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.
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.
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.
Implementation, reliability, and feasibility test of an Open-Source PACS.
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.
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.
[Change in process management by implementing RIS, PACS and flat-panel detectors].
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.
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.
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.
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.
Development and implementation of a PACS network and resource manager
NASA Astrophysics Data System (ADS)
Stewart, Brent K.; Taira, Ricky K.; Dwyer, Samuel J., III; Huang, H. K.
1992-07-01
Clinical acceptance of PACS is predicated upon maximum uptime. Upon component failure, detection, diagnosis, reconfiguration and repair must occur immediately. Our current PACS network is large, heterogeneous, complex and wide-spread geographically. The overwhelming number of network devices, computers and software processes involved in a departmental or inter-institutional PACS makes development of tools for network and resource management critical. The authors have developed and implemented a comprehensive solution (PACS Network-Resource Manager) using the OSI Network Management Framework with network element agents that respond to queries and commands for network management stations. Managed resources include: communication protocol layers for Ethernet, FDDI and UltraNet; network devices; computer and operating system resources; and application, database and network services. The Network-Resource Manager is currently being used for warning, fault, security violation and configuration modification event notification. Analysis, automation and control applications have been added so that PACS resources can be dynamically reconfigured and so that users are notified when active involvement is required. Custom data and error logging have been implemented that allow statistics for each PACS subsystem to be charted for performance data. The Network-Resource Manager allows our departmental PACS system to be monitored continuously and thoroughly, with a minimal amount of personal involvement and time.
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.
PACS archive upgrade and data migration: clinical experiences
NASA Astrophysics Data System (ADS)
Liu, Brent J.; Documet, Luis; Sarti, Dennis A.; Huang, H. K.; Donnelly, John
2002-05-01
Saint John's Health Center PACS data volumes have increased dramatically since the hospital became filmless in April of 1999. This is due in part of continuous image accumulation, and the integration of a new multi-slice detector CT scanner into PACS. The original PACS archive would not be able to handle the distribution and archiving load and capacity in the near future. Furthermore, there is no secondary copy backup of all the archived PACS image data for disaster recovery purposes. The purpose of this paper is to present a clinical and technical process template to upgrade and expand the PACS archive, migrate existing PACs image data to the new archive, and provide a back-up and disaster recovery function not currently available. Discussion of the technical and clinical pitfalls and challenges involved in this process will be presented as well. The server hardware configuration was upgraded and a secondary backup implemented for disaster recovery. The upgrade includes new software versions, database reconfiguration, and installation of a new tape jukebox to replace the current MOD jukebox. Upon completion, all PACS image data from the original MOD jukebox was migrated to the new tape jukebox and verified. The migration was performed during clinical operation continuously in the background. Once the data migration was completed the MOD jukebox was removed. All newly acquired PACS exams are now archived to the new tape jukebox. All PACs image data residing on the original MOD jukebox have been successfully migrated into the new archive. In addition, a secondary backup of all PACS image data has been implemented for disaster recovery and has been verified using disaster scenario testing. No PACS image data was lost during the entire process and there was very little clinical impact during the entire upgrade and data migration. Some of the pitfalls and challenges during this upgrade process included hardware reconfiguration for the original archive server, clinical downtime involved with the upgrade, and data migration planning to minimize impact on clinical workflow. The impact was minimized with a downtime contingency plan.
Current developments in departmental PACS for ultrasound.
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.
NASA Astrophysics Data System (ADS)
Taira, Ricky K.; Chan, Kelby K.; Stewart, Brent K.; Weinberg, Wolfram S.
1991-07-01
Reliability is an increasing concern when moving PACS from the experimental laboratory to the clinical environment. Any system downtime may seriously affect patient care. The authors report on the several classes of errors encountered during the pre-clinical release of the PACS during the past several months and present the solutions implemented to handle them. The reliability issues discussed include: (1) environmental precautions, (2) database backups, (3) monitor routines of critical resources and processes, (4) hardware redundancy (networks, archives), and (5) development of a PACS quality control program.
Knowledge barriers to PACS adoption and implementation in hospitals.
Paré, Guy; Trudel, Marie-Claude
2007-01-01
Drawing on the classical theory of diffusion of innovations advanced by Rogers [E.M. Rogers, Diffusion of Innovations, 4th ed., Free Press, New York, NY, 1995] and on the theory of barriers to innovation [P. Attewell, Technology diffusion and organizational learning: the case of business computing. Organ. Sci. 3 (1992) 1-19; H. Tanriverdi, C.S. Iacono, Knowledge barriers to diffusion of telemedicine. Proceedings of the 20th International Conference on Information Systems, Charlotte, NC, 1999, pp. 39-50; S. Nambisan, Y.-M. Wang, Roadblocks to web technology adoption? Commun. ACM, 42 (1) (1999) 98-101], this study seeks a better understanding of challenges faced in PACS implementations in hospitals and of the strategies required to ensure their success. To attain this objective, we describe and analyze the process used to adopt and implement PACS at two Canadian hospitals. Our findings clearly demonstrate the importance of treating any PACS deployment not simply as a rollout of new technology but as a project that will transform the organization. Proponents of these projects must not lose sight of the fact that, even if technological complexity represents a significant issue, it must not garner all the project team's attention. This situation is even more dangerous, inasmuch as the greatest risk to the implementation often lies elsewhere. It would also appear to be crucial to anticipate and address organizational and behavioral challenges from the very first phase of the innovation process, in order to ensure that all participants will be committed to the project. In order to maximize the likelihood of PACS success, it appears crucial to adopt a proactive implementation strategy, one that takes into consideration all the technical, economic, organizational, and human factors, and does so from the first phase of the innovation process.
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.
Impact of PACS on dictation turnaround time and productivity.
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.
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.
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.
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.
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.
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.
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.
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.
Tools to manage the enterprise-wide picture archiving and communications system environment.
