhodes, Kimberly M.; Schutz, Kristin C.; Falls, William A.; Braas, Karen M.; May, Victor

2009-01-01

Exposure to chronic stress has been argued to produce maladaptive anxiety-like behavioral states, and many of the brain regions associated with stressor responding also mediate anxiety-like behavior. Pituitary adenylate cyclase activating polypeptide (PACAP) and its specific G protein-coupled PAC1 receptor have been associated with many of these stress- and anxiety-associated brain regions, and signaling via this peptidergic system may facilitate the neuroplasticity associated with pathological affective states. Here we investigated whether chronic stress increased transcript expression for PACAP, PAC1 receptor, brain-derived neurotrophic factor (BDNF), and tyrosine receptor kinase B (TrkB) in several nuclei. In rats exposed to a 7 day chronic variate stress paradigm, chronic stress enhanced baseline startle responding induced by handling and exposure to bright lights. Following chronic stress, quantitative transcript assessments of brain regions demonstrated dramatic increases in PACAP and PAC1 receptor, BDNF, and TrkB receptor mRNA expression selectively in the dorsal aspect of the anterolateral bed nucleus of the stria terminalis (dBNST). Related vasoactive intestinal peptide (VIP) and VPAC receptor, and other stress peptide transcript levels were not altered compared to controls. Moreover, acute PACAP38 infusion into the dBNST resulted in a robust dose-dependent anxiogenic response on baseline startle responding that persisted for 7 days. PACAP/PAC1 receptor signaling has established trophic functions and its coordinate effects with chronic stress-induced dBNST BDNF and TrkB transcript expression may underlie the maladaptive BNST remodeling and plasticity associated with anxiety-like behavior. PMID:19181454

Evaluation of peptide adsorption-controlled liquid chromatography-tandem mass spectrometric (PAC-LC-MS/MS) method for simple and simultaneous quantitation of amyloid β 1-38, 1-40, 1-42 and 1-43 peptides in dog cerebrospinal fluid.

PubMed

Goda, Ryoya; Kobayashi, Nobuhiro

2012-05-01

To evaluate the usefulness of the peptide adsorption-controlled liquid chromatography-tandem mass spectrometry (PAC-LC-MS/MS) for reproducible measurement of peptides in biological fluids, simultaneous quantitation of amyloid β 1-38, 1-40, 1-42 and 1-43 peptides (Aβ38, Aβ40, Aβ42 and Aβ43) in dog cerebrospinal fluid (CSF) was tried. Each stable isotope labeled Aβ was used as the internal standard to minimize the influence of CSF matrix on the reproducible Aβ quantitation. To reduce a loss of Aβ during the pretreatment procedures, the dog CSF diluted by water-acetic acid-methanol (2:6:1, v/v/v) was loaded on PAC-LC-MS/MS directly. Quantification of the Aβ in the diluted dog CSF was carried out using multiple reaction monitoring (MRM) mode. The [M+5H(5+)] and b(5+) ion fragment of each peptide were chosen as the precursor and product ions for MRM transitions of each peptide. The calibration curves were drawn from Aβ standard calibration solutions using PAC-LC-MS/MS. Analysis of dog CSF samples suggests that the basal concentration of Aβ38, Aβ40, Aβ42 and Aβ43 in dog CSF is approximately 300, 900, 200 and 30 pM, respectively. This is the first time Aβ concentrations in dog CSF have been reported. Additionally, the evaluation of intra- and inter-day reproducibility of analysis of Aβ standard solution, the freeze-thaw stability and the room temperature stability of Aβ standard solution suggest that the PAC-LC-MS/MS method enables reproducible Aβ quantitation. Copyright © 2012 Elsevier B.V. All rights reserved.

Competitiveness of endophytic Phialocephala fortinii s.l. - Acephala applanata strains in Norway spruce roots.

PubMed

Stroheker, Sophie; Dubach, Vivanne; Sieber, Thomas N

2018-05-01

Dark septate endophytes of the Phialocephala fortinii s.l. - Acephala applanata species complex (PAC) are presumed to be the most abundant root colonizing endophytes of conifers across the Northern hemisphere. To test the competitiveness of different PAC strains, PAC-free Picea abies saplings were inoculated with five different PAC strains by planting them in pre-colonized substrates. Saplings were left to grow for six weeks and then transplanted crosswise into a substrate colonized by one of the other four strains for a further two weeks. PAC were isolated and genotyped using microsatellite markers. The power of colonization, i.e. the ability of colonizing roots already colonized by another PAC strain, and the power of retention, i.e. the ability of a resident strain of not being suppressed by an invading PAC strain, were calculated for each strain in every combination. The experiment was run twice under two different climatic conditions. Our results show that PAC strains differ (1) in their ability to colonize PAC-free, non-sterile roots, (2) in resistance against being suppressed by another PAC strain and (3) in their ability to invade roots already colonized by another PAC strain. In addition, both the PAC-PAC and the PAC-host interactions depend on the climatic conditions. Copyright © 2018 British Mycological Society. Published by Elsevier Ltd. All rights reserved.

Image manipulation software portable on different hardware platforms: what is the cost?

NASA Astrophysics Data System (ADS)

Ligier, Yves; Ratib, Osman M.; Funk, Matthieu; Perrier, Rene; Girard, Christian; Logean, Marianne

1992-07-01

A hospital wide PACS project is currently under development at the University Hospital of Geneva. The visualization and manipulation of images provided by different imaging modalities constitutes one of the most challenging components of a PACS. Because there are different requirements depending on the clinical usage, it was necessary for such a visualization software to be provided on different types of workstations in different sectors of the PACS. The user interface has to be the same independently of the underlying workstation. Beside, in addition to a standard set of image manipulation and processing tools there is a need for more specific clinical tools that should be easily adapted to specific medical requirements. To achieve operating and windowing systems: the standard Unix/X-11/OSF-Motif based workstations and the Macintosh family and should be easily ported on other systems. This paper describes the design of such a system and discusses the extra cost and efforts involved in the development of a portable and easily expandable software.

Contamination control engineering design guidelines for the aerospace community

NASA Technical Reports Server (NTRS)

Tribble, A. C. (Principal Investigator); Boyadjian, B.; Davis, J.; Haffner, J.; McCullough, E.

1996-01-01

Thermal control surfaces, solar arrays, and optical devices may be adversely affected by a small quantity of molecular and/or particulate contamination. What is rarely discussed is how one: (1) quantifies the level of contamination that must be maintained in order for the system to function properly, and (2) enforces contamination control to ensure compliance with requirements. This document is designed to address these specific issues and is intended to serve as a handbook on contamination control for the reader, illustrating process and methodology while providing direction to more detailed references when needed. The effects of molecular contamination on reflecting and transmitting surfaces are examined and quantified in accordance with MIL STD 1246C. The generation, transportation, and deposition of molecular contamination is reviewed and specific examples are worked to illustrate the process a design engineer can use to estimate end of life cleanliness levels required by solar arrays, thermal control surfaces, and optical surfaces. A similar process is used to describe the effect of particulate contamination as related to percent area coverage (PAC) and bi-directional reflectance distribution function (BRDF). Relationships between PAC and surface cleanliness, which include the effects of submicron sized particles, are developed and BRDF is related to specific sensor design parameters such as Point Source Transmittance (PST). The pros and cons of various methods of preventing, monitoring, and cleaning surfaces are examined and discussed.

Superfine powdered activated carbon (S-PAC) coatings on microfiltration membranes: Effects of milling time on contaminant removal and flux.

PubMed

Amaral, Pauline; Partlan, Erin; Li, Mengfei; Lapolli, Flavio; Mefford, O Thompson; Karanfil, Tanju; Ladner, David A

2016-09-01

In microfiltration processes for drinking water treatment, one method of removing trace contaminants is to add powdered activated carbon (PAC). Recently, a version of PAC called superfine PAC (S-PAC) has been under development. S-PAC has a smaller particle size and thus faster adsorption kinetics than conventionally sized PAC. Membrane coating performance of various S-PAC samples was evaluated by measuring adsorption of atrazine, a model micropollutant. S-PACs were created in-house from PACs of three different materials: coal, wood, and coconut shell. Milling time was varied to produce S-PACs pulverized with different amounts of energy. These had different particles sizes, but other properties (e.g. oxygen content), also differed. In pure water the coal based S-PACs showed superior atrazine adsorption; all milled carbons had over 90% removal while the PAC had only 45% removal. With addition of calcium and/or NOM, removal rates decreased, but milled carbons still removed more atrazine than PAC. Oxygen content and specific external surface area (both of which increased with longer milling times) were the most significant predictors of atrazine removal. S-PAC coatings resulted in loss of filtration flux compared to an uncoated membrane and smaller particles caused more flux decline than larger particles; however, the data suggest that NOM fouling is still more of a concern than S-PAC fouling. The addition of calcium improved the flux, especially for the longer-milled carbons. Overall the data show that when milling S-PAC with different levels of energy there is a tradeoff: smaller particles adsorb contaminants better, but cause greater flux decline. Fortunately, an acceptable balance may be possible; for example, in these experiments the coal-based S-PAC after 30 min of milling achieved a fairly high atrazine removal (overall 80%) with a fairly low flux reduction (under 30%) even in the presence of NOM. This suggests that relatively short duration (low energy) milling is viable for creating useful S-PAC materials applied in tandem with microfiltration. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of acute ecotoxicity removal from industrial wastewater using a battery of rapid bioassays.

PubMed

Dries, Jan; Daens, Dominique; Geuens, Luc; Blust, Ronny

2014-01-01

The present study compares conventional wastewater treatment technologies (coagulation-flocculation and activated sludge) and powdered activated carbon (PAC) treatment for the removal of acute ecotoxicity from wastewater generated by tank truck cleaning (TTC) processes. Ecotoxicity was assessed with a battery of four commercially available rapid biological toxicity testing systems, verified by the US Environmental Protection Agency. Chemical coagulation-flocculation of raw TTC wastewater had no impact on the inhibition of the bioluminescence by Vibrio fischeri (BioTox assay). Subsequent biological treatment with activated sludge without PAC resulted in BioTox inhibition-free effluent (<10% inhibition). In contrast, activated sludge treatment without PAC produced an effluent that significantly inhibited (>50%) (i) the bioluminescence by Photobacterium leiognathi (ToxScreen³ test kit), (ii) the photosynthesis by the green algae Chlorella vulgaris (LuminoTox SAPS test kit), and (iii) the particle ingestion by the crustacean Thamnocephalus platyurus (Rapidtoxkit test kit). The lowest inhibition was measured after activated sludge treatment with the highest PAC dose (400 mg/L), demonstrating the effectiveness of PAC treatment for ecotoxicity removal from TTC wastewater. In conclusion, the combination of bioassays applied in the present study represents a promising test battery for rapid ecotoxicty assessment in wastewater treatment.

Impact and utilization studies of a PACS display station in an ICU setting

NASA Astrophysics Data System (ADS)

Andriole, Katherine P.; Storto, Maria L.; Gamsu, Gordon; Huang, H. K.

1996-05-01

An assessment of changes in health-care professional behavior as a result of the introduction of a PACS (picture archiving and communication system) display station to an adult medical- surgical intensive care unit (ICU) is investigated via pre- and post-PACs evaluations. ICU display station utilization and the impact on clinical operations are also examined. Parameters measured both pre- and post-PACS ICU display station placement include the number of films per patient day, the number of clinician reviews of a patient's images per day and the percentage of images on which the unit interacts with a radiologist. The elapsed times from the time of exposure to the time of: review by the referring physician, radiologist-unit interaction and clinical action based on image information are also measured. The results of this investigation suggest that the introduction of a PaCS display station in the ICU may reduce the number of exams per patient day, decrease the elapsed time from the time of exposure to the time of review by the unit clinician, and improve the time to clinical action. Note, however, that it does not appear to change the percentage of total images on which the unit interacts with a radiologist.

Digital processing of radiographic images from PACS to publishing.

PubMed

Christian, M E; Davidson, H C; Wiggins, R H; Berges, G; Cannon, G; Jackson, G; Chapman, B; Harnsberger, H R

2001-03-01

Several studies have addressed the implications of filmless radiologic imaging on telemedicine, diagnostic ability, and electronic teaching files. However, many publishers still require authors to submit hard-copy images for publication of articles and textbooks. This study compares the quality digital images directly exported from picture archive and communications systems (PACS) to images digitized from radiographic film. The authors evaluated the quality of publication-grade glossy photographs produced from digital radiographic images using 3 different methods: (1) film images digitized using a desktop scanner and then printed, (2) digital images obtained directly from PACS then printed, and (3) digital images obtained from PACS and processed to improve sharpness prior to printing. Twenty images were printed using each of the 3 different methods and rated for quality by 7 radiologists. The results were analyzed for statistically significant differences among the image sets. Subjective evaluations of the filmless images found them to be of equal or better quality than the digitized images. Direct electronic transfer of PACS images reduces the number of steps involved in creating publication-quality images as well as providing the means to produce high-quality radiographic images in a digital environment.

Impaired periamygdaloid-cortex prodynorphin is characteristic of opiate addiction and depression.

PubMed

Anderson, Sarah Ann R; Michaelides, Michael; Zarnegar, Parisa; Ren, Yanhua; Fagergren, Pernilla; Thanos, Panayotis K; Wang, Gene-Jack; Bannon, Michael; Neumaier, John F; Keller, Eva; Volkow, Nora D; Hurd, Yasmin L

2013-12-01

Negative affect is critical for conferring vulnerability to opiate addiction as reflected by the high comorbidity of opiate abuse with major depressive disorder (MDD). Rodent models implicate amygdala prodynorphin (Pdyn) as a mediator of negative affect; however, evidence of PDYN involvement in human negative affect is limited. Here, we found reduced PDYN mRNA expression in the postmortem human amygdala nucleus of the periamygdaloid cortex (PAC) in both heroin abusers and MDD subjects. Similar to humans, rats that chronically self-administered heroin had reduced Pdyn mRNA expression in the PAC at a time point associated with a negative affective state. Using the in vivo functional imaging technology DREAMM (DREADD-assisted metabolic mapping, where DREADD indicates designer receptors exclusively activated by designer drugs), we found that selective inhibition of Pdyn-expressing neurons in the rat PAC increased metabolic activity in the extended amygdala, which is a key substrate of the extrahypothalamic brain stress system. In parallel, PAC-specific Pdyn inhibition provoked negative affect-related physiological and behavioral changes. Altogether, our translational study supports a functional role for impaired Pdyn in the PAC in opiate abuse through activation of the stress and negative affect neurocircuitry implicated in addiction vulnerability.

EIR: enterprise imaging repository, an alternative imaging archiving and communication system.

PubMed

Bian, Jiang; Topaloglu, Umit; Lane, Cheryl

2009-01-01

The enormous number of studies performed at the Nuclear Medicine Department of University of Arkansas for Medical Sciences (UAMS) generates a huge amount PET/CT images daily. A DICOM workstation had been used as "mini-PACS" to route all studies, which is historically proven to be slow due to various reasons. However, replacing the workstation with a commercial PACS server is not only cost inefficient; and more often, the PACS vendors are reluctant to take responsibility for the final integration of these components. Therefore, in this paper, we propose an alternative imaging archiving and communication system called Enterprise Imaging Repository (EIR). EIR consists of two distinguished components: an image processing daemon and a user friendly web interface. EIR not only reduces the overall waiting time of transferring a study from the modalities to radiologists' workstations, but also provides a more preferable presentation.

Providing oceanographic data and information for Pacific Island communities

NASA Astrophysics Data System (ADS)

Potemra, James; Maurer, John; Burns, Echelle

2016-04-01

The Pacific Islands Ocean Observing System (PacIOOS; http://pacioos.org) is a data-serving group that relies on and promotes data interoperability. The PacIOOS "enterprise" is part of a large, US National effort aimed at providing information about the ocean environment to a wide range of users. These users range from casual beach-goers interested in the latest weather forecast or wave conditions to federal agencies responsible for public safety. In an effort to bridge the gap between the scientific community, who are responsible for making measurements and running forecast models, and the wide-ranging end-users, the data management group in PacIOOS has developed the infrastructure to host and distribute ocean-related data. The efficiency of this system has also allowed the group to build web-based tools to further help users. In this presentation we describe these efforts in more detail.

Optimizing physicians' instruction of PACS through e-learning: cognitive load theory applied.

PubMed

Devolder, P; Pynoo, B; Voet, T; Adang, L; Vercruysse, J; Duyck, P

2009-03-01

This article outlines the strategy used by our hospital to maximize the knowledge transfer to referring physicians on using a picture archiving and communication system (PACS). We developed an e-learning platform underpinned by the cognitive load theory (CLT) so that in depth knowledge of PACS' abilities becomes attainable regardless of the user's prior experience with computers. The application of the techniques proposed by CLT optimizes the learning of the new actions necessary to obtain and manipulate radiological images. The application of cognitive load reducing techniques is explained with several examples. We discuss the need to safeguard the physicians' main mental processes to keep the patient's interests in focus. A holistic adoption of CLT techniques both in teaching and in configuration of information systems could be adopted to attain this goal. An overview of the advantages of this instruction method is given both on the individual and organizational level.

Patriot Advanced Capability-3 (PAC-3)

DTIC Science & Technology

2013-12-01

attack than is possible with actuator -driven aerodynamic control surfaces alone. The Patriot system is deployed world-wide in defense of U.S. and...Start Complete Low Rate Initial Production .. Low Rate Initial Production .. Low Rate Production First D ... First Unit EQuipped IOT &E Start...MAR 2002 SEP 2001 IOT &E Start JAN 2002 JAN 2002 JUL 2002 JAN 2002 Complete SEP 2002 SEP 2002 MAR 2003 SEP 2002 Block 2002 Production Decision OCT

Wireless local area networking for linking a PC reporting system and PACS: clinical feasibility in emergency reporting.

PubMed

Yoshihiro, Akiko; Nakata, Norio; Harada, Junta; Tada, Shimpei

2002-01-01

Although local area networks (LANs) are commonplace in hospital-based radiology departments today, wireless LANs are still relatively unknown and untried. A linked wireless reporting system was developed to improve work throughput and efficiency. It allows radiologists, physicians, and technologists to review current radiology reports and images and instantly compare them with reports and images from previous examinations. This reporting system also facilitates creation of teaching files quickly, easily, and accurately. It consists of a Digital Imaging and Communications in Medicine 3.0-based picture archiving and communication system (PACS), a diagnostic report server, and portable laptop computers. The PACS interfaces with magnetic resonance imagers, computed tomographic scanners, and computed radiography equipment. The same kind of functionality is achievable with a wireless LAN as with a wired LAN, with comparable bandwidth but with less cabling infrastructure required. This wireless system is presently incorporated into the operations of the emergency and radiology departments, with future plans calling for applications in operating rooms, outpatient departments, all hospital wards, and intensive care units. No major problems have been encountered with the system, which is in constant use and appears to be quite successful. Copyright RSNA, 2002

Implementation of a departmental picture archiving and communication system: a productivity and cost analysis.

PubMed

Macyszyn, Luke; Lega, Brad; Bohman, Leif-Erik; Latefi, Ahmad; Smith, Michelle J; Malhotra, Neil R; Welch, William; Grady, Sean M

2013-09-01

Digital radiology enhances productivity and results in long-term cost savings. However, the viewing, storage, and sharing of outside imaging studies on compact discs at ambulatory offices and hospitals pose a number of unique challenges to a surgeon's efficiency and clinical workflow. To improve the efficiency and clinical workflow of an academic neurosurgical practice when evaluating patients with outside radiological studies. Open-source software and commercial hardware were used to design and implement a departmental picture archiving and communications system (PACS). The implementation of a departmental PACS system significantly improved productivity and enhanced collaboration in a variety of clinical settings. Using published data on the rate of information technology problems associated with outside studies on compact discs, this system produced a cost savings ranging from $6250 to $33600 and from $43200 to $72000 for 2 cohorts, urgent transfer and spine clinic patients, respectively, therefore justifying the costs of the system in less than a year. The implementation of a departmental PACS system using open-source software is straightforward and cost-effective and results in significant gains in surgeon productivity when evaluating patients with outside imaging studies.

Mapping Cd²⁺-induced membrane permeability changes of single live cells by means of scanning electrochemical microscopy.

PubMed

Filice, Fraser P; Li, Michelle S M; Henderson, Jeffrey D; Ding, Zhifeng

2016-02-18

Scanning Electrochemical Microscopy (SECM) is a powerful, non-invasive, analytical methodology that can be used to investigate live cell membrane permeability. Depth scan SECM imaging allowed for the generation of 2D current maps of live cells relative to electrode position in the x-z or y-z plane. Depending on resolution, one depth scan image can contain hundreds of probe approach curves (PACs). Individual PACs were obtained by simply extracting vertical cross-sections from the 2D image. These experimental PACs were overlaid onto theoretically generated PACs simulated at specific geometry conditions. Simulations were carried out using 3D models in COMSOL Multiphysics to determine the cell membrane permeability coefficients at different locations on the surface of the cells. Common in literature, theoretical PACs are generated using a 2D axially symmetric geometry. This saves on both compute time and memory utilization. However, due to symmetry limitations of the model, only one experimental PAC right above the cell can be matched with simulated PAC data. Full 3D models in this article were developed for the SECM system of live cells, allowing all experimental PACs over the entire cell to become usable. Cd(2+)-induced membrane permeability changes of single human bladder (T24) cells were investigated at several positions above the cell, displaced from the central axis. The experimental T24 cells under study were incubated with Cd(2+) in varying concentrations. It is experimentally observed that 50 and 100 μM Cd(2+) caused a decrease in membrane permeability, which was uniform across all locations over the cell regardless of Cd(2+) concentration. The Cd(2+) was found to have detrimental effects on the cell, with cells shrinking in size and volume, and the membrane permeability decreasing. A mapping technique for the analysis of the cell membrane permeability under the Cd(2+) stress is realized by the methodology presented. Copyright © 2016 Elsevier B.V. All rights reserved.