Lannum, L M; Gumpf, S; Piraino, D
2001-06-01
The presentation will focus on the implementation and utilization of a central picture archiving and communications system (PACS) network-monitoring tool that allows for enterprise-wide operations management and support of the image distribution network. The MagicWatch (Siemens, Iselin, NJ) PACS/radiology information system (RIS) monitoring station from Siemens has allowed our organization to create a service support structure that has given us proactive control of our environment and has allowed us to meet the service level performance expectations of the users. The Radiology Help Desk has used the MagicWatch PACS monitoring station as an applications support tool that has allowed the group to monitor network activity and individual systems performance at each node. Fast and timely recognition of the effects of single events within the PACS/RIS environment has allowed the group to proactively recognize possible performance issues and resolve problems. The PACS/operations group performs network management control, image storage management, and software distribution management from a single, central point in the enterprise. The MagicWatch station allows for the complete automation of software distribution, installation, and configuration process across all the nodes in the system. The tool has allowed for the standardization of the workstations and provides a central configuration control for the establishment and maintenance of the system standards. This report will describe the PACS management and operation prior to the implementation of the MagicWatch PACS monitoring station and will highlight the operational benefits of a centralized network and system-monitoring tool.
Fully automated processing of fMRI data in SPM: from MRI scanner to PACS.
Maldjian, Joseph A; Baer, Aaron H; Kraft, Robert A; Laurienti, Paul J; Burdette, Jonathan H
2009-01-01
Here we describe the Wake Forest University Pipeline, a fully automated method for the processing of fMRI data using SPM. The method includes fully automated data transfer and archiving from the point of acquisition, real-time batch script generation, distributed grid processing, interface to SPM in MATLAB, error recovery and data provenance, DICOM conversion and PACS insertion. It has been used for automated processing of fMRI experiments, as well as for the clinical implementation of fMRI and spin-tag perfusion imaging. The pipeline requires no manual intervention, and can be extended to any studies requiring offline processing.
SCAR Radiologic Technologist Survey: analysis of the impact of digital technologies on productivity.
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.
Financing a large-scale picture archival and communication system.
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.
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.
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.
LongISLND: in silico sequencing of lengthy and noisy datatypes
Lau, Bayo; Mohiyuddin, Marghoob; Mu, John C.; Fang, Li Tai; Bani Asadi, Narges; Dallett, Carolina; Lam, Hugo Y. K.
2016-01-01
Summary: LongISLND is a software package designed to simulate sequencing data according to the characteristics of third generation, single-molecule sequencing technologies. The general software architecture is easily extendable, as demonstrated by the emulation of Pacific Biosciences (PacBio) multi-pass sequencing with P5 and P6 chemistries, producing data in FASTQ, H5, and the latest PacBio BAM format. We demonstrate its utility by downstream processing with consensus building and variant calling. Availability and Implementation: LongISLND is implemented in Java and available at http://bioinform.github.io/longislnd Contact: hugo.lam@roche.com Supplementary information: Supplementary data are available at Bioinformatics online. PMID:27667791
Defining the role of a PACS technologist.
Cabrera, Alfred
2002-01-01
As hospitals convert from conventional image processing to picture archiving and communication systems (PACS) technology, new job opportunities arose for PACS analysts, PACS system administrators, PACS operators, and PACS trainers. To support a PACS, these positions require education in computer information systems and work experience in information technology. At Texas Children's Hospital, new roles for radiologic technologists (RT) in supporting the operation of PACS were not recognized until after implementation of the filmless system. A new position entitled PACS technologis was created, but roles and responsibilities largely were undefined. The inadequate job description contributed to problems with appropriate utilization of the PACS technologist. The primary role of the technologist was nebulous, and the priority of tasks was undefined. There was an excessive volume of information and technology to be mastered. The role represented a new paradigm, so no template for the job description was available that encompassed the array of functions to be performed. The result was a "morph" of the RT and PACS analyst job descriptions that was contrived and unworkable. The role of the PACS technologist is vital to the operation of the radiology department that uses PACS. There is a well-established need for cross training of RTs in PACS. PACS technology is not taught in RT training programs. There are recurrent communications problems between RT and Information Technology (IT) personnel. The PACS technologist can participate in a number of activities that improve the overall level of proficiency in the imaging operation, such as specialized PACS training for RTs, collection and analysis of quality control data, and planning for installations of PACS acquisition modalities. RTs have acquired knowledge of medical terminology and human anatomy, imaging modalities, and workflow. These qualifications constitute a common basis for communication with other RTs, physicians, and other health care providers. In addition the appropriate candidate for PACS technologist should have computer software and hardware knowledge, interpersonal skills, oral and written communications skills, and analytical skills to troubleshoot issues. This report will describe the evolution of a more accurate job description for the PACS technologist, the relationship between the PACS technologist and the RT supervisor, and specific tasks are appropriate for the PACS technologist to perform.
Enterprise-wide PACS: beyond radiology, an architecture to manage all medical images.
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.
Children's hospitals and PACS: six profiles of planning and implementation.
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.
Evaluation of security algorithms used for security processing on DICOM images
NASA Astrophysics Data System (ADS)
Chen, Xiaomeng; Shuai, Jie; Zhang, Jianguo; Huang, H. K.
2005-04-01
In this paper, we developed security approach to provide security measures and features in PACS image acquisition and Tele-radiology image transmission. The security processing on medical images was based on public key infrastructure (PKI) and including digital signature and data encryption to achieve the security features of confidentiality, privacy, authenticity, integrity, and non-repudiation. There are many algorithms which can be used in PKI for data encryption and digital signature. In this research, we select several algorithms to perform security processing on different DICOM images in PACS environment, evaluate the security processing performance of these algorithms, and find the relationship between performance with image types, sizes and the implementation methods.
Silva, Luís A Bastião; Costa, Carlos; Oliveira, José Luis
2013-05-01
Healthcare institutions worldwide have adopted picture archiving and communication system (PACS) for enterprise access to images, relying on Digital Imaging Communication in Medicine (DICOM) standards for data exchange. However, communication over a wider domain of independent medical institutions is not well standardized. A DICOM-compliant bridge was developed for extending and sharing DICOM services across healthcare institutions without requiring complex network setups or dedicated communication channels. A set of DICOM routers interconnected through a public cloud infrastructure was implemented to support medical image exchange among institutions. Despite the advantages of cloud computing, new challenges were encountered regarding data privacy, particularly when medical data are transmitted over different domains. To address this issue, a solution was introduced by creating a ciphered data channel between the entities sharing DICOM services. Two main DICOM services were implemented in the bridge: Storage and Query/Retrieve. The performance measures demonstrated it is quite simple to exchange information and processes between several institutions. The solution can be integrated with any currently installed PACS-DICOM infrastructure. This method works transparently with well-known cloud service providers. Cloud computing was introduced to augment enterprise PACS by providing standard medical imaging services across different institutions, offering communication privacy and enabling creation of wider PACS scenarios with suitable technical solutions.
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...
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.
Making PACS the present, not the future.
Hunt, D
1998-01-01
Why haven't you moved forward with PACS? Have you just procrastinated or does your facility have legitimate reasons? Some say the technology is too confusing or too new, while others say the cost of PACS is too high. Many facilities say they haven't found a satisfactory way to deal with the conflicting opinions of their radiologists, IS department, administration, referring physicians and staff. Take time to compare the technology you do understand with something familiar such as your own PC or perhaps the current networks inside your facility. You'll soon begin to see that PACS is not a new technology, but rather a new methodology. To handle the perceived high cost of PACS, remember that every facility has different needs. Look at your work flow and then the many byproducts of PACS, such as marketing. If you are the first in your area to implement this new technology, you'll gain a marketing advantage in competing for referring physicians and managed care referral business. Follow the process you use to purchase other products, such as CT or MRI, as you investigate the vendors. Finally, make a plan! Determine departmental goals and gather information from vendors. Create a timeline, a financial plan and your marketing strategy. Together, these steps will help move PACS into the present for you.
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.
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.
Nair, Madhu K; Pettigrew, James C; Loomis, Jeffrey S; Bates, Robert E; Kostewicz, Stephen; Robinson, Boyd; Sweitzer, Jean; Dolan, Teresa A
2009-06-01
The implementation of digital radiography in dentistry in a large healthcare enterprise setting is discussed. A distinct need for a dedicated dental picture archiving and communication systems (PACS) exists for seamless integration of different vendor products across the system. Complex issues are contended with as each clinical department migrated to a digital environment with unique needs and workflow patterns. The University of Florida has had a dental PACS installed over 2 years ago. This paper describes the process of conversion from film-based imaging from the planning stages through clinical implementation. Dentistry poses many unique challenges as it strives to achieve better integration with systems primarily designed for imaging; however, the technical requirements for high-resolution image capture in dentistry far exceed those in medicine, as most routine dental diagnostic tasks are challenging. The significance of specification, evaluation, vendor selection, installation, trial runs, training, and phased clinical implementation is emphasized.
PACS--and beyond. A journey to the digital promised land.
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.
PACS: acceptance test, quality control, warranty, and maintenance continuum
NASA Astrophysics Data System (ADS)
Romlein, John R.; Norton, Gary S.; Lyche, David K.; Richardson, Ronald R., Jr.
1999-07-01
As PACS gain greater acceptance and use in medical facilities the question of life cycle management must be addressed in terms that relate to the common business practices for medical information system and medical devices. The issues in life cycle management of such a system are relatively new to the industry. Increased use of PACS within the medical community requires that standardized life cycle management practices by developed and implemented. This paper develops a new of life cycle issues as cyclic and related events that are not only manageable, but also predictable in terms, of, frequency, duration data content, data exchange, potential outcomes, staffing requirement, documentation, and staff interaction. This view is presented as a continuum that begins at the acceptance testing of a PACS and continues throughout its life cycle. The continuum incorporates the required relationship between quality control testing and maintenance actions during warranty period and the maintenance years. Interrelated cyclic events are described that bind these processes together and provide a basis for long-term proactive management of PACS in a medical environment.
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.
Natural Language Processing for Asthma Ascertainment in Different Practice Settings.
Wi, Chung-Il; Sohn, Sunghwan; Ali, Mir; Krusemark, Elizabeth; Ryu, Euijung; Liu, Hongfang; Juhn, Young J
We developed and validated NLP-PAC, a natural language processing (NLP) algorithm based on predetermined asthma criteria (PAC) for asthma ascertainment using electronic health records at Mayo Clinic. To adapt NLP-PAC in a different health care setting, Sanford Children Hospital, by assessing its external validity. The study was designed as a retrospective cohort study that used a random sample of 2011-2012 Sanford Birth cohort (n = 595). Manual chart review was performed on the cohort for asthma ascertainment on the basis of the PAC. We then used half of the cohort as a training cohort (n = 298) and the other half as a blind test cohort to evaluate the adapted NLP-PAC algorithm. Association of known asthma-related risk factors with the Sanford-NLP algorithm-driven asthma ascertainment was tested. Among the eligible test cohort (n = 297), 160 (53%) were males, 268 (90%) white, and the median age was 2.3 years (range, 1.5-3.1 years). NLP-PAC, after adaptation, and the human abstractor identified 74 (25%) and 72 (24%) subjects, respectively, with 66 subjects identified by both approaches. Sensitivity, specificity, positive predictive value, and negative predictive value for the NLP algorithm in predicting asthma status were 92%, 96%, 89%, and 97%, respectively. The known risk factors for asthma identified by NLP (eg, smoking history) were similar to the ones identified by manual chart review. Successful implementation of NLP-PAC for asthma ascertainment in 2 different practice settings demonstrates the feasibility of automated asthma ascertainment leveraging electronic health record data with a potential to enable large-scale, multisite asthma studies to improve asthma care and research. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
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.