Intraplate shearing and basin deformation in the Pacific Plate as a result of the Yakutat Block collision with North America

NASA Astrophysics Data System (ADS)

Reece, R.; Gulick, S. P.; Christeson, G. L.; Worthington, L. L.

2009-12-01

The Yakutat Block (YAK), an allochthonous terrane coupled to the Pacific Plate (PAC), collided with the North American plate ~10Ma and began subducting at the Aleutian Trench. Due to its thickness, the YAK is resistant to subduction compared to the PAC. As a result, the YAK is undergoing flat-slab subduction and now has developed its own vector relative to the PAC. High-resolution bathymetry data shows a 30km N-S trending ridge within the Surveyor Fan between the mouths of the Yakutat Sea Valley and Bering Trough. The ridge originates in the north at the base of the continental slope, which is coincident with the Transition Fault, the strike-slip boundary between the YAK and the PAC. The ridge exhibits greatest relief adjacent to the Transition Fault, and becomes less distinct farther from the shelf edge. As the highest relief feature in this part of the basin, the ridge has completely redefined sediment distribution patterns within the Surveyor Fan. Seismic reflection data reveal a sharp basement high beneath the ridge (1.1 sec of relief above “normal” basement in two-way travel time) as well as multiple strike-slip fault systems that are also N-S oriented. The ridge, basement high, and faults are aligned and co-located with an intraplate earthquake swarm on the PAC, which includes four events > 6.5 Mw that occurred from 1987-1992. This earthquake swarm is defined by mostly right-lateral strike-slip events, and is known as the Gulf of Alaska Shear Zone (GASZ). Based on the extent of seismicity, the GASZ extends 230km into the PAC. Tearing of oceanic crust on this scale is rare. A recent wide-angle seismic study shows the YAK to be a 20-25km thick mafic body while the 30 Myr old Pacific crust in the northern Gulf of Alaska is of normal thickness. Intraplate deformation occurring within the PAC could be the result of PAC-YAK coupling whereby YAK resistance to subduction is expressed as deformation in the thinner (weaker) PAC crust. Although a large tear in normal oceanic crust is unusual, preexisting zones of weakness within the PAC crust that are proximal to and under stress from the YAK may have proven to be a kinematically favorable localization for strain. These results support a recently proposed tectonic model wherein the differing YAK and PAC vectors caused the northern PAC to split into two different blocks, separated by the GASZ. In this model, the eastern block of the PAC would exhibit a counter-clockwise rotation that accounts for motion along the Transition Fault and GASZ. We will analyze this intraplate deformation zone using seismic imaging, bathymetry, and magnetic data in order to examine the cause of the strain localization and its southern termination, the influence of this shear zone on the sedimentary history, and relationship with the PAC-YAK interplate deformation along the Transition Fault.

A Feasibility Study of Real-Time Remote CT Reading for Suspected Acute Appendicitis Using an iPhone.

PubMed

Kim, Changsun; Kang, Bossng; Choi, Hyuk Joong; Park, Joon Bum

2015-08-01

We aimed to evaluate the feasibility of an iPhone-based remote control system as a real-time remote computed tomography (CT) reading tool for suspected appendicitis using a third-generation (3G) network under suboptimal illumination. One hundred twenty abdominal CT scans were selected; 60 had no signs of appendicitis, whereas the remaining 60 had signs of appendicitis. The 16 raters reviewed the images using the liquid crystal display (LCD) monitor of a picture archiving and communication system (PACS) workstation, as well as using an iPhone connected to the PACS workstation via a remote control system. We graded the probability of the presence of acute appendicitis for each examination using a five-point Likert scale. The overall sensitivity and specificity for the diagnosis of suspected appendicitis using the iPhone and the LCD monitor were high, and they were not significantly different (sensitivity P = 1.00, specificity P = 0.14). The average areas under the receiver operating characteristic curves for all CT readings with the iPhone and LCD monitor were 0.978 (confidence interval 0.965-0.991) and 0.974 (0.960-0.988), respectively, and the two devices did not have significantly different diagnostic performances (P = 0.55). The inter-rater agreement for both devices was very good; the kappa value for the iPhone was 0.809 (0.793-0.826), and that for the LCD monitor was 0.817 (0.801-0.834). Each rater had moderate-to-very good intra-observer agreement between the two devices. We verified the feasibility of an iPhone-based remote control system as a real-time remote CT reading tool for identifying suspected appendicitis using a 3G network and suboptimal illumination.

[Study on antibacterial properties and osteoblast activity of antimicrobial peptide coatings on titanium implants].

PubMed

Sun, F Q; Li, M Q; Peng, S H; Zhang, H M; Liu, M; Qu, X Y

2018-06-09

Objective: To investigate the antibacterial property and biological activity of Ti dental implant with antimicrobial peptide Pac-525 coatings, and to study the effect of peptide Pac-525 coatings on Porphyromonas gingivalis 's antibacterial performance and osteoblast proliferation and adhesion. Methods: After ultrasonic micro arc oxidation, alkali treatment and silane treatment, forty-five pure titanium specimens were exposed to antibacterial peptide Pac-525 in different concentration (0.25, 0.50, 0.75 g/L). The titanium specimens in the control group were only treated with ultrasonic micro arc oxidation, alkali treatment and silane treatment. The morphologies of coatings were observed by scanning electron microscope (SEM), and the element changes were detected by energy spectrum analyzer. Orange acridine-ethidium bromide double staining was used to detect the average percentage of live bacteria and biofilm thickness, after the specimens in each group and Porphyromonas gingivalis were co-cultured for 72 hours. Cell counting Kit-8 method and immunofluorescence staining were used to test the proliferation of osteoblasts, the number and growth morphologies of adherent cells, respectively. Results: SEM and energy spectrum analysis showed that the Pac-525 particles loaded on the surface of the coating, and the C and N elements in the Pac-525 coating group were significantly more than those in the control group. The average percentage of living bacteria in the control group, 0.25, 0.50 and 0.75 g/L antimicrobial peptides were 0.58%, 0.45%, 0.34% and 0.28%, respectively, and the difference between each group was statistically significant ( P< 0.05). The biofilm thickness of Porphyromonas gingivalis in 0.50 and 0.75 g/L antibacterial peptide group were (98.3±1.2) and (94.5±2.5) μm respectively, which were significantly less than those in control group and 0.25 g/L antibacterial peptide group [(117.6±1.5) and (118.0±1.3) μm] ( P< 0.05), respectively. The number of bone cell adhesion and proliferation of all antimicrobial peptides were significantly greater than those in the control group ( P< 0.05), and the cells stretched better. Conclusions: The antibacterial peptide coating of titanium implants could inhibit the formation of bacterial biofilm. It had good antibacterial properties and could promote the adhesion and proliferation of osteoblasts.

Functional characterization of a serine protease inhibitor modulated in the infection of the Aedes aegypti with dengue virus.

PubMed

Soares, Tatiane Sanches; Rodriguez Gonzalez, Boris Luis; Torquato, Ricardo José Soares; Lemos, Francisco Jose Alves; Costa-da-Silva, André L; Capurro Guimarães, Margareth de Lara; Tanaka, Aparecida Sadae

2018-01-01

During feeding with blood meal, female Aedes aegypti can transmit infectious agents, such as dengue, yellow fever, chikungunya and Zika viruses. Dengue virus causes human mortality in tropical regions of the world, and there is no specific treatment or vaccine with maximum efficiency being used for these infections. In the vector-virus interaction, the production of several molecules is modulated by both mosquitoes and invading agents. However, little information is available about these molecules in the Ae. aegypti mosquito during dengue infection. Inhibitors of the pacifastin family have been described to participate in the immune response of insects and Pac2 is the only gene of this family present in Ae. aegypti being then chosen for investigation. Pac2 was expressed in E. coli, purified and analyzed by mass spectrometry and SDS-PAGE. The Pac2 transcript was detected by qPCR, and its protein levels were assessed by Western blotting. The inhibitory activity of Pac2 was measured using its K i , IC 50 and zymography. Mosquito infections with DENV were introduced with the Brazilian ACS-46 DENV-2 strain propagated in C6/36 cells. In the present work, we showed that it is possibly involved in the interaction of the mosquitoes with the dengue virus. The Pac2 transcript was detected in larvae and in both the salivary gland and midgut of Ae. aegypti females, while the native protein was identified in females 3 h post-blood meal. Pac2 is a strong inhibitor of trypsin-like and thrombin-like proteases, which are present in 4th instar larvae midgut and females 24 h after blood meal. During DENV infection, up regulation of Pac2 expression occurs in the salivary gland and midgut. Pac2 is the first Pacifastin inhibitor member described in mosquitoes. Our results suggest that Pac2 acts on mosquito serine proteases, mainly the trypsin-like type, and is under transcriptional control by virus infection signals to allow its survival in the vector or by the mosquito as a defense mechanism against virus infection. Copyright © 2017 Elsevier B.V. and Société Française de Biochimie et Biologie Moléculaire (SFBBM). All rights reserved.

NASA Flight Operations of Ikhana and Global Hawk

NASA Technical Reports Server (NTRS)

Posada, Herman D.

2009-01-01

This viewgraph presentation reviews the flight operations of Ikhana and Global Hawk Fire missions. The Ikhana fire missions modifications, ground systems, flight operations, range safety zones, primary and secondary emergency landing sites, and the Ikhana western states fire missions of 2007 are described, along with The Global Hawk specs, a description of the Global Hawk Pacific Science Campaign (GloPac '09) and GloPac payloads.

Assessing task-technology fit in a PACS upgrade: do users' and developers' appraisals converge?

PubMed

Lepanto, Luigi; Sicotte, Claude; Lehoux, Pascale

2011-12-01

The purpose of this study was to measure users' perceived benefits of a picture archiving and communication system (PACS) upgrade, and compare their responses to those predicted by developers. The Task-Technology Fit (TTF) model served as the theoretical framework to study the relation between TTF, utilization, and perceived benefits. A self-administered survey was distributed to radiologists working in a university hospital undergoing a PACS upgrade. Four variables were measured: impact, utilization, TTF, and perceived net benefits. The radiologists were divided into subgroups according to their utilization profiles. Analysis of variance was performed and the hypotheses were tested with regression analysis. Interviews were conducted with developers involved in the PACS upgrade who were asked to predict impact and TTF. Users identified only a moderate fit between the PACS enhancements and their tasks, while developers predicted a high level of TTF. The combination of a moderate fit and an underestimation of the potential impact of changes in the PACS led to a low score for perceived net benefits. Results varied significantly among user subgroups. Globally, the data support the hypotheses that TTF predicts utilization and perceived net benefits, but not that utilization predicts perceived net benefits. TTF is a valid tool to assess perceived benefits, but it is important to take into account the characteristics of users. In the context of a technology that is rapidly evolving, there needs to be an alignment of what users perceive as a good fit and the functionality developers incorporate into their products.

Urological diagnosis using clinical PACS

NASA Astrophysics Data System (ADS)

Mills, Stephen F.; Spetz, Kevin S.; Dwyer, Samuel J., III

1995-05-01

Urological diagnosis using fluoroscopy images has traditionally been performed using radiographic films. Images are generally acquired in conjunction with the application of a contrast agent, processed to create analog films, and inspected to ensure satisfactory image quality prior to being provided to a radiologist for reading. In the case of errors the entire process must be repeated. In addition, the radiologist must then often go to a particular reading room, possibly in a remote part of the healthcare facility, to read the images. The integration of digital fluoroscopy modalities with clinical PACS has the potential to significantly improve the urological diagnosis process by providing high-speed access to images at a variety of locations within a healthcare facility without costly film processing. The PACS additionally provides a cost-effective and reliable means of long-term storage and allows several medical users to simultaneously view the same images at different locations. The installation of a digital data interface between the existing clinically operational PACS at the University of Virginia Health Sciences Center and a digital urology fluoroscope is described. Preliminary user interviews that have been conducted to determine the clinical effectiveness of PACS workstations for urological diagnosis are discussed. The specific suitability of the workstation medium is discussed, as are overall advantages and disadvantages of the hardcopy and softcopy media in terms of efficiency, timeliness and cost. Throughput metrics and some specific parameters of gray-scale viewing stations and the expected system impacts resulting from the integration of a urology fluoroscope with PACS are also discussed.

User acceptance of a picture archiving and communication system. Applying the unified theory of acceptance and use of technology in a radiological setting.

PubMed

Duyck, P; Pynoo, B; Devolder, P; Voet, T; Adang, L; Vercruysse, J

2008-01-01

The aim of this study is to gain insight into the individual user acceptance of PACS by the radiology department staff of the Ghent University Hospital. Hereto a basic--direct effects only--form of UTAUT was assessed. Ninety-four questionnaires were distributed and 56 usable questionnaires were returned (19 radiologists - 37 technologists). The questionnaire consisted of scales of Venkatesh et al. [13] for performance expectancy (PE), effort expectancy (EE), facilitating conditions (FC), social influence (SI), self-efficacy (SE), attitude (ATT), anxiety (ANX) and behavioral intention (BI), and a scale of Moore et al. [22] to assess the perceived voluntariness of PACS-use. The reliability of all scales, except FC and voluntariness, was acceptable to good. The voluntariness scale was divided into a mandatoriness (MAN) and a voluntariness (VOL) measure. Both radiologists and technologists seem to welcome PACS, with radiologists having higher ratings on PE, EE, ATT, VOL and BI. Only PE and FC were salient for predicting BI, while EE and SI were not salient. Variance explained in behavioral intention to use PACS was 48%. Both radiologists and technologists were positive towards PACS and had strong intentions to use PACS. As other healthcare professionals, they appear to make their technology acceptance decision independent from their superiors, hereby focusing on usefulness rather than on ease of use. It is also important that support is supplied. Basic UTAUT is an adequate model to assess technology acceptance in a radiological setting.

Integration of a clinical trial database with a PACS

NASA Astrophysics Data System (ADS)

van Herk, M.

2014-03-01

Many clinical trials use Electronic Case Report Forms (ECRF), e.g., from OpenClinica. Trial data is augmented if DICOM scans, dose cubes, etc. from the Picture Archiving and Communication System (PACS) are included for data mining. Unfortunately, there is as yet no structured way to collect DICOM objects in trial databases. In this paper, we obtain a tight integration of ECRF and PACS using open source software. Methods: DICOM identifiers for selected images/series/studies are stored in associated ECRF events (e.g., baseline) as follows: 1) JavaScript added to OpenClinica communicates using HTML with a gateway server inside the hospitals firewall; 2) On this gateway, an open source DICOM server runs scripts to query and select the data, returning anonymized identifiers; 3) The scripts then collects, anonymizes, zips and transmits selected data to a central trial server; 4) Here data is stored in a DICOM archive which allows authorized ECRF users to view and download the anonymous images associated with each event. Results: All integration scripts are open source. The PACS administrator configures the anonymization script and decides to use the gateway in passive (receiving) mode or in an active mode going out to the PACS to gather data. Our ECRF centric approach supports automatic data mining by iterating over the cases in the ECRF database, providing the identifiers to load images and the clinical data to correlate with image analysis results. Conclusions: Using open source software and web technology, a tight integration has been achieved between PACS and ECRF.

NASA Spacecraft Sees 'Pac-Man' on Saturn Moon

NASA Image and Video Library

2017-12-08

NASA release date March 29, 2010 The highest-resolution-yet temperature map and images of Saturn’s icy moon Mimas obtained by NASA’s Cassini spacecraft reveal surprising patterns on the surface of the small moon, including unexpected hot regions that resemble “Pac-Man” eating a dot, and striking bands of light and dark in crater walls. The left portion of this image shows Mimas in visible light, an image that has drawn comparisons to the "Star Wars" Death Star. The right portion shows the new temperature map, which resembles 1980s video game icon "Pac Man." To learn more about this image go to: www.nasa.gov/centers/goddard/news/features/2010/pac-man-m... Credit: NASA/JPL/Goddard/SWRI/SSI NASA Goddard Space Flight Center is home to the nation's largest organization of combined scientists, engineers and technologists that build spacecraft, instruments and new technology to study the Earth, the sun, our solar system, and the universe.

Hospital to Post-Acute Care Facility Transfers: Identifying Targets for Information Exchange Quality Improvement.

PubMed

Jones, Christine D; Cumbler, Ethan; Honigman, Benjamin; Burke, Robert E; Boxer, Rebecca S; Levy, Cari; Coleman, Eric A; Wald, Heidi L

2017-01-01

Information exchange is critical to high-quality care transitions from hospitals to post-acute care (PAC) facilities. We conducted a survey to evaluate the completeness and timeliness of information transfer and communication between a tertiary-care academic hospital and its related PAC facilities. This was a cross-sectional Web-based 36-question survey of 110 PAC clinicians and staff representing 31 PAC facilities conducted between October and December 2013. We received responses from 71 of 110 individuals representing 29 of 31 facilities (65% and 94% response rates). We collapsed 4-point Likert responses into dichotomous variables to reflect completeness (sufficient vs insufficient) and timeliness (timely vs not timely) for information transfer and communication. Among respondents, 32% reported insufficient information about discharge medical conditions and management plan, and 83% reported at least occasionally encountering problems directly related to inadequate information from the hospital. Hospital clinician contact information was the most common insufficient domain. With respect to timeliness, 86% of respondents desired receipt of a discharge summary on or before the day of discharge, but only 58% reported receiving the summary within this time frame. Through free-text responses, several participants expressed the need for paper prescriptions for controlled pain medications to be sent with patients at the time of transfer. Staff and clinicians at PAC facilities perceive substantial deficits in content and timeliness of information exchange between the hospital and facilities. Such deficits are particularly relevant in the context of the increasing prevalence of bundled payments for care across settings as well as forthcoming readmissions penalties for PAC facilities. Targets identified for quality improvement include structuring discharge summary information to include information identified as deficient by respondents, completion of discharge summaries before discharge to PAC facilities, and provision of hard-copy opioid prescriptions at discharge. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Case studies on design, simulation and visualization of control and measurement applications using REX control system

NASA Astrophysics Data System (ADS)

Ozana, Stepan; Pies, Martin; Docekal, Tomas

2016-06-01

REX Control System is a professional advanced tool for design and implementation of complex control systems that belongs to softPLC category. It covers the entire process starting from simulation of functionality of the application before deployment, through implementation on real-time target, towards analysis, diagnostics and visualization. Basically it consists of two parts: the development tools and the runtime system. It is also compatible with Simulink environment, and the way of implementation of control algorithm is very similar. The control scheme is finally compiled (using RexDraw utility) and uploaded into a chosen real-time target (using RexView utility). There is a wide variety of hardware platforms and real-time operating systems supported by REX Control System such as for example Windows Embedded, Linux, Linux/Xenomai deployed on SBC, IPC, PAC, Raspberry Pi and others with many I/O interfaces. It is modern system designed both for measurement and control applications, offering a lot of additional functions concerning data archiving, visualization based on HTML5, and communication standards. The paper will sum up possibilities of its use in educational process, focused on control of case studies of physical models with classical and advanced control algorithms.

Enhanced cephalomedullary nail lag screw placement and intraoperative tip-apex distance measurement with a novel computer assisted surgery system.

PubMed

Kuhl, Mitchell; Beimel, Claudia

2016-10-01

The goal of this study was to evaluate the ability of a novel computer assisted surgery system to guide ideal placement of a lag screw during cephalomedullary nailing and then accurately measure the tip-apex distance (TAD) measurement intraoperatively. Retrospective case review. Level II trauma hospital. The initial 98 consecutive clinical cases treated with a cephalomedullary nail in conjunction with a novel computer assisted surgery system were retrospectively reviewed. A novel computer assisted surgery system was utilized to enhance lag screw placement during cephalomedullary nailing procedures. The computer assisted surgery system calculates the TAD intraoperatively after final lag screw placement. The ideal TAD was considered to be within a range of 5mm-20mm. The ability of the computer assisted surgery system (CASS) to assist in placement of a lag screw within the ideal TAD was evaluated. Intraoperative TAD measurements provided by the computer assisted surgery system were then compared to standard postoperative TAD measurements on PACS (picture archiving and communication system) images to determine whether these measurements are equivalent. 79 cases (80.6%) were available with complete information for a retrospective review. All cases had CASS TAD and PACS TAD measurements >5mm and<20mm. In addition, no significant difference could be detected between the intraoperative CASS TAD and the postoperative PACS TAD (p=0.374, Wilcoxon Test; p=0.174, paired T-Test). A cut-out rate of 0% was observed in all patients who were treated with CASS in this case series (95% CI: 0 - 3.01%). The novel computer assisted surgery system tested here is an effective and reliable adjunct that can be utilized for optimal lag screw placement in cephalomedullary nailing procedures. The computer assisted surgery system provides an accurate intraoperative TAD measurement that is equivalent to the standard postoperative measurement utilizing PACS images. Therapeutic Level IV. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Handbook for Title I Migrant Parent Advisory Councils: Understanding the System=Un Folleto Para los Concilios de Padres Titulo I Migrante: Entendiendo el Sistema.