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.
New Mexico’s comprehensive impaired-driving program : a case study.
DOT National Transportation Integrated Search
2014-03-01
In late 2004, the National Highway Traffic Safety Administration provided funds to the New Mexico Department of Transportation to demonstrate a process for implementing a comprehensive State impaired driving system. NHTSA also contracted with the Pac...
Power Aware Signal Processing Environment (PASPE) for PAC/C
2003-02-01
vs. FFT Size For our implementation , the Annapolis FFT core was radix-256, and therefore the smallest PN code length that could be processed was the...PN-64. A C- code version of correlate was compared to the FPGA 61 implementation . The results in Figure 68 show that for a PN-1024, the...12a. DISTRIBUTION / AVAILABILITY STATEMENT APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED. 12b. DISTRIBUTION CODE 13. ABSTRACT (Maximum
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.
Patient Engagement in Community Health Center Leadership: How Does it Happen?
Sharma, Anjana E; Huang, Beatrice; Knox, Margae; Willard-Grace, Rachel; Potter, Michael B
2018-05-18
Patient engagement in primary care leadership is an important means to involve community voices at community health centers. Federally qualified health centers (FQHCs) are mandated to have patient representation within their governing boards, while practices seeking patient-centered medical home certification receive credit for implementing patient advisory councils (PACs). Our objective was to compare and contrast how community health centers engage patients in clinic management, decision-making and planning within governing boards versus PACs. Qualitative study conducted from August 2016 to June 2017 at community health centers in California, Arizona and Hawaii. We interviewed practice leaders of patient engagement programs at their site. Eligible clinics had patient representatives within their governing board, PAC, or both. We assessed patient demographics, roles and responsibilities of patients participating, and extent of involvement in quality improvement among governing boards versus PACs. We interviewed 19 sites, of which 17 were FQHCs that had governing boards. Of the 17 FQHCs, 11 had also implemented PACs. Two non-FQHC safety-net sites had PACs but did not have governing boards. Governing board members had formal, structured membership responsibilities such as finances and hiring personnel. PAC roles were more flexible, focusing on day-to-day clinic operations. Clinics tended to recruit governing board patient members for their skill set and professional experience; PAC member recruitment focused more on demographic representation of the clinic's patient population. Both groups worked on quality improvement, but governing boards tended to review clinic performance metrics, while PAC members were involved in specific project planning and implementation to improve clinical outcomes and patient experience. Patient involvement in clinic improvement in CHCs includes higher-level decision-making and governance through mechanisms such as governing boards, as well as engagement in day-to-day practice improvement through PACs. These roles offer differing, but valuable insights to clinic programs and policies.
HIPAA-compliant automatic monitoring system for RIS-integrated PACS operation
NASA Astrophysics Data System (ADS)
Jin, Jin; Zhang, Jianguo; Chen, Xiaomeng; Sun, Jianyong; Yang, Yuanyuan; Liang, Chenwen; Feng, Jie; Sheng, Liwei; Huang, H. K.
2006-03-01
As a governmental regulation, Health Insurance Portability and Accountability Act (HIPAA) was issued to protect the privacy of health information that identifies individuals who are living or deceased. HIPAA requires security services supporting implementation features: Access control; Audit controls; Authorization control; Data authentication; and Entity authentication. These controls, which proposed in HIPAA Security Standards, are Audit trails here. Audit trails can be used for surveillance purposes, to detect when interesting events might be happening that warrant further investigation. Or they can be used forensically, after the detection of a security breach, to determine what went wrong and who or what was at fault. In order to provide security control services and to achieve the high and continuous availability, we design the HIPAA-Compliant Automatic Monitoring System for RIS-Integrated PACS operation. The system consists of two parts: monitoring agents running in each PACS component computer and a Monitor Server running in a remote computer. Monitoring agents are deployed on all computer nodes in RIS-Integrated PACS system to collect the Audit trail messages defined by the Supplement 95 of the DICOM standard: Audit Trail Messages. Then the Monitor Server gathers all audit messages and processes them to provide security information in three levels: system resources, PACS/RIS applications, and users/patients data accessing. Now the RIS-Integrated PACS managers can monitor and control the entire RIS-Integrated PACS operation through web service provided by the Monitor Server. This paper presents the design of a HIPAA-compliant automatic monitoring system for RIS-Integrated PACS Operation, and gives the preliminary results performed by this monitoring system on a clinical RIS-integrated PACS.
Using an image-extended relational database to support content-based image retrieval in a PACS.
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.
Large-scale PACS implementation.
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.
Planning for PACS: a comprehensive guide to nontechnical considerations.
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.
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.
Templates and existing elements and models for implementation of patient exposure tracking.
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.
Enterprise PACS and image distribution.
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.
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.
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
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
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.
Nitrosi, Andrea; Borasi, Giovanni; Nicoli, Franco; Modigliani, Gino; Botti, Andrea; Bertolini, Marco; Notari, Pietro
2007-06-01
Reggio Emilia hospital installed Picture Archiving and Communications Systems (PACS) as the final step towards a completely digital clinical environment completing the HIS/EMR and 1,400 web/terminals for patient information access. Financial benefits throughout the hospital were assessed upfront and measured periodically. Key indicators (radiology exam turnaround time, number of radiology procedures performed, inpatients length of stay before and after the PACS implementation, etc.) were analyzed and values were statistically tested to assess workflow and productivity improvements. The hospital went "filmless" in 28 weeks. Between the half of 2004 and the respective period in 2003, overall Radiology Department productivity increased by 12%, TAT improved by more than 60%. Timelier patient care resulted in decreased lengths of stay. Neurology alone experienced a 12% improvement in average patient stay. To quantify the impact of PACS on the average hospital stays and the expected productivity benefits to inpatient productivity were used a "high level" and a "detailed" business model. Annual financial upsides have exceeded $1.9 millions/year. A well-planned PACS deployment simplifies imaging workflow and improves patient care throughout the hospital while delivering substantial financial benefits. Staff buy-in was the key in this process and on-going training and process monitoring are a must.
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.
Design and implementation of disaster recovery and business continuity solution for radiology PACS.
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.
Mingot, José-Manuel; Tilburn, Joan; Diez, Eliecer; Bignell, Elaine; Orejas, Margarita; Widdick, David A.; Sarkar, Sovan; Brown, Christopher V.; Caddick, Mark X.; Espeso, Eduardo A.; Arst, Herbert N.; Peñalva, Miguel A.
1999-01-01
The Aspergillus nidulans transcription factor PacC, which mediates pH regulation, is proteolytically processed to a functional form in response to ambient alkaline pH. The full-length PacC form is unstable in the presence of an operational pH signal transduction pathway, due to processing to the relatively stable short functional form. We have characterized and used an extensive collection of pacC mutations, including a novel class of “neutrality-mimicking” pacC mutations having aspects of both acidity- and alkalinity-mimicking phenotypes, to investigate a number of important features of PacC processing. Analysis of mutant proteins lacking the major translation initiation residue or truncated at various distances from the C terminus showed that PacC processing does not remove N-terminal residues, indicated that processing yields slightly heterogeneous products, and delimited the most upstream processing site to residues ∼252 to 254. Faithful processing of three mutant proteins having deletions of a region including the predicted processing site(s) and of a fourth having 55 frameshifted residues following residue 238 indicated that specificity determinants reside at sequences or structural features located upstream of residue 235. Thus, the PacC protease cuts a peptide bond(s) remote from these determinants, possibly thereby resembling type I endonucleases. Downstream of the cleavage site, residues 407 to 678 are not essential for processing, but truncation at or before residue 333 largely prevents it. Ambient pH apparently regulates the accessibility of PacC to proteolytic processing. Alkalinity-mimicking mutations L259R, L266F, and L340S favor the protease-accessible conformation, whereas a protein with residues 465 to 540 deleted retains a protease-inaccessible conformation, leading to acidity mimicry. Finally, not only does processing constitute a crucial form of modulation for PacC, but there is evidence for its conservation during fungal evolution. Transgenic expression of a truncated PacC protein, which was processed in a pH-independent manner, showed that appropriate processing can occur in Saccharomyces cerevisiae. PMID:9891072
NASA Astrophysics Data System (ADS)
Iwasaki, Y.
1997-02-01
The CP-PACS computer with a peak speed of 300 Gflops was completed in March 1996 and has started to operate. We describe the final specification and the hardware implementation of the CP-PACS computer, and its performance for QCD codes. A plan of the grade-up of the computer scheduled for fall of 1996 is also given.
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.
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.
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.
Wireless remote control clinical image workflow: utilizing a PDA for offsite distribution
NASA Astrophysics Data System (ADS)
Liu, Brent J.; Documet, Luis; Documet, Jorge; Huang, H. K.; Muldoon, Jean
2004-04-01
Last year we presented in RSNA an application to perform wireless remote control of PACS image distribution utilizing a handheld device such as a Personal Digital Assistant (PDA). This paper describes the clinical experiences including workflow scenarios of implementing the PDA application to route exams from the clinical PACS archive server to various locations for offsite distribution of clinical PACS exams. By utilizing this remote control application, radiologists can manage image workflow distribution with a single wireless handheld device without impacting their clinical workflow on diagnostic PACS workstations. A PDA application was designed and developed to perform DICOM Query and C-Move requests by a physician from a clinical PACS Archive to a CD-burning device for automatic burning of PACS data for the distribution to offsite. In addition, it was also used for convenient routing of historical PACS exams to the local web server, local workstations, and teleradiology systems. The application was evaluated by radiologists as well as other clinical staff who need to distribute PACS exams to offsite referring physician"s offices and offsite radiologists. An application for image workflow management utilizing wireless technology was implemented in a clinical environment and evaluated. A PDA application was successfully utilized to perform DICOM Query and C-Move requests from the clinical PACS archive to various offsite exam distribution devices. Clinical staff can utilize the PDA to manage image workflow and PACS exam distribution conveniently for offsite consultations by referring physicians and radiologists. This solution allows the radiologist to expand their effectiveness in health care delivery both within the radiology department as well as offisite by improving their clinical workflow.
Wireless-PDA-controlled image workflow from PACS: the next trend in the health care enterprise?
NASA Astrophysics Data System (ADS)
Erberich, Stephan G.; Documet, Jorge; Zhou, Michael Z.; Cao, Fei; Liu, Brent J.; Mogel, Greg T.; Huang, H. K.
2003-05-01
Image workflow in today's Picture Archiving and Communication Systems (PACS) is controlled from fixed Display Workstations (DW) using proprietary control interfaces. A remote access to the Hospital Information System (HIS) and Radiology Information System (RIS) for urgent patient information retrieval does not exist or gradually become available. The lack for remote access and workflow control for HIS and RIS is especially true when it comes to medical images of a PACS on Department or Hospital level. As images become more complex and data sizes expand rapidly with new image techniques like functional MRI, Mammography or routine spiral CT to name a few, the access and manageability becomes an important issue. Long image downloads or incomplete work lists cannot be tolerated in a busy health care environment. In addition, the domain of the PACS is no longer limited to the imaging department and PACS is also being used in the ER and emergency care units. Thus a prompt and secure access and manageability not only by the radiologist, but also from the physician becomes crucial to optimally utilize the PACS in the health care enterprise of the new millennium. The purpose of this paper is to introduce a concept and its implementation of a remote access and workflow control of the PACS combining wireless, Internet and Internet2 technologies. A wireless device, the Personal Digital Assistant (PDA), is used to communicate to a PACS web server that acts as a gateway controlling the commands for which the user has access to the PACS server. The commands implemented for this test-bed are query/retrieve of the patient list and study list including modality, examination, series and image selection and pushing any list items to a selected DW on the PACS network.
Short history of PACS. Part I: USA.