ERIC Educational Resources Information Center

Arredondo, C.; And Others

A bilingual handbook for Title I migrant Parent Advisory Councils (PACs) was designed to be used by administrators, teachers, consultants and parents in organizing and training PACs at local, district, and state levels. All information is duplicated in separate English and Spanish sections. The first part discusses the Texas migrant program,…

Keynote Address: ACR-NEMA standards and their implications for teleradiology

NASA Astrophysics Data System (ADS)

Horii, Steven C.

1990-06-01

The ACR-NEMA Standard was developed initially as an interface standard for the interconnection of two pieces of imaging equipment Essentially the Standard defmes a point-to-point hardware connection with the necessary protocol and data structure so that two differing devices which meet the specification will be able to communicate with each other. The Standard does not defme a particular PACS architecture nor does it specify a database structure. In part these are the reasons why implementers have had difficulty in using the Standard in a full PACS. Recent activity of the Working Groups formed by the Committee overseeing work on the ACR-NEMA Standard has changed some of the " flavor" of the Standard. It was realized that connection of PACS with hospital and radiology information systems (HIS and RIS) is necessary if a PACS is ever to be succesful. The idea of interconnecting heterogeneous computer systems has pushed Standards development beyond the scope of the original work. Teleradiology which inherenfly involves wide-area networking may be a direct beneficiary of the new directions taken by the Standards Working Groups. This paper will give a brief history of the ACR-NEMA effort describe the " parent" Standard and its " offspring" and describe the activity of the current Working Groups with particular emphasis on the potential impacts on teleradiology.

Adsorption of p-nitrophenols (PNP) on microalgal biochar: Analysis of high adsorption capacity and mechanism.

PubMed

Zheng, Heshan; Guo, Wanqian; Li, Shuo; Chen, Yidi; Wu, Qinglian; Feng, Xiaochi; Yin, Renli; Ho, Shih-Hsin; Ren, Nanqi; Chang, Jo-Shu

2017-11-01

Biochars derived from three microalgal strains (namely, Chlorella sp. Cha-01, Chlamydomonas sp. Tai-03 and Coelastrum sp. Pte-15) were evaluated for their capacity to adsorb p-nitrophenols (PNP) using raw microalgal biomass and powdered activated carbon (PAC) as the control. The results show that BC-Cha-01 (biochar from Chlorella sp. Cha-01) exhibited a high PNP adsorption capacity of 204.8mgg -1 , which is 250% and 140% higher than that of its raw biomass and PAC, respectively. The adsorption kinetics and equilibrium are well described with pseudo-second-order equation and Freundlich model, respectively. BC-Cha-01 was found to contain higher polarity moieties with more O-containing functional groups than PAC and other microalgae-derived biochars. The strong polarity of binding sites on BC-Cha-01 may be responsible for its superior adsorption capacity. The biochars from Chlorella sp. Cha-01 seem to have the potential to serve as a highly efficient PNP adsorbent for wastewater treatment or emergency water pollution control. Copyright © 2017 Elsevier Ltd. All rights reserved.

Mild deficits in mice lacking pituitary adenylate cyclase-activating polypeptide receptor type 1 (PAC1) performing on memory tasks.

PubMed

Sauvage, M; Brabet, P; Holsboer, F; Bockaert, J; Steckler, T

2000-12-08

Pituitary adenylate cyclase-activating polypeptide (PACAP) and its receptor subtype 1 (PAC1) have been suggested to play a role in the modulation of learning and memory. However, behavioral evidence for altered mnemonic function due to altered PAC1 activity is missing. Therefore, the role of PAC1 in learning and memory was studied in mouse mutants lacking this receptor (PAC1 knock-out mice), tested in water maze two-choice spatial discrimination, one-trial contextual and cued fear conditioning, and multiple-session contextual discrimination. Water maze spatial discrimination was unaffected in PAC1 mutants, while a mild deficit was observed in multiple session contextual discrimination in PAC1 knock-out mice. Furthermore, PAC1 knock-out mice were able to learn the association between context and shock in one-trial contextual conditioning, but showed faster return to baseline than wild-type mice. Thus, the effects of PAC1 knock-out on modulating performance in these tasks were subtle and suggest that PAC1 only plays a limited role in learning and memory.

PACS/information systems interoperability using Enterprise Communication Framework.

PubMed

alSafadi, Y; Lord, W P; Mankovich, N J

1998-06-01

Interoperability among healthcare applications goes beyond connectivity to allow components to exchange structured information and work together in a predictable, coordinated fashion. To facilitate building an interoperability infrastructure, an Enterprise Communication Framework (ECF) was developed by the members of the Andover Working Group for Healthcare Interoperability (AWG-OHI). The ECF consists of four models: 1) Use Case Model, 2) Domain Information Model (DIM), 3) Interaction Model, and 4) Message Model. To realize this framework, a software component called the Enterprise Communicator (EC) is used. In this paper, we will demonstrate the use of the framework in interoperating a picture archiving and communication system (PACS) with a radiology information system (RIS).

Promoting the bio-cathode formation of a constructed wetland-microbial fuel cell by using powder activated carbon modified alum sludge in anode chamber

PubMed Central

Xu, Lei; Zhao, Yaqian; Doherty, Liam; Hu, Yuansheng; Hao, Xiaodi

2016-01-01

MFC centered hybrid technologies have attracted attention during the last few years due to their compatibility and dual advantages of energy recovery and wastewater treatment. In this study, a MFC was integrated into a dewatered alum sludge (DAS)- based vertical upflow constructed wetland (CW). Powder activate carbon (PAC) was used in the anode area in varied percentage with DAS to explore its influences on the performance of the CW-MFC system. The trial has demonstrated that the inclusion of PAC improved the removal efficiencies of COD, TN and RP. More significantly, increasing the proportion of PAC from 2% to 10% can significantly enhance the maximum power densities from 36.58 mW/m2 to 87.79 mW/m2. The induced favorable environment for bio-cathode formation might be the main reason for this improvement since the content of total extracellular polymeric substances (TEPS) of the substrate in the cathode area almost doubled (from 44.59 μg/g wet sludge to 87.70 μg/g wet sludge) as the percentage of PAC increased to 10%. This work provides another potential usage of PAC in CW-MFCs with a higher wastewater treatment efficiency and energy recovery. PMID:27197845

Development of Cryogenic Filter Wheels for the HERSCHEL Photodetector Array Camera & Spectrometer (PACS)

NASA Technical Reports Server (NTRS)

Koerner, Christian; Kampf, Dirk; Poglitsch, Albrecht; Schubert, Josef; Ruppert, U.; Schoele, M.

2014-01-01

This paper describes the two PACS Filter Wheels that are direct-drive rotational mechanisms operated at a temperature below 5K inside the PACS focal plane unit of the Herschel Satellite. The purpose of the mechanisms is to switch between filters. The rotation axis is pivoted to the support structure via a slightly preloaded pair of ball bearings and driven by a Cryotorquer. Position sensing is realized by a pair of Hall effect sensors. Powerless positioning at the filter positions is achieved by a magnetic ratchet system. The key technologies are the Cryotorquer design and the magnetic ratchet design in the low temperature range. Furthermore, we will report on lessons learned during the development and qualification of the mechanism and the paint.

Altered Circadian Food Anticipatory Activity Rhythms in PACAP Receptor 1 (PAC1) Deficient Mice

PubMed Central

Hannibal, Jens; Georg, Birgitte; Fahrenkrug, Jan

2016-01-01

Light signals from intrinsically photosensitive retinal ganglion cells (ipRGCs) entrain the circadian clock and regulate negative masking. Two neurotransmitters, glutamate and Pituitary Adenylate Cyclase Activating Polypeptide (PACAP), found in the ipRGCs transmit light signals to the brain via glutamate receptors and the specific PACAP type 1 (PAC1) receptor. Light entrainment occurs during the twilight zones and has little effect on clock phase during daytime. When nocturnal animals have access to food only for a few hours during the resting phase at daytime, they adapt behavior to the restricted feeding (RF) paradigm and show food anticipatory activity (FAA). A recent study in mice and rats demonstrating that light regulates FAA prompted us to investigate the role of PACAP/PAC1 signaling in the light mediated regulation of FAA. PAC1 receptor knock out (PAC1-/-) and wild type (PAC1+/+) mice placed in running wheels were examined in a full photoperiod (FPP) of 12:12 h light/dark (LD) and a skeleton photoperiod (SPP) 1:11:1:11 h L:DD:L:DD at 300 and 10 lux light intensity. Both PAC1-/- mice and PAC1+/+ littermates entrained to FPP and SPP at both light intensities. However, when placed in RF with access to food for 4–5 h during the subjective day, a significant change in behavior was observed in PAC1-/- mice compared to PAC1+/+ mice. While PAC1-/- mice showed similar FAA as PAC1+/+ animals in FPP at 300 lux, PAC1-/- mice demonstrated an advanced onset of FAA with a nearly 3-fold increase in amplitude compared to PAC1+/+ mice when placed in SPP at 300 lux. The same pattern of FAA was observed at 10 lux during both FPP and SPP. The present study indicates a role of PACAP/PAC1 signaling during light regulated FAA. Most likely, PACAP found in ipRGCs mediating non-image forming light information to the brain is involved. PMID:26757053

Altered Circadian Food Anticipatory Activity Rhythms in PACAP Receptor 1 (PAC1) Deficient Mice.

PubMed

Hannibal, Jens; Georg, Birgitte; Fahrenkrug, Jan

2016-01-01

Light signals from intrinsically photosensitive retinal ganglion cells (ipRGCs) entrain the circadian clock and regulate negative masking. Two neurotransmitters, glutamate and Pituitary Adenylate Cyclase Activating Polypeptide (PACAP), found in the ipRGCs transmit light signals to the brain via glutamate receptors and the specific PACAP type 1 (PAC1) receptor. Light entrainment occurs during the twilight zones and has little effect on clock phase during daytime. When nocturnal animals have access to food only for a few hours during the resting phase at daytime, they adapt behavior to the restricted feeding (RF) paradigm and show food anticipatory activity (FAA). A recent study in mice and rats demonstrating that light regulates FAA prompted us to investigate the role of PACAP/PAC1 signaling in the light mediated regulation of FAA. PAC1 receptor knock out (PAC1-/-) and wild type (PAC1+/+) mice placed in running wheels were examined in a full photoperiod (FPP) of 12:12 h light/dark (LD) and a skeleton photoperiod (SPP) 1:11:1:11 h L:DD:L:DD at 300 and 10 lux light intensity. Both PAC1-/- mice and PAC1+/+ littermates entrained to FPP and SPP at both light intensities. However, when placed in RF with access to food for 4-5 h during the subjective day, a significant change in behavior was observed in PAC1-/- mice compared to PAC1+/+ mice. While PAC1-/- mice showed similar FAA as PAC1+/+ animals in FPP at 300 lux, PAC1-/- mice demonstrated an advanced onset of FAA with a nearly 3-fold increase in amplitude compared to PAC1+/+ mice when placed in SPP at 300 lux. The same pattern of FAA was observed at 10 lux during both FPP and SPP. The present study indicates a role of PACAP/PAC1 signaling during light regulated FAA. Most likely, PACAP found in ipRGCs mediating non-image forming light information to the brain is involved.

Neuroprotective effects of three different sizes nanochelating based nano complexes in MPP(+) induced neurotoxicity.

PubMed

Maghsoudi, Amirhossein; Fakharzadeh, Saideh; Hafizi, Maryam; Abbasi, Maryam; Kohram, Fatemeh; Sardab, Shima; Tahzibi, Abbas; Kalanaky, Somayeh; Nazaran, Mohammad Hassan

2015-03-01

Parkinson's disease (PD) is the world's second most common dementia, which the drugs available for its treatment have not had effects beyond slowing the disease process. Recently nanotechnology has induced the chance for designing and manufacturing new medicines for neurodegenerative disease. It is demonstrated that by tuning the size of a nanoparticle, the physiological effect of the nanoparticle can be controlled. Using novel nanochelating technology, three nano complexes: Pas (150 nm), Paf (100 nm) and Pac (40 nm) were designed and in the present study their neuroprotective effects were evaluated in PC12 cells treated with 1-methyl-4-phenyl-pyridine ion (MPP (+)). PC12 cells were pre-treated with the Pas, Paf or Pac nano complexes, then they were subjected to 10 μM MPP (+). Subsequently, cell viability, intracellular free Calcium and reactive oxygen species (ROS) levels, mitochondrial membrane potential, catalase (CAT) and superoxide dismutase (SOD) activity, Glutathione (GSH) and malondialdehyde (MDA) levels and Caspase 3 expression were evaluated. All three nano complexes, especially Pac, were able to increase cell viability, SOD and CAT activity, decreased Caspase 3 expression and prevented the generation of ROS and the loss of mitochondrial membrane potential caused by MPP(+). Pre-treatment with Pac and Paf nano complexes lead to a decrease of intracellular free Calcium, but Pas nano complex could not decrease it. Only Pac nano complex decreased MDA levels and other nano complexes could not change this parameter compared to MPP(+) treated cells. Hence according to the results, all nanochelating based nano complexes induced neuroprotective effects in an experimental model of PD, but the smallest nano complex, Pac, showed the best results.

Renin-angiotensin-aldosterone system activity in hyperthyroid cats with and without concurrent hypertension.

PubMed

Williams, T L; Elliott, J; Syme, H M

2013-01-01

Hypertension is present in some hyperthyroid cats at diagnosis or can develop after treatment for hyperthyroidism. Activation of the renin-angiotensin-aldosterone system (RAAS) could be involved in the pathogenesis of hypertension. Hyperthyroid cats that develop hypertension before or after treatment for hyperthyroidism will have greater RAAS activation than normotensive cats. Ninety-nine hyperthyroid cats. Retrospective case-control study. Plasma renin activity (PRA) and plasma aldosterone concentration (PAC) were measured in untreated hyperthyroid hypertensive cats (HT-Pre group), initially normotensive hyperthyroid cats that develop hypertension after treatment (HT-Post group), and hyperthyroid cats that are normotensive (NT group). Data are presented as median [25th, 75th percentile]. Baseline PRA was not significantly different among the 3 groups (HT-Pre group 1.50 [0.05, 2.37] ng/mL/h, HT-Post group 0.66 [0.17, 2.31] ng/mL/h, NT group 1.11 [0.57, 2.18] ng/mL/h; P = .44). PRA decreased significantly after treatment in the NT group (1.09 [0.53, 2.47] versus 0.22 [0.05, 0.76] ng/mL/h; P < .001) and the HT-Post group (0.71 [0.17, 2.33] versus 0.28 [0.07, 0.57] ng/mL/h; P = .006). Baseline PAC was not significantly different among the 3 groups (HT-Pre group 72.2 [40.0, 145.6] pg/mL, HT-Post group 69.7 [43.3, 142.6] pg/mL, NT group 109.0 [68.2, 184.6] pg/mL; P = .10). PAC decreased significantly after treatment in the NT group (114.4 [56.6, 204.1] versus 59.5 [32.4, 98.2] pg/mL; P < .001) but did not change significantly in the HT-Post group (61.2 [44.9, 124.0] versus 58.4 [42.0, 97.7] pg/mL; P = .59). RAAS activation occurs in hyperthyroid cats, but is not associated with the development of hypertension. PAC is not influenced by changes in PRA in hyperthyroid cats that develop hypertension after treatment, perhaps indicating RAAS dysfunction in these cats. Copyright © 2013 by the American College of Veterinary Internal Medicine.

Medical imaging, PACS, and imaging informatics: retrospective.

PubMed

Huang, H K

2014-01-01

Historical reviews of PACS (picture archiving and communication system) and imaging informatics development from different points of view have been published in the past (Huang in Euro J Radiol 78:163-176, 2011; Lemke in Euro J Radiol 78:177-183, 2011; Inamura and Jong in Euro J Radiol 78:184-189, 2011). This retrospective attempts to look at the topic from a different angle by identifying certain basic medical imaging inventions in the 1960s and 1970s which had conceptually defined basic components of PACS guiding its course of development in the 1980s and 1990s, as well as subsequent imaging informatics research in the 2000s. In medical imaging, the emphasis was on the innovations at Georgetown University in Washington, DC, in the 1960s and 1970s. During the 1980s and 1990s, research and training support from US government agencies and public and private medical imaging manufacturers became available for training of young talents in biomedical physics and for developing the key components required for PACS development. In the 2000s, computer hardware and software as well as communication networks advanced by leaps and bounds, opening the door for medical imaging informatics to flourish. Because many key components required for the PACS operation were developed by the UCLA PACS Team and its collaborative partners in the 1980s, this presentation is centered on that aspect. During this period, substantial collaborative research efforts by many individual teams in the US and in Japan were highlighted. Credits are due particularly to the Pattern Recognition Laboratory at Georgetown University, and the computed radiography (CR) development at the Fuji Electric Corp. in collaboration with Stanford University in the 1970s; the Image Processing Laboratory at UCLA in the 1980s-1990s; as well as the early PACS development at the Hokkaido University, Sapporo, Japan, in the late 1970s, and film scanner and digital radiography developed by Konishiroku Photo Ind. Co. Ltd. (Konica-Minolta), Japan, in the 1980-1990s. Major support from the US National Institutes of Health and other federal agencies and private medical imaging industry are appreciated. The NATO (North Atlantic Treaty Organization) Advanced Study Institute (ASI) sponsored the International PACS Conference at Evian, France, in 1990, the contents and presentations of which convinced a half dozen high-level US military healthcare personnel, including surgeons and radiologists, that PACS was feasible and would greatly streamline the current military healthcare services. The impact of the post-conference summary by these individuals to their superiors opened the doors for long-term support of PACS development by the US Military Healthcare Services. PACS and imaging informatics have thus emerged as a daily clinical necessity.

[The heart catheter table is not the operating table : Intraindividual comparison of pulmonary artery pressures].

PubMed

Ziegler, M U; Reinelt, H

2018-05-01

Patients undergoing cardiac surgery need extensive and invasive monitoring, which needs to be individually adapted for each patient and requires a diligent risk-benefit analysis. The use of a pulmonary artery catheter (PAC) seems to be justifiable in certain cases; therefore, the preoperative diagnosis of pulmonary hypertension represents an indication for perioperative monitoring with PAC in the S3 guidelines of the German Society for Anesthesiology and Intensive Care Medicine (DGAI). In many cases, however, this preoperative diagnosis cannot be confirmed intraoperatively. We wanted to find out whether this is just an impression or whether there actually are significant differences between preoperative, intraoperative and postoperative pulmonary artery pressures. After obtaining ethical approval, we retrospectively compared the pulmonary pressures of cardiac surgery patients with an elevated pulmonary pressure during preoperative right heart catheterization with those obtained intraoperatively and postoperatively by means of a PAC. All patients with a preoperatively documented pulmonary artery pressure of 40 mmHg or above and an intraoperative use of a PAC during a 4-year period were included. Exclusion criteria were intracardiac shunts, cardiogenic shock, emergency procedures, pulmonary hypertension of non-cardiac origin and a time span of more than 1 year between right heart catheterization and surgery. We included 90 patients. In the whole group and in the subgroups (according to diagnosis, time elapsed between heart catheterization and operation and pulmonary pressure), there were significant differences between preoperative and intraoperative pulmonary and systemic pressures. Systemic and pulmonary artery pressures were significantly higher during preoperative catheterization than intraoperatively. The systemic systolic pressure/systolic pulmonary pressure ratio, however, remained constant. The intraoperative and postoperative systemic and pulmonary artery pressures showed no significant differences. As a normal ejection fraction does not exclude heart failure with preserved ejection fraction and as we did not have any information on this condition, we did not group the patients according to the ejection fraction. An elevated pulmonary pressure obtained preoperatively during right heart catheterization is not indicative of an elevated pulmonary pressure either intraoperatively or postoperatively. There are various explanations for the differences (e.g., different physiological and pathophysiological settings, such as sedation with potential hypercapnia versus anesthesia with vasodilation when measured; newly prescribed medication coming into effect between the right heart catheterization and surgery; intraoperative positioning). Even though the inherent risks of a PAC seem to be low, we recommend refraining from using a PAC in patients with a once documented elevated pulmonary pressure by default. As an alternative we suggest estimating the pulmonary pressure by transesophageal echocardiography (TEE) as an aid to decide whether the patient will benefit from the use of a PAC. Especially if it is not possible to identify tricuspid valve regurgitation for determining the peak gradient, it is helpful to check for additional signs of pulmonary hypertension. But we also have to bear in mind that in the postoperative period only a PAC can provide continuous measurement of pulmonary pressure.

Variation in proanthocyanidin content and composition among commonly grown North American cranberry cultivars (Vaccinium macrocarpon).

PubMed

Carpenter, Jessica L; Caruso, Frank L; Tata, Anuradha; Vorsa, Nicholi; Neto, Catherine C

2014-10-01

Cranberry fruit (Vaccinium macrocarpon) is rich in polyphenols, particularly oligomeric proanthocyanidins (PACs) possessing antimicrobial and antioxidant properties. PACs may play a role in resistance to fruit rot. Although many cranberry cultivars are grown for use in foods, beverages and nutraceuticals, data on PAC content among cultivars is limited. Eight cultivars were sampled from four growing regions during the 2010 season and analyzed for PAC content and composition. MALDI-TOF MS showed that isolated PACs had similar oligomer profiles among cultivars. The major constituents were A-type (epi)catechin oligomers of two to eight degrees of polymerization. Total PAC content ranged between 18 and 92 g PAC kg⁻¹ dried fruit, quantified as procyanidin A2 by the dimethylaminocinnamaldehyde method. Among the cultivars sampled, Howes had the highest total PACs (76-92 g kg⁻¹), followed by Mullica Queen and Early Black (48-82 g kg⁻¹). Ben Lear, a disease-susceptible variety, was significantly lower in PACs than the other cultivars (P < 0.001). Several traditional and newer cultivars of cranberry from various growing regions in North America are excellent sources of PACs, particularly the Howes, Mullica Queen and Early Black cultivars. PAC content may play a role in keeping quality. © 2014 Society of Chemical Industry.