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.
Impact of the Medicare Short Stay Transfer Policy on Patients undergoing Major Orthopedic Surgery
FitzGerald, John D; John Boscardin, W; Hahn, Bevra H; Ettner, Susan L
2007-01-01
Objective To examine the impact of the Short Stay Transfer Policy (SSTP) on practice patterns. Data Sources This study uses data from the Centers for Medicare and Medicaid Services Medicare Provider Analysis and Review (MEDPAR) file, Home Health Standard Analytical File, 1999 Provider of Service file, and data from the 2000 United States Census. Study Design An interrupted time-series analysis was used to examine the length of stay (LOS) and probability of “early” discharge to post acute care (PAC). Data Collection Separate 100percent samples of all fee-for-service Medicare recipients undergoing either elective joint replacement (JR) surgery or surgical management of hip fracture (FX) between January 1, 1996 and December 31, 2000 were selected. Principal Findings Prior to implementation of the SSTP. LOS had been falling by 0.37 and 0.30 days per year for JR and FX patients respectively. After implementation of the SSTP, there was an immediate increase in LOS by 0.20 and 0.17 days, respectively. Thereafter, LOS remained flat. The proportion of patients discharged “early” to PAC had been rising by 4.4 and 2.6 percentage points per year for JR and FX patients respectively, to a peak of 28.8percent and 20.4percent early PAC utilization in September 1998. Immediately after implementation of the SSTP, there was a 4.3 and 3.0 percentage point drop in utilization of “early” PAC. Thereafter utilization of early PAC increased at a much slower rate (for JR) or remained flat (for FX). There was significant regional variation in the magnitude of response to the policy. Conclusion Implementation of the SSTP reduced the financial incentive to discharge patients early to PAC. This was accomplished primarily through longer LOS without meaningful change in PAC utilization. With the recent expansion of the SSTP to 29 DRGs (representing 34percent of all discharges), these findings have important implications regarding patient care. PMID:17355580
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.
Peer-to-peer architecture for multi-departmental distributed PACS
NASA Astrophysics Data System (ADS)
Rosset, Antoine; Heuberger, Joris; Pysher, Lance; Ratib, Osman
2006-03-01
We have elected to explore peer-to-peer technology as an alternative to centralized PACS architecture for the increasing requirements for wide access to images inside and outside a radiology department. The goal being to allow users across the enterprise to access any study anytime without the need for prefetching or routing of images from central archive. Images can be accessed between different workstations and local storage nodes. We implemented "bonjour" a new remote file access technology developed by Apple allowing applications to share data and files remotely with optimized data access and data transfer. Our Open-source image display platform called OsiriX was adapted to allow sharing of local DICOM images through direct access of each local SQL database to be accessible from any other OsiriX workstation over the network. A server version of Osirix Core Data database also allows to access distributed archives servers in the same way. The infrastructure implemented allows fast and efficient access to any image anywhere anytime independently from the actual physical location of the data. It also allows benefiting from the performance of distributed low-cost and high capacity storage servers that can provide efficient caching of PACS data that was found to be 10 to 20 x faster that accessing the same date from the central PACS archive. It is particularly suitable for large hospitals and academic environments where clinical conferences, interdisciplinary discussions and successive sessions of image processing are often part of complex workflow or patient management and decision making.
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
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.
Lin, Hongjun; Wang, Fangyuan; Ding, Linxian; Hong, Huachang; Chen, Jianrong; Lu, Xiaofeng
2011-09-15
The aim of this study was to investigate the feasibility of PAC-MBR process treating municipal secondary effluent. Two laboratory-scale submerged MBRs (SMBR) with and without PAC addition were continuously operated in parallel for secondary effluent treatment. Approximately 63%TOC, 95% NH(4)(+)-N and 98% turbidity in secondary effluent were removed by the PAC-MBR process. Most organics in the secondary effluent were found to be low molecular weight (MW) substances, which could be retained in the reactor and then removed to some extent by using PAC-MBR process. Parallel experiments showed that the addition of PAC significantly increased organic removal and responsible for the largest fraction of organic removal. Membrane fouling analysis showed the enhanced membrane performance in terms of sustainable operational time and filtration resistances by PAC addition. Based on these results, the PAC-MBR process was considered as an attractive option for the reduction of pollutants in secondary effluent. Copyright © 2011 Elsevier B.V. All rights reserved.
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.
DICOM-compliant PACS with CD-based image archival
NASA Astrophysics Data System (ADS)
Cox, Robert D.; Henri, Christopher J.; Rubin, Richard K.; Bret, Patrice M.
1998-07-01
This paper describes the design and implementation of a low- cost PACS conforming to the DICOM 3.0 standard. The goal was to provide an efficient image archival and management solution on a heterogeneous hospital network as a basis for filmless radiology. The system follows a distributed, client/server model and was implemented at a fraction of the cost of a commercial PACS. It provides reliable archiving on recordable CD and allows access to digital images throughout the hospital and on the Internet. Dedicated servers have been designed for short-term storage, CD-based archival, data retrieval and remote data access or teleradiology. The short-term storage devices provide DICOM storage and query/retrieve services to scanners and workstations and approximately twelve weeks of 'on-line' image data. The CD-based archival and data retrieval processes are fully automated with the exception of CD loading and unloading. The system employs lossless compression on both short- and long-term storage devices. All servers communicate via the DICOM protocol in conjunction with both local and 'master' SQL-patient databases. Records are transferred from the local to the master database independently, ensuring that storage devices will still function if the master database server cannot be reached. The system features rules-based work-flow management and WWW servers to provide multi-platform remote data access. The WWW server system is distributed on the storage, retrieval and teleradiology servers allowing viewing of locally stored image data directly in a WWW browser without the need for data transfer to a central WWW server. An independent system monitors disk usage, processes, network and CPU load on each server and reports errors to the image management team via email. The PACS was implemented using a combination of off-the-shelf hardware, freely available software and applications developed in-house. The system has enabled filmless operation in CT, MR and ultrasound within the radiology department and throughout the hospital. The use of WWW technology has enabled the development of an intuitive we- based teleradiology and image management solution that provides complete access to image data.