A written self-help intervention for depressed adults comparing behavioural activation combined with physical activity promotion with a self-help intervention based upon behavioural activation alone: study protocol for a parallel group pilot randomised controlled trial (BAcPAc).

PubMed

Farrand, Paul; Pentecost, Claire; Greaves, Colin; Taylor, Rod S; Warren, Fiona; Green, Colin; Hillsdon, Melvyn; Evans, Phil; Welsman, Jo; Taylor, Adrian H

2014-05-29

Challenges remain to find ways to support patients with depression who have low levels of physical activity (PA) to overcome perceived barriers and enhance the perceived value of PA for preventing future relapse. There is an evidence-base for behavioural activation (BA) for depression, which focuses on supporting patients to restore activities that have been avoided, but practitioners have no specific training in promoting PA. We aimed to design and evaluate an integrated BA and PA (BAcPAc) practitioner-led, written, self-help intervention to enhance both physical and mental health. This study is informed by the Medical Research Council Complex Intervention Framework and describes a protocol for a pilot phase II randomised controlled trial (RCT) to test the feasibility and acceptability of the trial methods to inform a definitive phase III RCT. Following development of the augmented written self-help intervention (BAcPAc) incorporating behavioural activation with physical activity promotion, depressed adults are randomised to receive up to 12 sessions over a maximum of 4 months of either BAcPAc or behavioural activation alone within a written self-help format, which represents treatment as usual. The study is located within two 'Improving Access to Psychological Therapies' services in South West England, with both written self-help interventions supported by mental health paraprofessionals. Measures assessed at 4, 9, and 12 month follow-up include the following: CIS-R, PHQ-9, accelerometer recorded (4 months only) and self-reported PA, body mass index, blood pressure, Insomnia Severity Index, quality of life, and health and social care service use. Process evaluation will include analysis of recorded support sessions and patient and practitioner interviews. At the time of writing the study has recruited 60 patients. The feasibility outcomes will inform a definitive RCT to assess the clinical and cost-effectiveness of the augmented BAcPAc written self-help intervention to reduce depression and depressive relapse, and bring about improvements across a range of physical health outcomes. Current Controlled Trials ISRCTN74390532, 26.03.2013.

What Is A Picture Archiving And Communication System (PACS)?

NASA Astrophysics Data System (ADS)

Marceau, Carla

1982-01-01

A PACS is a digital system for acquiring, storing, moving and displaying picture or image information. It is an alternative to film jackets that has been made possible by recent breakthroughs in computer technology: telecommunications, local area nets and optical disks. The fundamental concept of the digital representation of image information is introduced. It is shown that freeing images from a material representation on film or paper leads to a dramatic increase in flexibility in our use of the images. The ultimate goal of a medical PACS system is a radiology department without film jackets. The inherent nature of digital images and the power of the computer allow instant free "copies" of images to be made and thrown away. These copies can be transmitted to distant sites in seconds, without the "original" ever leaving the archives of the radiology department. The result is a radiology department with much freer access to patient images and greater protection against lost or misplaced image information. Finally, images in digital form can be treated as data for the computer in image processing, which includes enhancement, reconstruction and even computer-aided analysis.

An efficient architecture to support digital pathology in standard medical imaging repositories.

PubMed

Marques Godinho, Tiago; Lebre, Rui; Silva, Luís Bastião; Costa, Carlos

2017-07-01

In the past decade, digital pathology and whole-slide imaging (WSI) have been gaining momentum with the proliferation of digital scanners from different manufacturers. The literature reports significant advantages associated with the adoption of digital images in pathology, namely, improvements in diagnostic accuracy and better support for telepathology. Moreover, it also offers new clinical and research applications. However, numerous barriers have been slowing the adoption of WSI, among which the most important are performance issues associated with storage and distribution of huge volumes of data, and lack of interoperability with other hospital information systems, most notably Picture Archive and Communications Systems (PACS) based on the DICOM standard. This article proposes an architecture of a Web Pathology PACS fully compliant with DICOM standard communications and data formats. The solution includes a PACS Archive responsible for storing whole-slide imaging data in DICOM WSI format and offers a communication interface based on the most recent DICOM Web services. The second component is a zero-footprint viewer that runs in any web-browser. It consumes data using the PACS archive standard web services. Moreover, it features a tiling engine especially suited to deal with the WSI image pyramids. These components were designed with special focus on efficiency and usability. The performance of our system was assessed through a comparative analysis of the state-of-the-art solutions. The results demonstrate that it is possible to have a very competitive solution based on standard workflows. Copyright © 2017 Elsevier Inc. All rights reserved.

Integrating CAD modules in a PACS environment using a wide computing infrastructure.

PubMed

Suárez-Cuenca, Jorge J; Tilve, Amara; López, Ricardo; Ferro, Gonzalo; Quiles, Javier; Souto, Miguel

2017-04-01

The aim of this paper is to describe a project designed to achieve a total integration of different CAD algorithms into the PACS environment by using a wide computing infrastructure. The aim is to build a system for the entire region of Galicia, Spain, to make CAD accessible to multiple hospitals by employing different PACSs and clinical workstations. The new CAD model seeks to connect different devices (CAD systems, acquisition modalities, workstations and PACS) by means of networking based on a platform that will offer different CAD services. This paper describes some aspects related to the health services of the region where the project was developed, CAD algorithms that were either employed or selected for inclusion in the project, and several technical aspects and results. We have built a standard-based platform with which users can request a CAD service and receive the results in their local PACS. The process runs through a web interface that allows sending data to the different CAD services. A DICOM SR object is received with the results of the algorithms stored inside the original study in the proper folder with the original images. As a result, a homogeneous service to the different hospitals of the region will be offered. End users will benefit from a homogeneous workflow and a standardised integration model to request and obtain results from CAD systems in any modality, not dependant on commercial integration models. This new solution will foster the deployment of these technologies in the entire region of Galicia.

Short history of PACS. Part I: USA.

PubMed

Huang, H K

2011-05-01

This historical review covers the PACS development in the USA during the past 28 years from 1982 to 2010. General historical remarks of PACS and international scene in three stages from infancy, puberty to adolescence are presented. Early PACS development was mostly financed by the federal government including the National Institutes of Health (NIH) and the U.S. Army Medical Research and Materiel Command. PACS evolution went through several stages. The earliest stages included the definition of large-scale PACS, establishment of the DICOM and other standards, the development of some early key PACS related technologies, and PACS implementation strategies. The later stages were in the concept of enterprise PACS, IHE (Integrating the Healthcare Enterprise) workflow profiles, and ePR with image distribution. The current most excited accomplishment is in the development of the new field in medical imaging informatics. This review goes through these stages and events in the USA during these 28 years, whenever an event involved participants from other countries, the contributors are cited. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Determining the Value of Automation in Commercial and USAF Supplier Evaluation Systems

DTIC Science & Technology

2003-03-01

Component Analysis,” The Journal of Supply Chain Management, 36: 63-69 (Spring 2000). Piercy , Nigel F. and David W. Cravens. “Examining the Role of...includes content analysis of the interview responses of eight senior managers from commercial companies in the aerospace or air transportation industries...interviewing all ten personnel, the responses were transcribed and transferred into StatPac. The statistical 3 information from StatPac provided the

Picture Archiving And Communications Systems (PACS) And Radiation Therapy Planning: Data And Workstation Requirements

NASA Astrophysics Data System (ADS)

Reavis, R. J.; Zielonka, Jason S.

1986-06-01

PACS literature to date has emphasized the needs of diagnostic imaging; however, the ability to acquire, manipulate, and display data derived from multiple imaging modalities is also vital in the practice of radiation oncology and radiation therapy planning (RTP). Radiographic or scintigraphic images for RTP must include specific spatial calibration data, as well as data relating image acquisition to anatomic localization within the patient. The digital nature of PACS images and displays allows the radiation oncologist to interactively assist in evaluating whether or not near-by structures are tumor-free. The radiation oncologist may also need to review nonradiographic diagnostic images (e.g., endoscopic images or pathology tissue specimens). Finally, it must be possible to take data such as isodose lines and superimpose them onto images relating the proposed therapy field to patient anatomy. Not only would this be useful for the radiation oncologist, but it would also provide information currently not easily available to the diagnostician and useful in subsequent diagnostic efforts. The three-dimensional (volumetric) data creation for RTP is not currently widespread because of the difficulties in converting images into a coherent, reliable and registered data set; this is the unique contribution of PACS. Software must be developed to permit creation of volumetric models based on data derived from both planar images and various tomographic modalities, including calibration and localizaton data for accurate image registration and scaling. This will permit positive definition of tumor volume by diagnosticians and the radiation oncologists as an initial portion of the therapy planning process. As a part of the underlying data structure for such systems, there must be some uniformity of image format between modalities and vendors; this has been adequately addressed by the Digital Imaging and Communications Interface Standard recently adopted by the American College of Radiology and the National Electrical Manufacturers' Association (ACR-NEMA). In addition, such standardization efforts must also incorporate the necessary calibration and coordinate data. This paper will examine some of the unique requirements for PACS (and PACS workstations)optimized for RTP. The assumption is made here that these are not independent, self-sufficient devices; rather, they are subsystems of a PACS network, capable of sharing certain resources.

Combined effects of coagulation and adsorption on ultrafiltration membrane fouling control and subsequent disinfection in drinking water treatment.

PubMed

Xing, Jiajian; Liang, Heng; Cheng, Xiaoxiang; Yang, Haiyan; Xu, Daliang; Gan, Zhendong; Luo, Xinsheng; Zhu, Xuewu; Li, Guibai

2018-06-02

This study investigated the combined effects of coagulation and powdered activated carbon (PAC) adsorption on ultrafiltration (UF) membrane fouling control and subsequent disinfection efficiency through filtration performance, dissolved organic carbon (DOC) removal, fluorescence excitation-emission matrix (EEM) spectroscopy, and disinfectant curve. The fouling behavior of UF membrane was comprehensively analyzed especially in terms of pollutant removal and fouling reversibility to understand the mechanism of fouling accumulation and disinfectant dose reduction. Pre-coagulation with or without adsorption both achieved remarkable effect of fouling mitigation and disinfection dose reduction. The two pretreatments were effective in total fouling control and pre-coagulation combined with PAC adsorption even decreased hydraulically irreversible fouling notably. Besides, pre-coagulation decreased residual disinfectant decline due to the removal of hydrophobic components of natural organic matters (NOM). Pre-coagulation combined with adsorption had a synergistic effect on further disinfectant decline rate reduction and decreased total disinfectant consumption due to additional removal of hydrophilic NOM by PAC adsorption. The disinfectant demand was further reduced after membrane. These results show that membrane fouling and disinfectant dose can be reduced in UF coupled with pretreatment, which could lead to the avoidance of excessive operation cost disinfectant dose for drinking water supply.

Effect of mineral surface properties (alumina, kaolinite) on the sorptive fractionation mechanisms of soil fulvic acids: Molecular-scale ESI-MS studies

NASA Astrophysics Data System (ADS)

Fleury, Guillaume; Del Nero, Mirella; Barillon, Rémi

2017-01-01

We addressed the effects of mineral surface properties (kaolinite versus Al-oxide) on the sorption-driven fractionation of a soil fulvic acid (FA) at acidic pH, mainly by means of ESI(-)-FTMS analysis of initial and supernatant solutions of FA sorption batch experiments. The MS data provided clear molecular-scale evidence of distinct mechanisms and molecular parameters controlling the FA fractionation upon its sorption on clay and oxide surfaces, respectively. Identification of sorbing and not-sorbing FA compounds in kaolinite-solution systems revealed a weak fractionation among members of sbnd CO2 series of aliphatics or not-condensed aromatics (NCAs) at pH 3.8, and almost no sorption of poorly-oxygenated polycyclic aromatic compounds (PACs) and NCAs. This first molecular-scale description of a FA fractionation in a clay-solution system suggests that H-bonding with low affinity sites (aluminol/silanol) on the basal planes of the clay particles is the main mechanism of sorption. Due to the predominance of such weak and poorly-selective mechanism, the sorption of aliphatic and NCA molecules bearing oxygenated functionalities was prevented at pH 5, due to dissolved Al competing successfully for their coordination. In contrast, a strong FA fractionation was observed onto alumina, with a preferential retention of PACs and highly-oxygenated aliphatics and NCAs. The major part of the poorly oxygenated aliphatics was left in solution. The sorption degree of NCAs and aliphatics was strongly correlated with molecular acidity. For PACs and poorly-oxygenated NCAs, the sorption was driven by reactions of surface ligand exchange (for the most oxygenated compounds) or by hydrophobic interactions (for the least oxygenated compounds).

Impact of Increased Thermokarst Activity on Polycyclic Aromatic Compound (PAC) Accumulation in Sediment of Lakes in the Hydrocarbon-Rich Uplands Adjacent to the Mackenzie Delta, NT, Canada

NASA Astrophysics Data System (ADS)

Eickmeyer, D.; Thienpont, J. R.; Blais, J. M.

2017-12-01

In ecologically sensitive, hydrocarbon-rich regions like the western Canadian Arctic, environmental monitoring of oil and gas development often focuses on both direct and unintentional consequences of increased exploration and extraction of hydrocarbon resources. However, proper assessments of impact from these activities could be confounded by natural petrogenic sources in permafrost-rich regions where increased thermokarst activity results in permafrost exposure and erosion of hydrocarbon-rich deposits. Using a paired-lake design in the tundra uplands adjacent to the Mackenzie Delta, NT, we examined 4 lakes with retrogressive thaw slump scars along their shores, and 4 nearby undisturbed reference lakes, focusing on polycyclic aromatic compound (PAC) deposition and composition in the sediment. Total organic carbon (TOC)-normalized concentrations for parent and alkylated PACs were higher in surface sediments of slump-affected lakes than the reference lakes. This followed the pattern previously observed for persistent organic pollutants in these lakes where presence of thaw slumps on the lake shore was associated with lower TOC content in the water column, resulting in a smaller pool of available organic carbon, leading to higher PAC concentrations. Diagnostic ratios of specific PACs also suggested the sediment of slump-affected lakes had greater influence from petroleum-based PAC sources than their reference counterparts. This interpretation was corroborated by a principle components analysis of the metal content in the sediment. Slump-affected lakes were enriched in metals related to shale-based, Quaternary deposits of the Mackenzie Basin (e.g. Ca, Sr, Mg) when compared to reference lakes where these surficial materials were not exposed by thermokarst activity. Higher PAC concentrations and composition indicative of petrogenic sources observed in sediment of slump-affected lakes were best explained as a combination of low TOC availability and increased inputs of previously bound hydrocarbons from the catchment due to permafrost erosion. These findings demonstrate that, to avoid misinterpreting the scale and nature of the impact of hydrocarbon development in northern landscapes, monitoring of sediment PACs must be assessed in the proper framework of these dynamic freshwater systems.

Evaluation of a hospital-wide PACS: costs and benefits of the Hammersmith PACS installation

NASA Astrophysics Data System (ADS)

Bryan, Stirling; Keen, Justin; Buxton, Martin J.; Weatherburn, Gwyneth C.

1992-07-01

The unusual nature of sites chosen for hospital-wide PACS implementations and the very small number of proposed implementations make evaluation a complex task. The UK Department of Health is funding both the evaluation and implementation of a hospital-wide PACS. The Brunel University evaluation of the Hammersmith Hospital PACS has two main components: an economic evaluation of the costs and benefits of hospital-wide PACS installations and an exercise in monitoring the implementation process. This paper concentrates on the economic component.

The CP-PACS Project and Lattice QCD Results

NASA Astrophysics Data System (ADS)

Iwasaki, Y.

The aim of the CP-PACS project was to develop a massively parallel computer for performing numerical research in computational physics with primary emphasis on lattice QCD. The CP-PACS computer with a peak speed of 614 GFLOPS with 2048 processors was completed in September 1996, and has been in full operation since October 1996. We present an overview of the CP-PACS project and describe characteristics of the CP-PACS computer. The CP-PACS has been mainly used for hadron spectroscopy studies in lattice QCD. Main results in lattice QCD simulations are given.

WE-D-9A-06: Open Source Monitor Calibration and Quality Control Software for Enterprise Display Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bevins, N; Vanderhoek, M; Lang, S

2014-06-15

Purpose: Medical display monitor calibration and quality control present challenges to medical physicists. The purpose of this work is to demonstrate and share experiences with an open source package that allows for both initial monitor setup and routine performance evaluation. Methods: A software package, pacsDisplay, has been developed over the last decade to aid in the calibration of all monitors within the radiology group in our health system. The software is used to calibrate monitors to follow the DICOM Grayscale Standard Display Function (GSDF) via lookup tables installed on the workstation. Additional functionality facilitates periodic evaluations of both primary andmore » secondary medical monitors to ensure satisfactory performance. This software is installed on all radiology workstations, and can also be run as a stand-alone tool from a USB disk. Recently, a database has been developed to store and centralize the monitor performance data and to provide long-term trends for compliance with internal standards and various accrediting organizations. Results: Implementation and utilization of pacsDisplay has resulted in improved monitor performance across the health system. Monitor testing is now performed at regular intervals and the software is being used across multiple imaging modalities. Monitor performance characteristics such as maximum and minimum luminance, ambient luminance and illuminance, color tracking, and GSDF conformity are loaded into a centralized database for system performance comparisons. Compliance reports for organizations such as MQSA, ACR, and TJC are generated automatically and stored in the same database. Conclusion: An open source software solution has simplified and improved the standardization of displays within our health system. This work serves as an example method for calibrating and testing monitors within an enterprise health system.« less

The Impact of a Health IT Changeover on Medical Imaging Department Work Processes and Turnaround Times

PubMed Central

Georgiou, A.; Lymer, S.; Hordern, A.; Ridley, L.; Westbrook, J.

2015-01-01

Summary Objectives To assess the impact of introducing a new Picture Archiving and Communication System (PACS) and Radiology Information System (RIS) on: (i) Medical Imaging work processes; and (ii) turnaround times (TATs) for x-ray and CT scan orders initiated in the Emergency Department (ED). Methods We employed a mixed method study design comprising: (i) semi-structured interviews with Medical Imaging Department staff; and (ii) retrospectively extracted ED data before (March/April 2010) and after (March/April 2011 and 2012) the introduction of a new PACS/RIS. TATs were calculated as: processing TAT (median time from image ordering to examination) and reporting TAT (median time from examination to final report). Results Reporting TAT for x-rays decreased significantly after introduction of the new PACS/RIS; from a median of 76 hours to 38 hours per order (p<.0001) for patients discharged from the ED, and from 84 hours to 35 hours (p<.0001) for patients admitted to hospital. Medical Imaging staff reported that the changeover to the new PACS/RIS led to gains in efficiency, particularly regarding the accessibility of images and patient-related information. Nevertheless, assimilation of the new PACS/RIS with existing Departmental work processes was considered inadequate and in some instances unsafe. Issues highlighted related to the synchronization of work tasks (e.g., porter arrangements) and the material set up of the work place (e.g., the number and location of computers). Conclusions The introduction of new health IT can be a “double-edged sword” providing improved efficiency but at the same time introducing potential hazards affecting the effectiveness of the Medical Imaging Department. PMID:26448790

[Wish and reality in installation of a clinic-wide system for image and documentation access].

PubMed

Rau, W S; Schwabe, C

1999-04-01

This report describes the problems that can occur in the representation of the radiological workplace in a digital environment. On one hand the radiologist can sometimes access good equipment in "stand-alone" surroundings (CT, laser printer, workstations,...); on the other hand, the existing insufficient communication between different components is only rarely qualified to support the radiological workflow. This unsatisfactory framework handicaps the required clinic-wide distribution of radiological information. From the beginning we defined user groups requiring different radiological data closely associated with specific hard- and software: The radiological workstation in the department for reporting and image processing. The demonstration workstation in wards/outpatient departments for clinicians involved in treatment. Standard PCs with access to the digital medical document for clinicians involved in treatment. At all workstations the medical as well as the legal unity of digital radiological images and the corresponding report is ensured. Only the first two user groups have unrestricted access to the RIS database and to the PACS archive. We have decided that the RIS should be the master of the RIS/PACS-System. For an effective master/slave relationship between RIS and PACS archive and PACS workstations we suggest to mark images and/or series of images. The third user group depends on the information exported by the radiologist from PACS. After the report is written and signed by the radiologist, the digital report is transferred from the RIS to the HIS. The report is automatically attached to these images. Authorized personnel at the wards and outpatient are able to read the combination of validated report and exported radiological images as part of the digital medical record with an intranet browser on standard PCs.

RNA Sequencing of Contaminated Seeds Reveals the State of the Seed Permissive for Pre-Harvest Aflatoxin Contamination and Points to a Potential Susceptibility Factor

PubMed Central

Clevenger, Josh; Marasigan, Kathleen; Liakos, Vasileios; Sobolev, Victor; Vellidis, George; Holbrook, Corley; Ozias-Akins, Peggy

2016-01-01

Pre-harvest aflatoxin contamination (PAC) is a major problem facing peanut production worldwide. Produced by the ubiquitous soil fungus, Aspergillus flavus, aflatoxin is the most naturally occurring known carcinogen. The interaction between fungus and host resulting in PAC is complex, and breeding for PAC resistance has been slow. It has been shown that aflatoxin production can be induced by applying drought stress as peanut seeds mature. We have implemented an automated rainout shelter that controls temperature and moisture in the root and peg zone to induce aflatoxin production. Using polymerase chain reaction (PCR) and high performance liquid chromatography (HPLC), seeds meeting the following conditions were selected: infected with Aspergillus flavus and contaminated with aflatoxin; and not contaminated with aflatoxin. RNA sequencing analysis revealed groups of genes that describe the transcriptional state of contaminated vs. uncontaminated seed. These data suggest that fatty acid biosynthesis and abscisic acid (ABA) signaling are altered in contaminated seeds and point to a potential susceptibility factor, ABR1, as a repressor of ABA signaling that may play a role in permitting PAC. PMID:27827875

Human Prostatic Acid Phosphatase: Structure, Function and Regulation

PubMed Central

Muniyan, Sakthivel; Chaturvedi, Nagendra K.; Dwyer, Jennifer G.; LaGrange, Chad A.; Chaney, William G.; Lin, Ming-Fong

2013-01-01

Human prostatic acid phosphatase (PAcP) is a 100 kDa glycoprotein composed of two subunits. Recent advances demonstrate that cellular PAcP (cPAcP) functions as a protein tyrosine phosphatase by dephosphorylating ErbB-2/Neu/HER-2 at the phosphotyrosine residues in prostate cancer (PCa) cells, which results in reduced tumorigenicity. Further, the interaction of cPAcP and ErbB-2 regulates androgen sensitivity of PCa cells. Knockdown of cPAcP expression allows androgen-sensitive PCa cells to develop the castration-resistant phenotype, where cells proliferate under an androgen-reduced condition. Thus, cPAcP has a significant influence on PCa cell growth. Interestingly, promoter analysis suggests that PAcP expression can be regulated by NF-κB, via a novel binding sequence in an androgen-independent manner. Further understanding of PAcP function and regulation of expression will have a significant impact on understanding PCa progression and therapy. PMID:23698773

Systematic review with meta-analysis: highly selective 5-HT4 agonists (prucalopride, velusetrag or naronapride) in chronic constipation.

PubMed

Shin, A; Camilleri, M; Kolar, G; Erwin, P; West, C P; Murad, M H

2014-02-01

Highly selective 5-HT4 agonists have been suggested for the treatment of chronic constipation (CC). To assess the effects of highly selective 5-HT4 agonists (prucalopride, velusetrag or naronapride) on patient-important clinical efficacy outcomes and safety in adults with CC. We searched the medical literature in January 2013 using MEDLINE/Pubmed, Embase, Cochrane Library, and Web of Science/Scopus for randomised, controlled trials of highly selective 5-HT4 agonists in adults with CC, with no minimum duration of therapy (maximum 12 weeks) or date limitations. Data were extracted from intention-to-treat analyses, pooled using a random-effects model, and reported as relative risk (RR), mean differences, or standardised mean differences with 95% confidence intervals (CI). Main outcomes included stool frequency, Patient-Assessment of Constipation Quality of Life (PAC-QOL), PAC of symptoms (PAC-SYM) and adverse events. Thirteen eligible trials were identified: 11 prucalopride, 1 velusetrag, 1 naronapride. Relative to control, treatment with highly selective 5-HT4 agonists was superior for all outcomes: mean ≥3 spontaneous complete bowel movements (SCBM)/week (RR = 1.85; 95% CI 1.23-2.79); mean ≥1 SCBM over baseline (RR = 1.57; 95% CI 1.19, 2.06); ≥1 point improvement in PAC-QOL and PAC-SYM scores. The only active comparator trial of prucalopride and PEG3350 suggested PEG3350 is more efficacious for some end points. Adverse events were more common with highly selective 5-HT4 agonists, but were generally minor; headache was the most frequent. Most trials studied prucalopride. Demonstration of efficacy on patient-important outcomes and a favourable safety profile support the continued use and development of highly selective 5-HT4 agonists in the treatment of chronic constipation. © 2013 John Wiley & Sons Ltd.

The effects of conservative treatment for constipation on symptom severity and quality of life in community-dwelling adults.

PubMed

Ostaszkiewicz, Joan; Hornby, Linda; Millar, Lynne; Ockerby, Cherene

2010-01-01

Constipation is a common symptom in the general community that incurs considerable cost and negative effects on quality of life. This article reports the effects of an individualized, multimodal, conservative intervention on symptom severity and quality of life in community-dwelling adults who presented with constipation and specific lower urinary tract symptoms to a community-based continence service. The study was a within-subject, pretest-posttest design that utilized purposeful recruitment. The sample was drawn from a clinical population of patients attending a community-based continence service. Twenty-seven community-dwelling adults aged 35 to 83 years (mean age 63.85 years) who presented with lower urinary tract symptoms and constipation received individualized conservative treatment of constipation that comprised advice on dietary supplementation, fluid intake, exercise, position to defecate, the gastrocolic reflex, and over-the-counter laxatives. Participants completed the Patient Assessment of Constipation Symptom Questionnaire (PAC-SYM) and the Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) prior to the intervention and 8 to 12 weeks later. Wilcoxon signed ranks test results indicated that the intervention significantly reduced the severity of overall constipation symptoms measured by the PAC-SYM (T = 75.5, P < .01). In particular, there were significant improvements in abdominal and stool symptoms subscales. Participants also reported statistically significant improvements in their overall quality of life as measured by the PAC-QOL (T = 48.5, P < .01). There were significant improvements in relation to psychosocial discomfort, worries and concerns, and satisfaction as measured by the PAC-QOL. While no participants felt in control of their situation "all of the time" prior to treatment, 26.9% of participants reported feeling in control of their situation "all of the time" following treatment. The severity of constipation symptoms are reduced following a multimodal, individually tailored conservative intervention. This improvement in symptoms corresponds with quality-of-life improvements.

Pollution abatement and control expenditures

DOT National Transportation Integrated Search

1996-09-01

BEAs pollution abatement and control program (PAC) is being discontinued. The estimates presented in this article are the last of the annual series. BEA is reallocating resources away from some existing programs in order to move ahead with the mos...

Comparison of isolated cranberry (Vaccinium macrocarpon Ait.) proanthocyanidins to catechin and procyanidins A2 and B2 for use as standards in the 4-(dimethylamino)cinnamaldehyde assay.

PubMed

Feliciano, Rodrigo P; Shea, Michael P; Shanmuganayagam, Dhanansayan; Krueger, Christian G; Howell, Amy B; Reed, Jess D

2012-05-09

The 4-(dimethylamino)cinnamaldehyde (DMAC) assay is currently used to quantify proanthocyanidin (PAC) content in cranberry products. However, this method suffers from issues of accuracy and precision in the analysis and comparison of PAC levels across a broad range of cranberry products. Current use of procyanidin A2 as a standard leads to an underestimation of PACs content in certain cranberry products, especially those containing higher molecular weight PACs. To begin to address the issue of accuracy, a method for the production of a cranberry PAC standard, derived from an extraction of cranberry (c-PAC) press cake, was developed and evaluated. Use of the c-PAC standard to quantify PAC content in cranberry samples resulted in values that were 2.2 times higher than those determined by procyanidin A2. Increased accuracy is critical for estimating PAC content in relationship to research on authenticity, efficacy, and bioactivity, especially in designing clinical trials for determination of putative health benefits.

Development and demonstration of autonomous behaviors for urban environment exploration

NASA Astrophysics Data System (ADS)

Ahuja, Gaurav; Fellars, Donald; Kogut, Gregory; Pacis Rius, Estrellina; Schoolov, Misha; Xydes, Alexander

2012-06-01

Under the Urban Environment Exploration project, the Space and Naval Warfare Systems Center Pacic (SSC- PAC) is maturing technologies and sensor payloads that enable man-portable robots to operate autonomously within the challenging conditions of urban environments. Previously, SSC-PAC has demonstrated robotic capabilities to navigate and localize without GPS and map the ground oors of various building sizes.1 SSC-PAC has since extended those capabilities to localize and map multiple multi-story buildings within a specied area. To facilitate these capabilities, SSC-PAC developed technologies that enable the robot to detect stairs/stairwells, maintain localization across multiple environments (e.g. in a 3D world, on stairs, with/without GPS), visualize data in 3D, plan paths between any two points within the specied area, and avoid 3D obstacles. These technologies have been developed as independent behaviors under the Autonomous Capabilities Suite, a behavior architecture, and demonstrated at a MOUT site at Camp Pendleton. This paper describes the perceptions and behaviors used to produce these capabilities, as well as an example demonstration scenario.

Maintaining a legal status for filmless archived digital medical images

NASA Astrophysics Data System (ADS)

Shani, Uri

2001-08-01

Most medical images today are generated digitally before exposure on film. In hospitals that employ Picture Archiving and Communication Systems (PACS), the images are also stored and managed digitally. Indeed, film copies of images are still used at large, but the new generation of filmless hospitals tend to minimize the production of films unless deem necessary, or required by the patients or third parties. There are basically two main reasons for working with films in 'filmless' hospitals. One is that in fact, these are 'less film' hospitals due to the film-oriented environment where they operate. Environment which has not yet entered the PACS and DICOM era; Neither in operation, nor in intercommunication. The other reason is that films are needed for legal purposes as a sole indicator to the medical image evidence used during diagnosis. PACS offer numerous advantages, but a high entry cost which can be balanced with the savings in films production and handling. However, as long as films are mandatory, they do not help to lower the inhibitory cost of PACS, and the use of films prevails.

Luteinizing hormone-stimulated pituitary adenylate cyclase-activating polypeptide system and its role in progesterone production in human luteinized granulosa cells.

PubMed

Park, Hyun-Jeong; Choi, Bum-Chae; Song, Sang-Jin; Lee, Dong-Sik; Roh, Jaesook; Chun, Sang-Young

2010-01-01

The present study examined the gonadotropin regulation of pituitary adenylate cyclase-activating polypeptide (PACAP) and PACAP type I receptor (PAC(1)-R) expression, and its role in progesterone production in the human luteinized granulosa cells. The stimulation of both PACAP and PAC(1)-R mRNA levels by LH was detected using a competitive reverse transcription-polymerase chain reaction (RT-PCR). PACAP transcript was stimulated by LH reaching maximum levels at 12 hours in a dose dependent manner. LH treatment also stimulated PAC(1)-R mRNA levels within 24 hours. Addition of PACAP-38 (10(-7) M) as well as LH significantly stimulated progesterone production during 48 hours culture. Furthermore, co-treatment with PACAP antagonist partially inhibited LH-stimulated progesterone production. Treatment with vasoactive intestinal peptide, however, did not affect progesterone production. Taken together, the present study demonstrates that LH causes a transient stimulation of PACAP and PAC(1)-R expression and that PACAP stimulates progesterone production in the human luteinized granulosa cells, suggesting a possible role of PACAP as a local ovarian regulator in luteinization.

Cd hyperfine interactions in DNA bases and DNA of mouse strains infected with Trypanosoma cruzi investigated by perturbed angular correlation spectroscopy and ab initio calculations.

PubMed

Petersen, Philippe A D; Silva, Andreia S; Gonçalves, Marcos B; Lapolli, André L; Ferreira, Ana Maria C; Carbonari, Artur W; Petrilli, Helena M

2014-06-03

In this work, perturbed angular correlation (PAC) spectroscopy is used to study differences in the nuclear quadrupole interactions of Cd probes in DNA molecules of mice infected with the Y-strain of Trypanosoma cruzi. The possibility of investigating the local genetic alterations in DNA, which occur along generations of mice infected with T. cruzi, using hyperfine interactions obtained from PAC measurements and density functional theory (DFT) calculations in DNA bases is discussed. A comparison of DFT calculations with PAC measurements could determine the type of Cd coordination in the studied molecules. To the best of our knowledge, this is the first attempt to use DFT calculations and PAC measurements to investigate the local environment of Cd ions bound to DNA bases in mice infected with Chagas disease. The obtained results also allowed the detection of local changes occurring in the DNA molecules of different generations of mice infected with T. cruzi, opening the possibility of using this technique as a complementary tool in the characterization of complicated biological systems.

Templates and existing elements and models for implementation of patient exposure tracking.

PubMed

Rehani, Madan M; Berris, Theocharis

2014-01-01

There is wide interest currently in patient exposure tracking. This paper provides templates for implementation of tracking at the practice (hospital) level, multi-practice level, national level and international level. It provides suggestions for implementation in less-resourced countries. It includes elements such as patient identifier, dose quantities that should be covered and how to make sense from dose figures, availability of digital imaging and communications in medicine files with dose information or structured dose reports and capabilities of picture archiving and communication system (PACS). While tracking at several hospitals in a country connected by PACS and nationwide PACS is also a reality, tracking at the international level is currently a challenge. Guidance provided in this paper will facilitate its implementation at all levels.

Aldosterone response to angiotensin II during hypoxemia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Colice, G.L.; Ramirez, G.

1986-07-01

Exercise stimulates the renin-angiotensin-aldosterone system (RAAS). However, increases in plasma aldosterone concentrations (PAC) are suppressed when exercise is performed at high altitude or under hypoxemic conditions. As the angiotensin-II response to high-altitude exercise is normal, it is speculated that an inhibitor, discharged during hypoxemia, acted to suppress angiotensin-II-mediated aldosterone release. A study was conducted to test this hypothesis, taking into account the measurement of the aldosterone response to exogenous angiotensin II during normoxemia and hypoxemia. It was found that the dose-response curve of PAC to angiotensin II was not significantly inhibited by the considered model of hypoxemia. The hypoxemia-mediated releasemore » of an angiotensin II inhibitor does, therefore, not explain the previous observations of PAC suppression during hypoxemic exercise. 28 references.« less

Removal of micropollutants with coarse-ground activated carbon for enhanced separation with hydrocyclone classifiers.

PubMed

Otto, N; Platz, S; Fink, T; Wutscherk, M; Menzel, U

2016-01-01

One key technology to eliminate organic micropollutants (OMP) from wastewater effluent is adsorption using powdered activated carbon (PAC). To avoid a discharge of highly loaded PAC particles into natural water bodies a separation stage has to be implemented. Commonly large settling tanks and flocculation filters with the application of coagulants and flocculation aids are used. In this study, a multi-hydrocyclone classifier with a downstream cloth filter has been investigated on a pilot plant as a space-saving alternative with no need for a dosing of chemical additives. To improve the separation, a coarser ground PAC type was compared to a standard PAC type with regard to elimination results of OMP as well as separation performance. With a PAC dosing rate of 20 mg/l an average of 64.7 wt% of the standard PAC and 79.5 wt% of the coarse-ground PAC could be separated in the hydrocyclone classifier. A total average separation efficiency of 93-97 wt% could be reached with a combination of both hydrocyclone classifier and cloth filter. Nonetheless, the OMP elimination of the coarse-ground PAC was not sufficient enough to compete with the standard PAC. Further research and development is necessary to find applicable coarse-grained PAC types with adequate OMP elimination capabilities.

Assessing the impact of a radiology information management system in the emergency department

NASA Astrophysics Data System (ADS)

Redfern, Regina O.; Langlotz, Curtis P.; Lowe, Robert A.; Horii, Steven C.; Abbuhl, Stephanie B.; Kundel, Harold L.

1998-07-01

To evaluate a conventional radiology image management system, by investigating information accuracy, and information delivery. To discuss the customization of a picture archival and communication system (PACS), integrated radiology information system (RIS) and hospital information system (HIS) to a high volume emergency department (ED). Materials and Methods: Two data collection periods were completed. After the first data collection period, a change in work rules was implemented to improve the quality of data in the image headers. Data from the RIS, the ED information system, and the HIS as well as observed time motion data were collected for patients admitted to the ED. Data accuracy, patient waiting times, and radiology exam information delivery were compared. Results: The percentage of examinations scheduled in the RIS by the technologists increased from 0% (0 of 213) during the first period to 14% (44 of 317) during the second (p less than 0.001). The percentage of images missing identification numbers decreased from 36% (98 of 272) during the first data collection period to 10% (56 of 562) during the second period (p less than 0.001). Conclusions: Radiologic services in a high-volume ED, requiring rapid service, present important challenges to a PACS system. Strategies can be implemented to improve accuracy and completeness of the data in PACS image headers in such an environment.

Specification and evaluation of a regional PACS in the SaxTeleMed project

NASA Astrophysics Data System (ADS)

Lemke, Heinz U.; Niederlag, W.; Heuser, H.

2002-05-01

During the early development phase of PACS, its implementation was mainly a matter of the radiological department of a hospital. This is changing rapidly and PACS planning and realization is increasingly seen in the context of a hospital-wide approach. With a growth of networking amongst healthcare institutions and the growing relevance of teleradiological scenarios, new strategies must be followed which take not only local but also regional and global aspects of PACS into consideration. One such regional PACS project was initiated by the Ministry of Social Welfare of the Free State of Saxony in Germany. This 'reference model program for the digitization of imaging procedures and communication of images between hospitals in the free state of Saxony' (SaxTeleMed) covers seven regional projects distributed throughout Saxony. Each regional project is organized around so called lead hospitals, which network with other cooperating hospitals and medical practices. The regional reference projects are designed to be largely independent from one another. In some instances, however, a network connection between reference projects is also considered. Altogether, 39 hospitals and medical centers are involved in the model program. The aim of this program is to test the technical, organizational, legal and economic problems in the area of digitization and networking within the free State of Saxony. With the knowledge gained it is expected to improve future investment decisions in healthcare and above all to implement secure systems.

Incorporating electronic media into medical student education: a survey of AMSER members on computer and web use in radiology courses. Alliance of Medical Student Educators in Radiology.

PubMed

Durfee, Sara M; Jain, Sidney; Shaffer, Kitt

2003-02-01

The purpose of this study was to define the current use of information technology in radiology tutorials for medical students. The authors conducted a Web-based survey of directors of medical school courses in radiology. The survey dealt with the details of the courses and the use of computers and the Web during the courses. There were 48 responses. Most radiology courses were elective (73%) and were offered monthly. Most institutions (79%) had picture archiving and communication systems (PACS) available or were completely filmless. The teaching case presentations, however, often included film images displayed on a view box or by an overhead projector. Computers dedicated to student use were uncommon (28%). The Web was used infrequently as a teaching resource, and a Web site was not available in most courses. Computer technical support was variable and usually provided by the course director. Course directors at institutions with PACS were more likely to use digital technology for case presentations and more likely to use the Web for teaching purposes. Despite the widespread use of digital technology and PACS in the field of radiology, digital technology is underused in radiology courses. However, departments with PACS tend to use digital technology more frequently in education than do departments without PACS.

Anatomy of an Extensible Open Source PACS.

PubMed

Valente, Frederico; Silva, Luís A Bastião; Godinho, Tiago Marques; Costa, Carlos

2016-06-01

The conception and deployment of cost effective Picture Archiving and Communication Systems (PACS) is a concern for small to medium medical imaging facilities, research environments, and developing countries' healthcare institutions. Financial constraints and the specificity of these scenarios contribute to a low adoption rate of PACS in those environments. Furthermore, with the advent of ubiquitous computing and new initiatives to improve healthcare information technologies and data sharing, such as IHE and XDS-i, a PACS must adapt quickly to changes. This paper describes Dicoogle, a software framework that enables developers and researchers to quickly prototype and deploy new functionality taking advantage of the embedded Digital Imaging and Communications in Medicine (DICOM) services. This full-fledged implementation of a PACS archive is very amenable to extension due to its plugin-based architecture and out-of-the-box functionality, which enables the exploration of large DICOM datasets and associated metadata. These characteristics make the proposed solution very interesting for prototyping, experimentation, and bridging functionality with deployed applications. Besides being an advanced mechanism for data discovery and retrieval based on DICOM object indexing, it enables the detection of inconsistencies in an institution's data and processes. Several use cases have benefited from this approach such as radiation dosage monitoring, Content-Based Image Retrieval (CBIR), and the use of the framework as support for classes targeting software engineering for clinical contexts.

Small PACS implementation using publicly available software

NASA Astrophysics Data System (ADS)

Passadore, Diego J.; Isoardi, Roberto A.; Gonzalez Nicolini, Federico J.; Ariza, P. P.; Novas, C. V.; Omati, S. A.

1998-07-01

Building cost effective PACS solutions is a main concern in developing countries. Hardware and software components are generally much more expensive than in developed countries and also more tightened financial constraints are the main reasons contributing to a slow rate of implementation of PACS. The extensive use of Internet for sharing resources and information has brought a broad number of freely available software packages to an ever-increasing number of users. In the field of medical imaging is possible to find image format conversion packages, DICOM compliant servers for all kinds of service classes, databases, web servers, image visualization, manipulation and analysis tools, etc. This paper describes a PACS implementation for review and storage built on freely available software. It currently integrates four diagnostic modalities (PET, CT, MR and NM), a Radiotherapy Treatment Planning workstation and several computers in a local area network, for image storage, database management and image review, processing and analysis. It also includes a web-based application that allows remote users to query the archive for studies from any workstation and to view the corresponding images and reports. We conclude that the advantage of using this approach is twofold. It allows a full understanding of all the issues involved in the implementation of a PACS and also contributes to keep costs down while enabling the development of a functional system for storage, distribution and review that can prove to be helpful for radiologists and referring physicians.