Interfacing the PACS and the HIS: results of a 5-year implementation.
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).
Anatomy of an Extensible Open Source PACS.
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.
LongISLND: in silico sequencing of lengthy and noisy datatypes.
Lau, Bayo; Mohiyuddin, Marghoob; Mu, John C; Fang, Li Tai; Bani Asadi, Narges; Dallett, Carolina; Lam, Hugo Y K
2016-12-15
LongISLND is a software package designed to simulate sequencing data according to the characteristics of third generation, single-molecule sequencing technologies. The general software architecture is easily extendable, as demonstrated by the emulation of Pacific Biosciences (PacBio) multi-pass sequencing with P5 and P6 chemistries, producing data in FASTQ, H5, and the latest PacBio BAM format. We demonstrate its utility by downstream processing with consensus building and variant calling. LongISLND is implemented in Java and available at http://bioinform.github.io/longislnd CONTACT: hugo.lam@roche.comSupplementary information: Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press.
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.
NASA Astrophysics Data System (ADS)
Sappington, Rodney W.
2005-04-01
In research conducted at academic and community hospitals in the United States since 2001, this paper examines complex human and technological relationships employed to renegotiate behavior within hospital administrative and clinical cultures. In the planning and implementation of PACS in a four-facility hospital we will enter into what can be described as processes of "adoption" and "resistance", seemingly opposite approaches to system implementation, which I argue are in fact key responses to planning, design, and customization of imaging and information systems in a context of convergence. In a larger context of convergence known as NBIC tools (nanotechnology, biotechnology, information technology, and cognitive sciences) it has become increasingly clear to leaders in the field that it is essential to redesign organizational technologies. A novel system has little chance of being fully utilized by conventional organizational structures in an era of system convergence. The challenge of embracing a larger systems perspective lies in opening untapped potential within the healthcare enterprise by preparing the ground for reflection on new approaches to training, and bridging specialized knowledge across computer engineering, clinical decision making, and organizational perspectives for the benefit of patient care. Case studies will demonstrate how organizational and system design technologies are crucial in insuring that PACS implementation strategies can encourage the emergence of new levels of quality for patient care. The goal is to provide successful design-build models that are true to organizational specificity, persons, and clinical practices undergoing change and uncertainty.
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.
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.
The Herschel Data Processing System - Hipe And Pipelines - During The Early Mission Phase
NASA Astrophysics Data System (ADS)
Ardila, David R.; Herschel Science Ground Segment Consortium
2010-01-01
The Herschel Space Observatory, the fourth cornerstone mission in the ESA science program, was launched 14th of May 2009. With a 3.5 m telescope, it is the largest space telescope ever launched. Herschel's three instruments (HIFI, PACS, and SPIRE) perform photometry and spectroscopy in the 55 - 672 micron range and will deliver exciting science for the astronomical community during at least three years of routine observations. Here we summarize the state of the Herschel Data Processing System and give an overview about future development milestones and plans. The development of the Herschel Data Processing System started seven years ago to support the data analysis for Instrument Level Tests. Resources were made available to implement a freely distributable Data Processing System capable of interactively and automatically reduce Herschel data at different processing levels. The system combines data retrieval, pipeline execution and scientific analysis in one single environment. The software is coded in Java and Jython to be platform independent and to avoid the need for commercial licenses. The Herschel Interactive Processing Environment (HIPE) is the user-friendly face of Herschel Data Processing. The first PACS preview observation of M51 was processed with HIPE, using basic pipeline scripts to a fantastic image within 30 minutes of data reception. Also the first HIFI observations on DR-21 were successfully reduced to high quality spectra, followed by SPIRE observations on M66 and M74. The Herschel Data Processing System is a joint development by the Herschel Science Ground Segment Consortium, consisting of ESA, the NASA Herschel Science Center, and the HIFI, PACS and SPIRE consortium members.
NASA Astrophysics Data System (ADS)
Iwasaki, Y.; CP-PACS Collaboration
1998-01-01
The CP-PACS project is a five year plan, which formally started in April 1992 and has been completed in March 1997, to develop a massively parallel computer for carrying out research in computational physics with primary emphasis on lattice QCD. The initial version of the CP-PACS computer with a theoretical peak speed of 307 GFLOPS with 1024 processors was completed in March 1996. The final version 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 describe the architecture, the final specification, the hardware implementation, and the software of the CP-PACS computer. The CP-PACS has been used for hadron spectroscopy production runs since July 1996. The performance for lattice QCD applications and the LINPACK benchmark are given.
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.
NASA Astrophysics Data System (ADS)
Peer, Regina; Peer, Siegfried; Sander, Heike; Marsolek, Ingo; Koller, Wolfgang; Pappert, Dirk; Hierholzer, Johannes
2002-05-01
If new technology is introduced into medical practice it must prove to make a difference. However traditional approaches of outcome analysis failed to show a direct benefit of PACS on patient care and economical benefits are still in debate. A participatory process analysis was performed to compare workflow in a film based hospital and a PACS environment. This included direct observation of work processes, interview of involved staff, structural analysis and discussion of observations with staff members. After definition of common structures strong and weak workflow steps were evaluated. With a common workflow structure in both hospitals, benefits of PACS were revealed in workflow steps related to image reporting with simultaneous image access for ICU-physicians and radiologists, archiving of images as well as image and report distribution. However PACS alone is not able to cover the complete process of 'radiography for intensive care' from ordering of an image till provision of the final product equals image + report. Interference of electronic workflow with analogue process steps such as paper based ordering reduces the potential benefits of PACS. In this regard workflow modeling proved to be very helpful for the evaluation of complex work processes linking radiology and the ICU.
Medical image security in a HIPAA mandated PACS environment.
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.