Influence of light-curing sources on polymerization reaction kinetics of a restorative system.

PubMed

D'Alpino, Paulo H P; Svizero, Nádia R; Pereira, José C; Rueggeberg, Frederick A; Carvalho, Ricardo M; Pashley, David H

2007-02-01

To determine the effect of using a variety of commercial light-curing units on polymerization of a dentin-bonding agent (Adper Single Bond) and of a resin composite (Filtek Z250). Infrared (IR) spectra were obtained kinetically at one scan/second at 2 cm(-1) resolution for a period of 5 minutes and were analyzed for: maximum conversion rate (%/s), time into exposure when maximum rate occurred (seconds), conversion at maximum rate (%), and total conversion (%) at 300 seconds by comparison of aliphatic-to-aromatic absorption IR peak ratios, before and after polymerization. Light units used were: QTH 540 mW/cm2 (XL3000); LED 750 mW/cm2 (Elipar FreeLight 2); PAC 2,130 mW/cm2 (ARC II). Exposure followed manufacturers' recommendations: dentin bonding agent for 10 seconds, RC for 20 seconds (QTH), and 10 seconds (LED and PAC). Polymerization kinetics was evaluated at the bottom surface (2.5 mm thick) for the resin composite and as a thin film for the dentin bonding agent on the diamond surface of an attenuated total reflectance accessory in the IR spectrometer. Values (n = 5) were compared using ANOVA and Tukey's pairwise post-hoc test: pre-set alpha 0.05. PAC produced the highest total conversion and conversion rate for the resin composite (P < 0.05). Total conversion was lower for dentin bonding adhesive using PAC than with LED or QTH (P < 0.05). LED provided the highest proportion of conversion at the maximum rate with respect to conversion at 300 seconds for both materials. QTH demonstrated the lowest maximum rate value that occurred at a longer time into exposure (P < 0.05). Polymerization kinetic parameters varied greatly between the restorative materials as well as among light-curing unit types when compared to values observed when using a QTH light as control.

Nuclear physics research at the University of Richmond. Progress report, November 1, 1994--October 31, 1995

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vineyard, M.F.; Gilfoyle, G.P.; Major, R.W.

Summarized in this report is the progress achieved during the period from November 1, 1994 to October 31, 1995. The experimental work described in this report is in electromagnetic and heavy-ion nuclear physics. The effort in electromagnetic nuclear physics is in preparation for the research program at the Continuous Electron Beam Accelerator Facility (CEBAF) and is focused on the construction and use of the CEBAF Large Acceptance Spectrometer (CLAS). The heavy-ion experiments were performed at the Argonne National Laboratory ATLAS facility and SUNY, Stony Brook. The physics interests driving these efforts at CEBAF are in the study of the structure,more » interactions, and nuclear-medium modifications of mesons and baryons. This year, an extension of the experiment to measure the magnetic form factor of the neutron was approved by the CEBAF Program Advisory Committee Nine (PAC9) for beam at 6 GeV. The authors also submitted updates to PAC9 on the experiments to measure inclusive {eta} photoproduction in nuclei and electroproduction of the {Lambda}, {Lambda}*(1520), and f{sub 0}(975). In addition to these experiments, the authors collaborated on a proposal to measure rare radiative decays of the {phi} meson which was also approved by PAC9. Their contributions to the construction of the CLAS include the development of the drift-chamber gas system, drift-chamber software, and controls software. Major has been leading the effort in the construction of the gas system. In the last year, the Hall B gas shed was constructed and the installation of the gas system components built at the University of Richmond has begun. Over the last six years, the efforts in low-energy heavy-ion physics have decreased due to the change in focus to electromagnetic nuclear physics at CEBAF. Most of the heavy-ion work is completed and there are now new experiments planned. Included in this report are two papers resulting from collaborations on heavy-ion experiments.« less

Zeolite Combined with Alum and Polyaluminum Chloride Mixed with Agricultural Slurries Reduces Carbon Losses in Runoff from Grassed Soil Boxes.

PubMed

Murnane, J G; Brennan, R B; Fenton, O; Healy, M G

2016-11-01

Carbon (C) losses from agricultural soils to surface waters can migrate through water treatment plants and result in the formation of disinfection by-products, which are potentially harmful to human health. This study aimed to quantify total organic carbon (TOC) and total inorganic C losses in runoff after application of dairy slurry, pig slurry, or milk house wash water (MWW) to land and to mitigate these losses through coamendment of the slurries with zeolite (2.36-3.35 mm clinoptilolite) and liquid polyaluminum chloride (PAC) (10% AlO) for dairy and pig slurries or liquid aluminum sulfate (alum) (8% AlO) for MWW. Four treatments under repeated 30-min simulated rainfall events (9.6 mm h) were examined in a laboratory study using grassed soil runoff boxes (0.225 m wide, 1 m long; 10% slope): control soil, unamended slurries, PAC-amended dairy and pig slurries (13.3 and 11.7 kg t, respectively), alum-amended MWW (3.2 kg t), combined zeolite and PAC-amended dairy (160 and 13.3 kg t zeolite and PAC, respectively) and pig slurries (158 and 11.7 kg t zeolite and PAC, respectively), and combined zeolite and alum-amended MWW (72 and 3.2 kg t zeolite and alum, respectively). The unamended and amended slurries were applied at net rates of 31, 34, and 50 t ha for pig and dairy slurries and MWW, respectively. Significant reductions of TOC in runoff compared with unamended slurries were measured for PAC-amended dairy and pig slurries (52 and 56%, respectively) but not for alum-amended MWW. Dual zeolite and alum-amended MWW significantly reduced TOC in runoff compared with alum amendment only. We conclude that use of PAC-amended dairy and pig slurries and dual zeolite and alum-amended MWW, although effective, may not be economically viable to reduce TOC losses from organic slurries given the relatively low amounts of TOC measured in runoff from unamended slurries compared with the amounts applied. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

Operational field evaluation of the PAC-MAG man-portable magnetometer array

NASA Astrophysics Data System (ADS)

Keranen, Joe; Topolosky, Zeke; Schultz, Gregory; Miller, Jonathan

2013-06-01

Detection and discrimination of unexploded ordnance (UXO) in areas of prior conflict is of high importance to the international community and the United States government. For humanitarian applications, sensors and processing methods need to be robust, reliable, and easy to train and implement using indigenous UXO removal personnel. This paper describes system characterization, system testing, and a continental United States (CONUS) Operational Field Evaluations (OFE) of the PAC-MAG man-portable UXO detection system. System testing occurred at a government test facility in June, 2010 and December, 2011 and the OFE occurred at the same location in June, 2012. NVESD and White River Technologies personnel were present for all testing and evaluation. The PAC-MAG system is a manportable magnetometer array for the detection and characterization of ferrous UXO. System hardware includes four Cesium vapor magnetometers for detection, a Real-time Kinematic Global Position System (RTK-GPS) for sensor positioning, an electronics module for merging array data and WiFi communications and a tablet computer for transmitting and logging data. An odometer, or "hipchain" encoder, provides position information in GPS-denied areas. System software elements include data logging software and post-processing software for detection and characterization of ferrous anomalies. The output of the post-processing software is a dig list containing locations of potential UXO(s), formatted for import into the system GPS equipment for reacquisition of anomalies. Results from system characterization and the OFE will be described.

Experience with PACS in an ATM/Ethernet switched network environment.

PubMed

Pelikan, E; Ganser, A; Kotter, E; Schrader, U; Timmermann, U

1998-03-01

Legacy local area network (LAN) technologies based on shared media concepts are not adequate for the growth of a large-scale picture archiving and communication system (PACS) in a client-server architecture. First, an asymmetric network load, due to the requests of a large number of PACS clients for only a few main servers, should be compensated by communication links to the servers with a higher bandwidth compared to the clients. Secondly, as the number of PACS nodes increases, the network throughout should not measurably cut production. These requirements can easily be fulfilled using switching technologies. Here asynchronous transfer mode (ATM) is clearly one of the hottest topics in networking because the ATM architecture provides integrated support for a variety of communication services, and it supports virtual networking. On the other hand, most of the imaging modalities are not yet ready for integration into a native ATM network. For a lot of nodes already joining an Ethernet, a cost-effective and pragmatic way to benefit from the switching concept would be a combined ATM/Ethernet switching environment. This incorporates an incremental migration strategy with the immediate benefits of high-speed, high-capacity ATM (for servers and high-sophisticated display workstations), while preserving elements of the existing network technologies. In addition, Ethernet switching instead of shared media Ethernet improves the performance considerably. The LAN emulation (LANE) specification by the ATM forum defines mechanisms that allow ATM networks to coexist with legacy systems using any data networking protocol. This paper points out the suitability of this network architecture in accordance with an appropriate system design.

Case studies on design, simulation and visualization of control and measurement applications using REX control system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ozana, Stepan, E-mail: stepan.ozana@vsb.cz; Pies, Martin, E-mail: martin.pies@vsb.cz; Docekal, Tomas, E-mail: docekalt@email.cz

REX Control System is a professional advanced tool for design and implementation of complex control systems that belongs to softPLC category. It covers the entire process starting from simulation of functionality of the application before deployment, through implementation on real-time target, towards analysis, diagnostics and visualization. Basically it consists of two parts: the development tools and the runtime system. It is also compatible with Simulink environment, and the way of implementation of control algorithm is very similar. The control scheme is finally compiled (using RexDraw utility) and uploaded into a chosen real-time target (using RexView utility). There is a widemore » variety of hardware platforms and real-time operating systems supported by REX Control System such as for example Windows Embedded, Linux, Linux/Xenomai deployed on SBC, IPC, PAC, Raspberry Pi and others with many I/O interfaces. It is modern system designed both for measurement and control applications, offering a lot of additional functions concerning data archiving, visualization based on HTML5, and communication standards. The paper will sum up possibilities of its use in educational process, focused on control of case studies of physical models with classical and advanced control algorithms.« less

Fault-tolerant back-up archive using an ASP model for disaster recovery

NASA Astrophysics Data System (ADS)

Liu, Brent J.; Huang, H. K.; Cao, Fei; Documet, Luis; Sarti, Dennis A.

2002-05-01

A single point of failure in PACS during a disaster scenario is the main archive storage and server. When a major disaster occurs, it is possible to lose an entire hospital's PACS data. Few current PACS archives feature disaster recovery, but the design is limited at best. These drawbacks include the frequency with which the back-up is physically removed to an offsite facility, the operational costs associated to maintain the back-up, the ease-of-use to perform the backup consistently and efficiently, and the ease-of-use to perform the PACS image data recovery. This paper describes a novel approach towards a fault-tolerant solution for disaster recovery of short-term PACS image data using an Application Service Provider model for service. The ASP back-up archive provides instantaneous, automatic backup of acquired PACS image data and instantaneous recovery of stored PACS image data all at a low operational cost. A back-up archive server and RAID storage device is implemented offsite from the main PACS archive location. In the example of this particular hospital, it was determined that at least 2 months worth of PACS image exams were needed for back-up. Clinical data from a hospital PACS is sent to this ASP storage server in parallel to the exams being archived in the main server. A disaster scenario was simulated and the PACS exams were sent from the offsite ASP storage server back to the hospital PACS. Initially, connectivity between the main archive and the ASP storage server is established via a T-1 connection. In the future, other more cost-effective means of connectivity will be researched such as the Internet 2. A disaster scenario was initiated and the disaster recovery process using the ASP back-up archive server was success in repopulating the clinical PACS within a short period of time. The ASP back-up archive was able to recover two months of PACS image data for comparison studies with no complex operational procedures. Furthermore, no image data loss was encountered during the recovery.

Clinical experiences with an ASP model backup archive for PACS images

NASA Astrophysics Data System (ADS)

Liu, Brent J.; Cao, Fei; Documet, Luis; Huang, H. K.; Muldoon, Jean

2003-05-01

Last year we presented a Fault-Tolerant Backup Archive using an Application Service Provider (ASP) model for disaster recovery. The purpose of this paper is to update and provide clinical experiences related towards implementing the ASP model archive solution for short-term backup of clinical PACS image data as well as possible applications other than disaster recovery. The ASP backup archive provides instantaneous, automatic backup of acquired PACS image data and instantaneous recovery of stored PACS image data all at a low operational cost and with little human intervention. This solution can be used for a variety of scheduled and unscheduled downtimes that occur on the main PACS archive. A backup archive server with hierarchical storage was implemented offsite from the main PACS archive location. Clinical data from a hospital PACS is sent to this ASP storage server in parallel to the exams being archived in the main server. Initially, connectivity between the main archive and the ASP storage server is established via a T-1 connection. In the future, other more cost-effective means of connectivity will be researched such as the Internet 2. We have integrated the ASP model backup archive with a clinical PACS at Saint John's Health Center and has been operational for over 6 months. Pitfalls encountered during integration with a live clinical PACS and the impact to clinical workflow will be discussed. In addition, estimations of the cost of establishing such a solution as well as the cost charged to the users will be included. Clinical downtime scenarios, such as a scheduled mandatory downtime and an unscheduled downtime due to a disaster event to the main archive, were simulated and the PACS exams were sent successfully from the offsite ASP storage server back to the hospital PACS in less than 1 day. The ASP backup archive was able to recover PACS image data for comparison studies with no complex operational procedures. Furthermore, no image data loss was encountered during the recovery. During any clinical downtime scenario, the ASP backup archive server can repopulate a clinical PACS quickly with the majority of studies available for comparison during the interim until the main PACS archive is fully recovered.

Cronobacter sakazakii reduction by blueberry proanthocyanidins.

PubMed

Joshi, Snehal S; Howell, Amy B; D'Souza, Doris H

2014-05-01

Blueberry juice and blueberry polyphenols reportedly have antimicrobial properties against foodborne pathogens, without much currently known on their effects against Cronobacter sakazakii. This study evaluated the antimicrobial effects of blueberry proanthocyanidins (PAC) and commercial blueberry juice (BJ) against two strains of C. sakazakii, ATCC 29004 and 29544. BJ (pH 2.8), blueberry PAC (5 mg/ml) and controls (phosphate buffered saline (PBS), pH 7.2, and malic acid pH 3.0) were mixed with equal volumes of washed overnight cultures of C. sakazakii and incubated for 30 min, 1 h, 3 h and 6 h at 37°C. Reductions of ∼1 and 1.50 log CFU/ml were obtained for strains 29004 and 29544, respectively after 30 min with BJ or blueberry PAC. Both C. sakazakii strains 29004 and 29544 were reduced to undetectable levels from 8.25 ± 0.12 log CFU/ml and 8.48 ± 0.03 log CFU/ml, respectively with BJ (pH 2.8) or blueberry PAC after 1 h, while malic acid (pH 3.0) showed ∼1.3 log CFU/ml reduction for both strains. Scanning electron microscopy studies showed differences in cell membrane morphology with clumping and formation of blebs of the treated strains compared to untreated controls. These results warrant further in vivo studies with blueberry bioactives to determine potential for preventing and treating C. sakazakii infections. Copyright © 2013. Published by Elsevier Ltd.

Development of a low cost laparostomy technique. Two years experience in the Trauma Center of Cesena, Italy.

PubMed

Ruscelli, Paolo; Buccoliero, Francesco

2013-01-01

In the last few years laparostomy has become an even more useful option for the surgeon due to the development of the experience in the critical abdominal trauma and in the severe surgical urgencies as PANE and peritonitis with the introduction of Damage Control as surgical strategy to prevent the abdominal compartimental syndrom (ACS). After a laparostomy the surgeon needs to provide a delayed fascial closure to achieve the best outcome for the patient. The aim of this paper is to illustrate the experience and the results after the introduction of a modified laparostomy technique in our surgical activity. Protection of intestinal content, aspiration under sub-athmospheric pressure, control in quality and quantity of the drainage and skin temporary closure, rappresent the four principles of the PACS tecnique. In order to evaluate the rate of delayed fascial closure and the rate of ACS onset, we have retrospectively studied 31 patients over a period of 2 years treated with open abdomen with an amount of 36 PACS performed. Routinely IAP measurament was also performed. ACS was developed in no patients. IAP was measured on average at 19. DFC was achieved in 33 PACS of 36 (91.7%) after 5 days on average (20 hours as minimum; 20 days as maximum). Aspected mortality (SAPSII) in ICU for these patient was 76.5% on average. On 31 patients, 20 (64.5%) died and 11 (35.5%) survived. PACS seems to be an effective, easy and low cost technique for the management of open abdomen.

Immunogenicity and prediction of epitopic region of antigen Ag I/II and glucosyltransferase from Streptococcus mutans.

PubMed

Cao, Xi-Xi; Fan, Jian; Chen, Jiang; Li, Yu-Hong; Fan, Ming-Wen

2016-06-01

The levels of Streptococcus (S.) mutans infections in saliva were evaluated and a comparison for specific antibody levels among children with different levels of S. mutans infection was made. The promising epitopic regions of antigen AgI/II (PAc) and glucosyltransferase (GTF) for potential vaccine targets related to S. mutans adherence were screened. A total of 94 children aged 3-4 years were randomly selected, including 53 caries-negative and 41 caries-positive children. The values of S. mutans and those of salivary total secretory immunoglobulin A (sIgA), anti-PAc and anti-Glucan binding domain (anti-GLU) were compared to determine the correlation among them. It was found the level of s-IgA against specific antigens did not increase with increasing severity of S. mutans infection, and the complete amino acid sequence of PAc and GTFB was analyzed using the DNAStar Protean system for developing specific anti-caries vaccines related to S. mutans adherence. A significantly positive correlation between the amount of S. mutans and children decayed, missing, and filled teeth index was observed. No significant difference was detected in specific sIgA against PAc or GLU between any two groups. No significant correlation was found between such specific sIgA and caries index. A total of 16 peptides from PAc as well as 13 peptides from GTFB were chosen for further investigation. S. mutans colonization contributed to early children caries as an important etiological factor. The level of sIgA against specific antigens did not increase with increasing severity of S. mutans infection in children. The epitopes of PAc and GTF have been screened to develop the peptide-based or protein-based anti-caries vaccines.

Advancing the Legislative Priorities of Cardiothoracic Surgeons: The Society of Thoracic Surgeons Political Action Committee.

PubMed

Thompson, Jess L; Speir, Alan M; Mathisen, Douglas J; Naunheim, Keith S; Prager, Richard L; Lahey, Stephen J

2018-03-01

In the late 1990s, several federal government health policy decisions threatened the viability of thoracic surgery as a specialty. To respond to such decisions, active participation in political processes was given extremely high priority by the Executive Committee of The Society of Thoracic Surgeons (STS). Creation of the STS Political Action Committee (STS-PAC) in 1997 was a part of the platform of participation. The purpose of the STS-PAC is to enhance the Society's voice and stature in health care policymaking. Although the STS-PAC receives voluntary contributions from STS members, on average, only 10% of STS members contribute to the STS-PAC. For the 2015-2016 election cycle, there were 542 contributors to the STS-PAC totaling $273,000. An annual contribution of $100 from every STS member would put the STS-PAC into the top 10 for medical PACs (whereas currently it is ranked 22nd of 28 in the group of physician and dental association PACs). Despite the relatively small dollar amount the STS-PAC directs, its strategic disbursement of these dollars has yielded impressive results. For example, the STS-PAC was able to use its influence to effectively stop the Centers for Medicare and Medicaid Services from implementing a potentially calamitous rule that would effectively end traditional global surgical payments. Other advocacy successes include providing guidance to the Centers for Medicare and Medicaid Services in developing the national coverage determination for transcatheter aortic valve replacement and structuring its complex reimbursement schedule, and ensuring that a provision was included in the bill that would give the STS National Database access to claims data. The STS-PAC is a principal component of the STS' advocacy armamentarium. Despite the many successes of the STS-PAC, with even modest contributions by more STS members, the STS-PAC could become a leading medical PAC, and would give the STS an even stronger presence and voice in Washington, DC. Clearly, contributing to the STS-PAC provides STS members the opportunity to have a voice and an impact on health policy and the care of their patients. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

H2O-Polyaluminium chloride-TBAB as synergistic catalysts for the synthesis of cyclic carbonate

NASA Astrophysics Data System (ADS)

Liu, X. J.; Yan, P.; Han, Y.

2018-01-01

An efficient catalytic system consisting of H2O, Polyaluminium chloride (PAC) and Tetrabutylammonium bromide (TBAB) was applied to the cycloaddition of carbon dioxide (CO2) to epoxides under mild conditions. Their catalytic cycloaddition activities were found to be well correlated with H2O and polyaluminium chloride, which had a synergetic effect with the halide anion of TBAB. The presence of H2O and PAC could remarkably improve the yield of propylene carbonate (PC) by which the reaction yield is about 4-5 times higher than TBAB. alone.The catalytic system also exhibited excellent cycloaddition activities for various epoxide substrates.

Development of a mobile HIS/PACS workstation to assist critical cardiac patients in an intensive care unit

NASA Astrophysics Data System (ADS)

Gutierrez, Marco A.; Cestari, Idagene A.; Hamamoto, Gina; Bacht, Simão; Rebelo, Marina S.; Silva, João E. M. M.; Lage, Silvia G.

2008-03-01

The current study describes the experience in the implementation of a mobile HIS/PACS workstation to assist critical cardiac patients in an Intensive Care Unit (ICU). Recently, mobile devices connected to a WiFi network were incorporated to the Hospital information System, providing the same functionalities of common desktop counterpart. However, the use of commercially devices like PDAs and Pocket PCs presented a series of problems that are more emphasized in the ICUs 1) low autonomy of the batteries, which need constant recharges; 2) low robustness of the devices; 3) insufficient display area to show medical images and vital signals; 4) data entry remains a major problem and imposes an extra time consumption to the staff; 5) high cost when fully equipped with WiFi connection, optical reader to access bar codes and memory. To address theses problems we developed a mobile workstation (MedKart) that provides access the HIS and PACS systems, with all resources and an ergonomic and practical design to be used by physicians and nurses inside the ICU. The system fulfills the requirements to assist, in the point-of-care, critical cardiac patients in Intensive Care Units.

Archival storage solutions for PACS

NASA Astrophysics Data System (ADS)

Chunn, Timothy

1997-05-01

While they are many, one of the inhibitors to the wide spread diffusion of PACS systems has been robust, cost effective digital archive storage solutions. Moreover, an automated Nearline solution is key to a central, sharable data repository, enabling many applications such as PACS, telemedicine and teleradiology, and information warehousing and data mining for research such as patient outcome analysis. Selecting the right solution depends on a number of factors: capacity requirements, write and retrieval performance requirements, scaleability in capacity and performance, configuration architecture and flexibility, subsystem availability and reliability, security requirements, system cost, achievable benefits and cost savings, investment protection, strategic fit and more.This paper addresses many of these issues. It compares and positions optical disk and magnetic tape technologies, which are the predominant archive mediums today. Price and performance comparisons will be made at different archive capacities, plus the effect of file size on storage system throughput will be analyzed. The concept of automated migration of images from high performance, high cost storage devices to high capacity, low cost storage devices will be introduced as a viable way to minimize overall storage costs for an archive. The concept of access density will also be introduced and applied to the selection of the most cost effective archive solution.

In vivo flow speed measurement of capillaries by photoacoustic correlation spectroscopy.

PubMed

Chen, Sung-Liang; Xie, Zhixing; Carson, Paul L; Wang, Xueding; Guo, L Jay

2011-10-15

We recently proposed photoacoustic correlation spectroscopy (PACS) and demonstrated a proof-of-concept experiment. Here we use the technique for in vivo flow speed measurement in capillaries in a chick embryo model. The photoacoustic microscopy system is used to render high spatial resolution and high sensitivity, enabling sufficient signals from single red blood cells. The probe beam size is calibrated by a blood-mimicking phantom. The results indicate the feasibility of using PACS to study flow speeds in capillaries.

Delivery of Unmanned Aerial Vehicle Data

NASA Technical Reports Server (NTRS)

Ivancic, William D.; Sullivan, Donald V.

2011-01-01

To support much of NASA's Upper Atmosphere Research Program science, NASA has acquired two Global Hawk Unmanned Aerial Vehicles (UAVs). Two major missions are currently planned using the Global Hawk: the Global Hawk Pacific (GloPac) and the Genesis and Rapid Intensification Processes (GRIP) missions. This paper briefly describes GloPac and GRIP, the concept of operations and the resulting requirements and communication architectures. Also discussed are requirements for future missions that may use satellite systems and networks owned and operated by third parties.

75 FR 80082 - State, Local, Tribal, And Private Sector Policy Advisory Committee (SLTPS-PAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-21

..., Tribal, And Private Sector Policy Advisory Committee (SLTPS-PAC) AGENCY: Information Security Oversight... State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC). The SLTPS-PAC will..., Tribal, and Private Sector Entities, as specified in Executive Order 13549 and its implementing directive...

ASP archiving solution of regional HUSpacs.

PubMed

Pohjonen, Hanna; Kauppinen, Tomi; Ahovuo, Juhani

2004-09-01

The application service provider (ASP) model is not novel, but widely used in several non-health care-related business areas. In this article, ASP is described as a potential solution for long-term and back-up archiving of the picture archiving and communication system (PACS) of the Hospital District of Helsinki and Uusimaa (HUS). HUSpacs is a regional PACS for 21 HUS hospitals serving altogether 1.4 million citizens. The ultimate goal of this study was to define the specifications for the ASP archiving service and to compare different commercial options for archiving solutions (costs derived by unofficial requests for proposal): in-house PACS components, the regional ASP concept and the hospital-based ASP concept. In conclusion, the large scale of the HUS installation enables a cost-effective regional ASP archiving, resulting in a four to five times more economical solution than hospital-based ASP.

Efficient radiologic reading environment by using an open-source macro program as connection software.

PubMed

Lee, Young Han

2012-01-01

The objectives are (1) to introduce an easy open-source macro program as connection software and (2) to illustrate the practical usages in radiologic reading environment by simulating the radiologic reading process. The simulation is a set of radiologic reading process to do a practical task in the radiologic reading room. The principal processes are: (1) to view radiologic images on the Picture Archiving and Communicating System (PACS), (2) to connect the HIS/EMR (Hospital Information System/Electronic Medical Record) system, (3) to make an automatic radiologic reporting system, and (4) to record and recall information of interesting cases. This simulation environment was designed by using open-source macro program as connection software. The simulation performed well on the Window-based PACS workstation. Radiologists practiced the steps of the simulation comfortably by utilizing the macro-powered radiologic environment. This macro program could automate several manual cumbersome steps in the radiologic reading process. This program successfully acts as connection software for the PACS software, EMR/HIS, spreadsheet, and other various input devices in the radiologic reading environment. A user-friendly efficient radiologic reading environment could be established by utilizing open-source macro program as connection software. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

The physical model for research of behavior of grouting mixtures

NASA Astrophysics Data System (ADS)

Hajovsky, Radovan; Pies, Martin; Lossmann, Jaroslav

2016-06-01

The paper deals with description of physical model designed for verification of behavior of grouting mixtures when applied below underground water level. Described physical model has been set up to determine propagation of grouting mixture in a given environment. Extension of grouting in this environment is based on measurement of humidity and temperature with the use of combined sensors located within preinstalled special measurement probes around grouting needle. Humidity was measured by combined capacity sensor DTH-1010, temperature was gathered by a NTC thermistor. Humidity sensors measured time when grouting mixture reached sensor location point. NTC thermistors measured temperature changes in time starting from initial of injection. This helped to develop 3D map showing the distribution of grouting mixture through the environment. Accomplishment of this particular measurement was carried out by a designed primary measurement module capable of connecting 4 humidity and temperature sensors. This module also takes care of converting these physical signals into unified analogue signals consequently brought to the input terminals of analogue input of programmable automation controller (PAC) WinPAC-8441. This controller ensures the measurement itself, archiving and visualization of all data. Detail description of a complex measurement system and evaluation in form of 3D animations and graphs is supposed to be in a full paper.

Fuzzy crane control with sensorless payload deflection feedback for vibration reduction

NASA Astrophysics Data System (ADS)

Smoczek, Jaroslaw

2014-05-01

Different types of cranes are widely used for shifting cargoes in building sites, shipping yards, container terminals and many manufacturing segments where the problem of fast and precise transferring a payload suspended on the ropes with oscillations reduction is frequently important to enhance the productivity, efficiency and safety. The paper presents the fuzzy logic-based robust feedback anti-sway control system which can be applicable either with or without a sensor of sway angle of a payload. The discrete-time control approach is based on the fuzzy interpolation of the controllers and crane dynamic model's parameters with respect to the varying rope length and mass of a payload. The iterative procedure combining a pole placement method and interval analysis of closed-loop characteristic polynomial coefficients is proposed to design the robust control scheme. The sensorless anti-sway control application developed with using PAC system with RX3i controller was verified on the laboratory scaled overhead crane.

PRELIMINARY ESTIMATES OF PERFORMANCE AND COST OF MERCURY EMISSION CONTROL TECHNOLOGY APPLICATIONS ON ELECTRIC UTILITY BOILERS: AN UPDATE

EPA Science Inventory

The paper presents estimates of performance levels and related costs associated with controlling mercury (Hg) emissions from coal-fired power plants using either powdered activated carbon (PAC) injection or multipollutant control in which Hg capture is enhanced in existing and ne...

Qualitative evaluation of the iris and ciliary body by ultrasound biomicroscopy in subjects with angle closure.

PubMed

Ku, Judy Y; Nongpiur, Monisha E; Park, Judy; Narayanaswamy, Arun K; Perera, Shamira A; Tun, Tin A; Kumar, Rajesh S; Baskaran, Mani; Aung, Tin

2014-12-01

To qualitatively analyze anterior chamber structures imaged by ultrasound biomicroscopy (UBM) in primary angle-closure patients. Subjects diagnosed as primary angle-closure suspect (PACS), primary angle-closure glaucoma (PACG), and previous acute primary angle closure (APAC) were recruited prospectively along with a group of normal controls. UBM was performed under standardized dark room conditions and qualitative assessment was carried out using a set of reference photographs of standard UBM images to categorize the various anatomic features related to angle configuration. These included overall and basal iris thicknesses, iris convexity, iris angulation, ciliary body size, and ciliary sulcus. A total of 60 PACS, 114 PACG, 41 APAC, and 33 normal controls were included. Patients were predominantly older Chinese females. After controlling the confounding effect of age and sex, eyes with overall thicker irides [medium odds ratio (OR) 3.58, thick OR 2.84] when compared with thin irides have a significantly higher likelihood of having PACS/PACG/APAC versus controls. Thicker basal iris component (medium OR 4.13, thick OR 3.39) also have higher likelihood of having angle closure when compared with thin basal iris thickness. Subjects with basal iris insertion, mild iris angulation, and large ciliary body have a higher OR of having angle closure. In contrast, the presence/absence of a ciliary sulcus did not influence the likelihood of angle closure. Eyes with thicker overall and basal iris thicknesses are more likely to have angle closure than controls. Other features that increase the likelihood of angle closure include basal iris insertion, mild iris angulation, and large ciliary body.

A Dependable Massive Storage Service for Medical Imaging.

PubMed

Núñez-Gaona, Marco Antonio; Marcelín-Jiménez, Ricardo; Gutiérrez-Martínez, Josefina; Aguirre-Meneses, Heriberto; Gonzalez-Compean, José Luis

2018-05-18

We present the construction of Babel, a distributed storage system that meets stringent requirements on dependability, availability, and scalability. Together with Babel, we developed an application that uses our system to store medical images. Accordingly, we show the feasibility of our proposal to provide an alternative solution for massive scientific storage and describe the software architecture style that manages the DICOM images life cycle, utilizing Babel like a virtual local storage component for a picture archiving and communication system (PACS-Babel Interface). Furthermore, we describe the communication interface in the Unified Modeling Language (UML) and show how it can be extended to manage the hard work associated with data migration processes on PACS in case of updates or disaster recovery.

Paclitaxel-induced lung injury and its amelioration by parecoxib sodium.

PubMed

Liu, Wen-jie; Zhong, Zhong-jian; Cao, Long-hui; Li, Hui-ting; Zhang, Tian-hua; Lin, Wen-qian

2015-08-10

To investigate the mechanism of paclitaxel-induced lung injury and its amelioration by parecoxib sodium. In this study, rats were randomly divided into: the control group (Con); the paclitaxel chemotherapy group (Pac); the paclitaxel+ parecoxib sodium intervention group (Pac + Pare); and the parecoxib sodium group (Pare). We observed changes in alveolar ventilation function, alveolar-capillary membrane permeability, lung tissue pathology and measured the levels of inflammatory cytokines and cyclooxygenase-2 (Cox-2) in lung tissue, the expression of tight junction proteins (Zo-1 and Claudin-4). Compared with the Con group, the lung tissue of the Pac group showed significantly increased expression of Cox-2 protein (p < 0.01), significant lung tissue inflammatory changes, significantly increased expression of inflammatory cytokines, decreased expression of Zo-1 and Claudin-4 proteins (p < 0.01), increased alveolar-capillary membrane permeability (p < 0.01), and reduced ventilation function (p < 0.01). Notably, in Pac + Pare group, intraperitoneal injection of parecoxib sodium led to decreased Cox-2 and ICAM-1 levels and reduced inflammatory responses, the recovered expression of Zo-1 and Claudin-4, reduced level of indicators reflecting the high permeability state, and close-to-normal levels of ventilation function. Intervention by the Cox-2-specific inhibitor parecoxib sodium can block this damage.

Power Pacs for Teaching Home Economics Related Science and Math.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This guide contains materials designed to assist teachers and students in home economics related courses with mastery of job-related mathematics, science, and behavioral science. The 40 Power Pacs are divided into mathematics (16 Power Pacs), science (15), and behavioral science (9). Each Power Pac contains teacher materials and student materials.…

Tubulin chaperone E binds microtubules and proteasomes and protects against misfolded protein stress.

PubMed

Voloshin, Olga; Gocheva, Yana; Gutnick, Marina; Movshovich, Natalia; Bakhrat, Anya; Baranes-Bachar, Keren; Bar-Zvi, Dudy; Parvari, Ruti; Gheber, Larisa; Raveh, Dina

2010-06-01

Mutation of tubulin chaperone E (TBCE) underlies hypoparathyroidism, retardation, and dysmorphism (HRD) syndrome with defective microtubule (MT) cytoskeleton. TBCE/yeast Pac2 comprises CAP-Gly, LRR (leucine-rich region), and UbL (ubiquitin-like) domains. TBCE folds alpha-tubulin and promotes alpha/beta dimerization. We show that Pac2 functions in MT dynamics: the CAP-Gly domain binds alpha-tubulin and MTs, and functions in suppression of benomyl sensitivity of pac2Delta mutants. Pac2 binds proteasomes: the LRR binds Rpn1, and the UbL binds Rpn10; the latter interaction mediates Pac2 turnover. The UbL also binds the Skp1-Cdc53-F-box (SCF) ubiquitin ligase complex; these competing interactions for the UbL may impact on MT dynamics. pac2Delta mutants are sensitive to misfolded protein stress. This is suppressed by ectopic PAC2 with both the CAP-Gly and UbL domains being essential. We propose a novel role for Pac2 in the misfolded protein stress response based on its ability to interact with both the MT cytoskeleton and the proteasomes.

An Efficient Method for High-Fidelity BAC/PAC Retrofitting with a Selectable Marker for Mammalian Cell Transfection

PubMed Central

Wang, Zunde; Engler, Peter; Longacre, Angelika; Storb, Ursula

2001-01-01

Large-scale genomic sequencing projects have provided DNA sequence information for many genes, but the biological functions for most of them will only be known through functional studies. Bacterial artificial chromosomes (BACs) and P1-derived artificial chromosomes (PACs) are large genomic clones stably maintained in bacteria and are very important in functional studies through transfection because of their large size and stability. Because most BAC or PAC vectors do not have a mammalian selection marker, transfecting mammalian cells with genes cloned in BACs or PACs requires the insertion into the BAC/PAC of a mammalian selectable marker. However, currently available procedures are not satisfactory in efficiency and fidelity. We describe a very simple and efficient procedure that allows one to retrofit dozens of BACs in a day with no detectable deletions or unwanted recombination. We use a BAC/PAC retrofitting vector that, on transformation into competent BAC or PAC strains, will catalyze the specific insertion of itself into BAC/PAC vectors through in vivo cre/loxP site-specific recombination. PMID:11156622

Gonioscopy findings and prevalence of occludable angles in a Burmese population: the Meiktila Eye Study.

PubMed

Casson, R J; Newland, H S; Muecke, J; McGovern, S; Abraham, L M; Shein, W K; Selva, D; Aung, T

2007-07-01

To determine the prevalence of preglaucomatous angle-closure disease in central Myanmar. A population-based survey of inhabitants >or=40 years in the Meiktila District was carried out; 2481 subjects were identified, 2076 participated and 2060 underwent gonioscopy of at least one eye. Eyes with angles traditionally described as "occludable" were recorded as primary angle-closure suspects (PACS); eyes with PACS and peripheral anterior synechiae (PAS), or an increased intraocular pressure but without primary angle-closure glaucoma, were recorded as primary angle closure (PAC). The prevalence of PACS in at least one eye was 5.7% (95% CI 4.72 to 6.62); prevalence increased with age and was more common in women (p<0.001). The prevalence of PAC in at least one eye was 1.50% (95% CI 1.47 to 1.53). All participants with PAS had at least 90 degrees of closure (range 90-360 degrees). The prevalence of preglaucomatous angle-closure disease (PACS and PAC) in this population was 5.7% and 1.5%, respectively. PACS was more common in women, and its prevalence increased with age.

[Validation of the Physical Appearance Comparison Scale (PACS) in a German Sample: Psychometric Properties and Association with Eating Behavior, Body Image and Self-Esteem].

PubMed

Claire Mölbert, Simone; Hautzinger, Martin; Karnath, Hans-Otto; Zipfel, Stephan; Giel, Katrin

2017-02-01

The Physical Appearance Comparison Scale (PACS [14]) is the most commonly used validated measure of body-related social comparison habits. Here we investigate reliability and construct validity of the PACS in a German sample. Participants (n=75 men, n=75 women and n=25 women with a confirmed diagnosis of anorexia nervosa) completed the PACS along with measures of eating disorder pathology, body image and self-esteem. Results show an adequate internal consistency of the PACS for the female subgroups and medium to high correlations with eating disorder pathology, body image and self-esteem. PACS total score differed significantly between groups, with men scoring lowest and women with anorexia nervosa scoring highest. We conclude that the PACS is a sufficiently reliable and valid measure of body-related social comparison habits in women. In men, it should only be used with special care. The PACS is generally suitable to promote patient studies testing the role of social comparisons for the patho-mechanisms of eating disorders. © Georg Thieme Verlag KG Stuttgart · New York.

Regulation of the reserve carbohydrate metabolism by alkaline pH and calcium in Neurospora crassa reveals a possible cross-regulation of both signaling pathways.

PubMed

Virgilio, Stela; Cupertino, Fernanda Barbosa; Ambrosio, Daniela Luz; Bertolini, Maria Célia

2017-06-09

Glycogen and trehalose are storage carbohydrates and their levels in microorganisms vary according to environmental conditions. In Neurospora crassa, alkaline pH stress highly influences glycogen levels, and in Saccharomyces cerevisiae, the response to pH stress also involves the calcineurin signaling pathway mediated by the Crz1 transcription factor. Recently, in yeast, pH stress response genes were identified as targets of Crz1 including genes involved in glycogen and trehalose metabolism. In this work, we present evidence that in N. crassa the glycogen and trehalose metabolism is modulated by alkaline pH and calcium stresses. We demonstrated that the pH signaling pathway in N. crassa controls the accumulation of the reserve carbohydrates glycogen and trehalose via the PAC-3 transcription factor, which is the central regulator of the signaling pathway. The protein binds to the promoters of most of the genes encoding enzymes of glycogen and trehalose metabolism and regulates their expression. We also demonstrated that the reserve carbohydrate levels and gene expression are both modulated under calcium stress and that the response to calcium stress may involve the concerted action of PAC-3. Calcium activates growth of the Δpac-3 strain and influences its glycogen and trehalose accumulation. In addition, calcium stress differently regulates glycogen and trehalose metabolism in the mutant strain compared to the wild-type strain. While glycogen levels are decreased in both strains, the trehalose levels are significantly increased in the wild-type strain and not affected by calcium in the mutant strain when compared to mycelium not exposed to calcium. We previously reported the role of PAC-3 as a transcription factor involved in glycogen metabolism regulation by controlling the expression of the gsn gene, which encodes an enzyme of glycogen synthesis. In this work, we extended the investigation by studying in greater detail the effects of pH on the metabolism of the reserve carbohydrate glycogen and trehalose. We also demonstrated that calcium stress affects the reserve carbohydrate levels and the response to calcium stress may require PAC-3. Considering that the reserve carbohydrate metabolism may be subjected to different signaling pathways control, our data contribute to the understanding of the N. crassa responses under pH and calcium stresses.

The dipeptidyl peptidase-4 inhibitor Saxagliptin improves function of circulating pro-angiogenic cells from type 2 diabetic patients

PubMed Central

2014-01-01

Background Type 2 diabetes (T2D) is associated with reduction and dysfunction of circulating pro-angiogenic cells (PACs). DPP-4 inhibitors, a class of oral agents for T2D, might possess pleiotropic vasculoprotective activities. Herein, we tested whether DPP-4 inhibition with Saxagliptin affects the function of circulating PACs from T2D and healthy subjects. Methods PACs were isolated from T2D (n = 20) and healthy (n = 20) subjects. Gene expression, clonogenesis, proliferation, adhesion, migration and tubulisation were assessed in vitro by incubating PACs with or without Saxagliptin and SDF-1α. Stimulation of angiogenesis by circulating cells from T2D patients treated with Saxagliptin or other non-incretinergic drugs was assessed in vivo using animal models. Results Soluble DPP-4 activity was predominant over cellular activity and was successfully inhibited by Saxagliptin. At baseline, T2D compared to healthy PACs contained less acLDL+Lectin+ cells, and showed altered expression of genes related to adhesion and cell cycle regulation. This was reflected by impaired adhesion and clonogenesis/proliferative response of T2D PACs. Saxagliptin + SDF-1α improved adhesion and tube sustaining capacity of PACs from T2D patients. CD14+ PACs were more responsive to Saxagliptin than CD14- PACs. While Saxagliptin modestly reduced angiogenesis by mature endothelial cells, circulating PACs-progeny cells from T2D patients on Saxagliptin treatment displayed higher growth factor-inducible in vivo angiogenetic activity, compared to cells from T2D patients on non-incretinergic regimen. Conclusions Saxagliptin reverses PACs dysfunction associated with T2D in vitro and improves inducible angiogenesis by circulating cells in vivo. These data add knowledge to the potential pleiotropic cardiovascular effects of DPP-4 inhibition. PMID:24886621

The dipeptidyl peptidase-4 inhibitor saxagliptin improves function of circulating pro-angiogenic cells from type 2 diabetic patients.

PubMed

Poncina, Nicol; Albiero, Mattia; Menegazzo, Lisa; Cappellari, Roberta; Avogaro, Angelo; Fadini, Gian Paolo

2014-05-14

Type 2 diabetes (T2D) is associated with reduction and dysfunction of circulating pro-angiogenic cells (PACs). DPP-4 inhibitors, a class of oral agents for T2D, might possess pleiotropic vasculoprotective activities. Herein, we tested whether DPP-4 inhibition with Saxagliptin affects the function of circulating PACs from T2D and healthy subjects. PACs were isolated from T2D (n = 20) and healthy (n = 20) subjects. Gene expression, clonogenesis, proliferation, adhesion, migration and tubulisation were assessed in vitro by incubating PACs with or without Saxagliptin and SDF-1α. Stimulation of angiogenesis by circulating cells from T2D patients treated with Saxagliptin or other non-incretinergic drugs was assessed in vivo using animal models. Soluble DPP-4 activity was predominant over cellular activity and was successfully inhibited by Saxagliptin. At baseline, T2D compared to healthy PACs contained less acLDL(+)Lectin(+) cells, and showed altered expression of genes related to adhesion and cell cycle regulation. This was reflected by impaired adhesion and clonogenesis/proliferative response of T2D PACs. Saxagliptin + SDF-1α improved adhesion and tube sustaining capacity of PACs from T2D patients. CD14+ PACs were more responsive to Saxagliptin than CD14- PACs. While Saxagliptin modestly reduced angiogenesis by mature endothelial cells, circulating PACs-progeny cells from T2D patients on Saxagliptin treatment displayed higher growth factor-inducible in vivo angiogenetic activity, compared to cells from T2D patients on non-incretinergic regimen. Saxagliptin reverses PACs dysfunction associated with T2D in vitro and improves inducible angiogenesis by circulating cells in vivo. These data add knowledge to the potential pleiotropic cardiovascular effects of DPP-4 inhibition.

Ammonia removal in the carbon contactor of a hybrid membrane process.

PubMed

Stoquart, Céline; Servais, Pierre; Barbeau, Benoit

2014-12-15

The hybrid membrane process (HMP) coupling powdered activated carbon (PAC) and low-pressure membrane filtration is emerging as a promising new option to remove dissolved contaminants from drinking water. Yet, defining optimal HMP operating conditions has not been confirmed. In this study, ammonia removal occurring in the PAC contactor of an HMP was simulated at lab-scale. Kinetics were monitored using three PAC concentrations (1-5-10 g L(-1)), three PAC ages (0-10-60 days), two temperatures (7-22 °C), in ambient influent condition (100 μg N-NH4 L(-1)) as well as with a simulated peak pollution scenario (1000 μg N-NH4L(-1)). The following conclusions were drawn: i) Using a colonized PAC in the HMP is essential to reach complete ammonia removal, ii) an older PAC offers a higher resilience to temperature decrease as well as lower operating costs; ii) PAC concentration inside the HMP reactor is not a key operating parameter as under the conditions tested, PAC colonization was not limited by the available surface; iii) ammonia flux limited biomass growth and iv) hydraulic retention time was a critical parameter. In the case of a peak pollution, the process was most probably phosphate-limited but a mixed adsorption/nitrification still allowed reaching a 50% ammonia removal. Finally, a kinetic model based on these experiments is proposed to predict ammonia removal occurring in the PAC reactor of the HMP. The model determines the relative importance of the adsorption and biological oxidation of ammonia on colonized PAC, and demonstrates the combined role of nitrification and residual adsorption capacity of colonized PAC. Copyright © 2014 Elsevier Ltd. All rights reserved.

Quantitative Analysis of Pac1/LIS1-mediated Dynein Targeting: Implications for Regulation of Dynein Activity in Budding Yeast

PubMed Central

Markus, Steven M.; Plevock, Karen M.; St. Germain, Bryan J.; Punch, Jesse J.; Meaden, Christopher W.; Lee, Wei-Lih

2011-01-01

LIS1 is a critical regulator of dynein function during mitosis and organelle transport. Here, we investigated how Pac1, the budding yeast LIS1 homologue, regulates dynein targeting and activity during nuclear migration. We show that Pac1 and Dyn1 (dynein heavy chain) are dependent upon each other and upon Bik1 (budding yeast CLIP-170 homologue) for plus end localization, whereas Bik1 is independent of either. Dyn1, Pac1 and Bik1 interact in vivo at the plus ends, where an excess amount of Bik1 recruits approximately equal amounts of Pac1 and Dyn1. Overexpression of Pac1 enhanced plus end targeting of Dyn1 and vice versa, while affinity-purification of Dyn1 revealed that it exists in a complex with Pac1 in the absence of Bik1, leading us to conclude that the Pac1-Dyn1 complex preassembles in the cytoplasm prior to loading onto Bik1-decorated plus ends. Strikingly, we found that Pac1-overexpression augments cortical dynein activity through a mechanism distinct from loss of She1, a negative regulator of dynein-dynactin association. While Pac1-overexpression enhances the frequency of cortical targeting for dynein and dynactin, the stoichiometry of these complexes remains relatively unchanged at the plus ends compared to that in wild-type cells (~3 dynein to 1 dynactin). Loss of She1, however, enhances dynein-dynactin association at the plus ends and the cell cortex, resulting in an apparent 1:1 stoichiometry. Our results reveal differential regulation of cortical dynein activity by She1 and Pac1, and provide a potentially new regulatory step in the off-loading model for dynein function. PMID:21294277

Radiology workstation design for the medical intensive care unit.

PubMed

Moise, Adrian; Atkins, Stella M

2002-01-01

The "one-size-fits-all" approach for radiology workstation design is not good enough anymore. While most of the picture archiving and communication system (PACS) vendors are racing to add more features to the radiology workstation, there is little interest in addressing the specific needs of other hospital departments. Significant delays in the availability of radiology reports are often caused by the fact there is not enough Intensive Care Unit (ICU) volume to justify a full time radiologist. Consequently, the radiologist assigned to cover the ICU exams, most likely working from a different building, will read the ICU exams only at certain times, depending on the limitations for remote image availability. This paper addresses the main objectives in designing a digital radiology workstation for use in the medical ICU (MICU), requiring enhancements to current PACS systems. Our suggestions for PACS improvement follow the ICU digital workflow starting with the transfer of the images from the modality, continuing with the presentation of the radiology examination to different types of users (radiologists or ICU staff), up to the creation and distribution of the reports.

GASPS Photometry of the Tucana-Horologium Association

NASA Technical Reports Server (NTRS)

Roberge, Donaldson J.; Roberge, Aki

2010-01-01

The GASPS Open Time Key Programme on Herschel represents a new opportunity to sensitively probe protoplanetary and debris disks at far-IR wavelengths. We present preliminary PACS 70 and 160 micron photometry of eighteen stars in the 30 Myr-old Tucana-Horologium association. Of these eighteen, eight were detected in the 70 micron band. Four of these eight were also detected in the 160 micron band. We constructed SEDs for these systems using optical data from Hipparcos (B and V), near-IR data from 2MASS (J, H, and K), mid-IR data from IRAS and Spitzer MIPS (12 and 24 microns, respectively), and the new far-IR data from PACS. For the stars showing IR excess emission, we fit simple single-temperature blackbody curves to the IR excess in order to determine the rough dust abundances and temperatures. Dust observations at these wavelengths will also be important for comparison with upcoming Herschel PACS spectra that will search for gas in the disks. Our goal is to determine or limit the ever-allusive gas-to-dust ratio for these disk systems.

Sizing a PACS

NASA Astrophysics Data System (ADS)

Wilson, Dennis L.; Glicksman, Robert A.

1994-05-01

A Picture Archiving and Communications System (PACS) must be able to support the image rate of the medical treatment facility. In addition the PACS must have adequate working storage and archive storage capacity required. The calculation of the number of images per minute and the capacity of working storage and of archiving storage is discussed. The calculation takes into account the distribution of images over the different size of radiological images, the distribution between inpatient and outpatient, and the distribution over plain film CR images and other modality images. The support of the indirect clinical image load is difficult to estimate and is considered in some detail. The result of the exercise for a particular hospital is an estimate of the average size of the images and exams on the system, of the number of gigabytes of working storage, of the number of images moved per minute, of the size of the archive in gigabytes, and of the number of images that are to be moved by the archive per minute. The types of storage required to support the image rates and the capacity required are discussed.

Using IHE and HL7 conformance to specify consistent PACS interoperability for a large multi-center enterprise.

PubMed

Henderson, Michael L; Dayhoff, Ruth E; Titton, Csaba P; Casertano, Andrew

2006-01-01

As part of its patient care mission, the U.S. Veterans Health Administration performs diagnostic imaging procedures at 141 medical centers and 850 outpatient clinics. VHA's VistA Imaging Package provides a full archival, display, and communications infrastructure and interfaces to radiology and other HIS modules as well as modalities and a worklist provider In addition, various medical center entities within VHA have elected to install commercial picture archiving and communications systems to enable image organization and interpretation. To evaluate interfaces between commercial PACS, the VistA hospital information system, and imaging modalities, VHA has built a fully constrained specification that is based on the Radiology Technical Framework (Rad-TF) Integrating the Healthcare Enterprise. The Health Level Seven normative conformance mechanism was applied to the IHE Rad-TF and agency requirements to arrive at a baseline set of message specifications. VHA provides a thorough implementation and testing process to promote the adoption of standards-based interoperability by all PACS vendors that want to interface with VistA Imaging.

PacC and pH–dependent transcriptome of the mycotrophic fungus Trichoderma virens

PubMed Central

2013-01-01

Background In fungi, environmental pH is an important signal for development, and successful host colonization depends on homeostasis. Surprisingly, little is known regarding the role of pH in fungal-fungal interactions. Species of Trichoderma grow as soil saprobes but many are primarily mycotrophic, using other fungi as hosts. Therefore, Trichoderma spp. are studied for their potential in biocontrol of plant diseases. Particularly in alkaline soil, pH is a critical limiting factor for these biofungicides, whose optimal growth pH is 4–6. Gaining an understanding of pH adaptability is an important step in broadening the activity spectrum of these economically important fungi. Results We studied the pH-responsive transcription factor PacC by gene knockout and by introduction of a constitutively active allele (pacCc). ΔpacC mutants exhibited reduced growth at alkaline pH, while pacCc strains grew poorly at acidic pH. In plate confrontation assays ΔpacC mutants showed decreased ability to compete with the plant pathogens Rhizoctonia solani and Sclerotium rolfsii. The pacCc strain exhibited an overgrowth of R. solani that was comparable to the wild type, but was unable to overgrow S. rolfsii. To identify genes whose expression is dependent on pH and pacC, we designed oligonucleotide microarrays from the transcript models of the T. virens genome, and compared the transcriptomes of wild type and mutant cultures exposed to high or low pH. Transcript levels from several functional classes were dependent on pacC, on pH, or on both. Furthermore, the expression of a set of pacC-dependent genes was increased in the constitutively-active pacCc strain, and was pH-independent in some, but not all cases. Conclusions PacC is important for biocontrol-related antagonism of other fungi by T. virens. As much as 5% of the transcriptome is pH-dependent, and of these genes, some 25% depend on pacC. Secondary metabolite biosynthesis and ion transport are among the relevant gene classes. We suggest that ΔpacC mutants may have lost their full biocontrol potential due to their inability to adapt to alkaline pH, to perceive ambient pH, or both. The results raise the novel possibility of genetically manipulating Trichoderma in order to improve adaptability and biocontrol at alkaline pH. PMID:23445374

Development of a mobile emergency patient information and imaging communication system based on CDMA-1X EVDO

NASA Astrophysics Data System (ADS)

Yang, Keon Ho; Jung, Haijo; Kang, Won-Suk; Jang, Bong Mun; Kim, Joong Il; Han, Dong Hoon; Yoo, Sun-Kook; Yoo, Hyung-Sik; Kim, Hee-Joung

2006-03-01

The wireless mobile service with a high bit rate using CDMA-1X EVDO is now widely used in Korea. Mobile devices are also increasingly being used as the conventional communication mechanism. We have developed a web-based mobile system that communicates patient information and images, using CDMA-1X EVDO for emergency diagnosis. It is composed of a Mobile web application system using the Microsoft Windows 2003 server and an internet information service. Also, a mobile web PACS used for a database managing patient information and images was developed by using Microsoft access 2003. A wireless mobile emergency patient information and imaging communication system is developed by using Microsoft Visual Studio.NET, and JPEG 2000 ActiveX control for PDA phone was developed by using the Microsoft Embedded Visual C++. Also, the CDMA-1X EVDO is used for connections between mobile web servers and the PDA phone. This system allows fast access to the patient information database, storing both medical images and patient information anytime and anywhere. Especially, images were compressed into a JPEG2000 format and transmitted from a mobile web PACS inside the hospital to the radiologist using a PDA phone located outside the hospital. Also, this system shows radiological images as well as physiological signal data, including blood pressure, vital signs and so on, in the web browser of the PDA phone so radiologists can diagnose more effectively. Also, we acquired good results using an RW-6100 PDA phone used in the university hospital system of the Sinchon Severance Hospital in Korea.

Offset-Free Model Predictive Control of Open Water Channel Based on Moving Horizon Estimation

NASA Astrophysics Data System (ADS)

Ekin Aydin, Boran; Rutten, Martine

2016-04-01

Model predictive control (MPC) is a powerful control option which is increasingly used by operational water managers for managing water systems. The explicit consideration of constraints and multi-objective management are important features of MPC. However, due to the water loss in open water systems by seepage, leakage and evaporation a mismatch between the model and the real system will be created. These mismatch affects the performance of MPC and creates an offset from the reference set point of the water level. We present model predictive control based on moving horizon estimation (MHE-MPC) to achieve offset free control of water level for open water canals. MHE-MPC uses the past predictions of the model and the past measurements of the system to estimate unknown disturbances and the offset in the controlled water level is systematically removed. We numerically tested MHE-MPC on an accurate hydro-dynamic model of the laboratory canal UPC-PAC located in Barcelona. In addition, we also used well known disturbance modeling offset free control scheme for the same test case. Simulation experiments on a single canal reach show that MHE-MPC outperforms disturbance modeling offset free control scheme.

Clinical results of HIS, RIS, PACS integration using data integration CASE tools

NASA Astrophysics Data System (ADS)

Taira, Ricky K.; Chan, Hing-Ming; Breant, Claudine M.; Huang, Lu J.; Valentino, Daniel J.

1995-05-01

Current infrastructure research in PACS is dominated by the development of communication networks (local area networks, teleradiology, ATM networks, etc.), multimedia display workstations, and hierarchical image storage architectures. However, limited work has been performed on developing flexible, expansible, and intelligent information processing architectures for the vast decentralized image and text data repositories prevalent in healthcare environments. Patient information is often distributed among multiple data management systems. Current large-scale efforts to integrate medical information and knowledge sources have been costly with limited retrieval functionality. Software integration strategies to unify distributed data and knowledge sources is still lacking commercially. Systems heterogeneity (i.e., differences in hardware platforms, communication protocols, database management software, nomenclature, etc.) is at the heart of the problem and is unlikely to be standardized in the near future. In this paper, we demonstrate the use of newly available CASE (computer- aided software engineering) tools to rapidly integrate HIS, RIS, and PACS information systems. The advantages of these tools include fast development time (low-level code is generated from graphical specifications), and easy system maintenance (excellent documentation, easy to perform changes, and centralized code repository in an object-oriented database). The CASE tools are used to develop and manage the `middle-ware' in our client- mediator-serve architecture for systems integration. Our architecture is scalable and can accommodate heterogeneous database and communication protocols.

Intravesical PAC1 Receptor Antagonist, PACAP(6–38), Reduces Urinary Bladder Frequency and Pelvic Sensitivity in NGF-OE Mice

PubMed Central

Girard, Beatrice M.; Malley, Susan E.; Mathews, Morgan M.; May, Victor

2017-01-01

Chronic NGF overexpression (OE) in the urothelium, achieved through the use of a highly urothelium-specific uroplakin II promoter, stimulates neuronal sprouting in the urinary bladder, produces increased voiding frequency and non-voiding contractions, and referred somatic sensitivity. Additional NGF-mediated pleiotropic changes might contribute to increased voiding frequency and pelvic hypersensitivity in NGF-OE mice such as neuropeptide/receptor systems including PACAP(Adcyap1) and PAC1 receptor (Adcyap1r1). Given the presence of PAC1-immunoreactive fibers and the expression of PAC1 receptor expression in bladder tissues, and PACAP-facilitated detrusor contraction, whether PACAP/receptor signaling contributes to increased voiding frequency and somatic sensitivity was evaluated in NGF-OE mice. Intravesical administration of the PAC1 receptor antagonist, PACAP(6–38) (300 nM), significantly (p ≤ 0.01) increased intercontraction interval (2.0-fold) and void volume (2.5-fold) in NGF-OE mice. Intravesical instillation of PACAP(6–38) also decreased baseline bladder pressure in NGF-OE mice. PACAP(6–38) had no effects on bladder function in WT mice. Intravesical administration of PACAP(6–38) (300 nM) significantly (p ≤ 0.01) reduced pelvic sensitivity in NGF-OE mice but was without effect in WT mice. PACAP/receptor signaling contributes to the increased voiding frequency and pelvic sensitivity observed in NGF-OE mice. PMID:27146136

Stress-related disorders, pituitary adenylate cyclase-activating peptide (PACAP)ergic system, and sex differences.

PubMed

Ramikie, Teniel S; Ressler, Kerry J

2016-12-01

Trauma-related disorders, such as posttraumatic stress disorder (PTSD) are remarkably common and debilitating, and are often characterized by dysregulated threat responses. Across numerous epidemiological studies, females have been found to have an approximately twofold increased risk for PTSD and other stress-related disorders. Understanding the biological mechanisms of this differential risk is of critical importance. Recent data suggest that the pituitary adenylate cyclase-activating polypeptide (PACAP) pathway is a critical regulator of the stress response across species. Moreover, increasing evidence suggests that this pathway is regulated by both stress and estrogen modulation and may provide an important window into understanding mechanisms of sex differences in the stress response. We have recently shown that PACAP and its receptor (PAC1R) are critical mediators of abnormal processes after psychological trauma. Notably, in heavily traumatized human subjects, there appears to be a robust sex-specific association of PACAP blood levels and PAC1R gene variants with fear physiology, PTSD diagnosis, and symptoms, specifically in females. The sex-specific association occurs within a single-nucleotide polymorphism (rs2267735) that resides in a putative estrogen response element involved in PAC1R gene regulation. Complementing these human data, the PAC1R messenger RNA is induced with fear conditioning or estrogen replacement in rodent models. These data suggest that perturbations in the PACAP-PAC1R pathway are regulated by estrogen and are involved in abnormal fear responses underlying PTSD.

Synthesis of photobleachable deep UV resists based on single component nonchemically amplified resist system

NASA Astrophysics Data System (ADS)

Kim, Kyoung-Seon; Kim, Su-Min; Park, Ji-Young; Kim, Jin-Baek

2006-03-01

In a general way, non-CARs consist of the matrix resins and photoactive compounds (PACs), and the dissolution properties of the resists are dependent on the amount of PACs. In common, I-line and G-line resists based on novolac and diazonaphthoquinone (DNQ) are typical non-CARs. But most PACs absorb much light in the deep UV, and they are poorly photobleached by deep UV exposure. This strong absorption of PACs prevents the deep UV light from reaching the bottom of the resist film, leading to scum and sloped pattern profiles. Several PACs which contain diazoketo groups have been reported for deep UV lithography. Our goal in this investigation is to find a proper resist that is processable without photoacid generator and induces both photobleaching in the deep UV regions and polarity change upon exposure. We thought diazoketo groups attached to the polymer side chains could give such effects. There is no necessity for the post-exposure bake step that is the cause of acid-diffusion. The diazoketo groups undergo the Wolff rearrangement upon irradiation in the deep UV, affording ketenes that react with water to provide base soluble photoproducts. The polymers were synthesized by radical copolymerization of 2-(2-diazo-3-oxo-butyryloxy)-ethyl methacrylate, 2-hydroxyethyl methacrylate, and γ-butyrolacton-2-yl methacrylate. The single component resist showed 0.7μm line and space patterns using a mercury-xenon lamp in a contact printing mode.

Two year experience with Web connectivity to PACS at a community-based hospital

NASA Astrophysics Data System (ADS)

Wadley, Brian D.; Hayward, Ulrike; Trambert, Michael; Kywi, Alberto; Hartzman, Steven

2002-05-01

Referring physician web based access to a PACS is evaluated at a community-based hospital. Survey results show 100% perceived improvement in referring physician productivity, and 97% perceived improvement in patient care. Overall satisfaction and perception of ease of use is greater than 90%.Web connectivity to PACS is perceived by 97% to result in decreased visits and calls to the radiology department due to the availability of virtual results, with high value placed on the voice clip summary results by 94% of respondents (the voice clip is a recording made by the radiologist at the time of reading the exam, which summarizes the results of the study).The availability of exams and virtual results via web-based connectivity is perceived to result in increase referrals by 58% of respondents. Web log audit trails are analyzed to evaluate the use of the system by referring physicians. The gross number of cases retrieved over the web for a two-week period is assessed. The number of times a voice clip was played is also evaluated. The results overall show a very positive experience with web connectivity to PACS.