An Implemented Strategy for Campus Connectivity and Cooperative Computing.
ERIC Educational Resources Information Center
Halaris, Antony S.; Sloan, Lynda W.
1989-01-01
ConnectPac, a software package developed at Iona College to allow a computer user to access all services from a single personal computer, is described. ConnectPac uses mainframe computing to support a campus computing network, integrating personal and centralized computing into a menu-driven user environment. (Author/MLW)
Ammonia removal in the carbon contactor of a hybrid membrane process.
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.
NASA Astrophysics Data System (ADS)
Tang, Fuk-hay; Law, Yuen Y.; Zhang, Jianguo; Liu, Hai L.; Chang, Tony; Matsuda, Koyo; Cao, Fei
2001-08-01
The Hong Kong Polytechnic University has a Radiography Division under the Development of Optometry and Radiography. The Division trains both diagnostic and therapeutic radiographers with 60 students/year and offers a B.Sc. degree. In addition the Division together with the University Health Service operates a radiography clinic with radiology consultation from radiologists from other hospitals and clinics. This paper describers the implementation of a PACS in the Division for radiography training, and for clinical service.
Postacute rehabilitation quality of care: toward a shared conceptual framework.
Jesus, Tiago Silva; Hoenig, Helen
2015-05-01
There is substantial interest in mechanisms for measuring, reporting, and improving the quality of health care, including postacute care (PAC) and rehabilitation. Unfortunately, current activities generally are either too narrow or too poorly specified to reflect PAC rehabilitation quality of care. In part, this is caused by a lack of a shared conceptual understanding of what construes quality of care in PAC rehabilitation. This article presents the PAC-rehab quality framework: an evidence-based conceptual framework articulating elements specifically pertaining to PAC rehabilitation quality of care. The widely recognized Donabedian structure, process, and outcomes (SPO) model furnished the underlying structure for the PAC-rehab quality framework, and the International Classification of Functioning, Disability and Health (ICF) framed the functional outcomes. A comprehensive literature review provided the evidence base to specify elements within the SPO model and ICF-derived framework. A set of macrolevel-outcomes (functional performance, quality of life of patient and caregivers, consumers' experience, place of discharge, health care utilization) were defined for PAC rehabilitation and then related to their (1) immediate and intermediate outcomes, (2) underpinning care processes, (3) supportive team functioning and improvement processes, and (4) underlying care structures. The role of environmental factors and centrality of patients in the framework are explicated as well. Finally, we discuss why outcomes may best measure and reflect the quality of PAC rehabilitation. The PAC-rehab quality framework provides a conceptually sound, evidence-based framework appropriate for quality of care activities across the PAC rehabilitation continuum. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
The Commercial Challenges Of Pacs
NASA Astrophysics Data System (ADS)
Vanden Brink, John A.
1984-08-01
The increasing use of digital imaging techniques create a need for improved methods of digital processing, communication and archiving. However, the commercial opportunity is dependent on the resolution of a number of issues. These issues include proof that digital processes are more cost effective than present techniques, implementation of information system support in the imaging activity, implementation of industry standards, conversion of analog images to digital formats, definition of clinical needs, the implications of the purchase decision and technology requirements. In spite of these obstacles, a market is emerging, served by new and existing companies, that may become a $500 million market (U.S.) by 1990 for equipment and supplies.
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.
Evolutionistic or revolutionary paths? A PACS maturity model for strategic situational planning.
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.
Planning, expectation, and image evaluation for PACS at the University of Iowa Hospitals and Clinics
NASA Astrophysics Data System (ADS)
Franken, E. A., Jr.; Smith, Wilbur L.; Berbaum, Kevin S.; Owen, David A.; Hilsenrath, Peter
1990-08-01
Our strategy in studying PACS is to evaluate its clinical implementation working with equipment supplied by an established manufacturer. Fiscal and personnel resources required to design and integrate the hardware components and operational software to develop a functional PACS precluded a bottom up development approach at our institution. Imaging equipment vendors possess more abundant design development resources for this task and therefore can support a more rapid development of the initial components of PACS. For this reason we have chosen to serve as a beta test site to study the viability of the basic PACS components in a clinical setting. Our efforts primarily focus on: (1) image quality; (2) cost effectiveness; (3) PACS/HIS/RIS integration; (4) equipment and software reliability; and (5) overall system performance. The results of our studies are shared with the vendor for future PACS development and refi nement. To attain our investigational goals we have formed an interdisciplinary team of Radiologists, Perceptual Psychologist, Economist, Electrical and Industrial Engineers, Hospital Information System personnel and key departmental administrative staff. For several reasons Pediatric Radiology was targeted as the initial area for our PACS study: a small area representative of the overall operation,tight operational controls and willingness of physicians. We used a step-wise approach, the first step being the installation of PACS exclusively within the physical confines of Pediatric Radiology.
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.
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.
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.
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.
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.
Löwenberg, Jonas; Zenker, Armin; Krahnstöver, Thérèse; Boehler, Marc; Baggenstos, Martin; Koch, Gerhard; Wintgens, Thomas
2016-05-01
The removal of micropollutants from drinking and wastewater by powdered activated carbon (PAC) adsorption has received considerable attention in research over the past decade with various separation options having been investigated. With Switzerland as the first country in the world having adopted a new legislation, which forces about 100 wastewater treatment plants to be upgraded for the removal of organic micropollutants from municipal wastewater, the topic has reached practical relevance. In this study, the process combination of powdered activated carbon (PAC) adsorption and deep bed filtration (DBF) for advanced municipal wastewater treatment was investigated over an extended period exceeding one year of operation in technical scale. The study aimed to determine optimum process conditions to achieve sufficient micropollutant removal in agreement with the new Swiss Water Ordinance under most economic process design. It was shown that the addition of PAC and Fe(3+) as combined coagulation and flocculation agent improved effluent water quality with respect to dissolved organic pollutants as well as total suspended solids (TSS), turbidity and PO4-P concentration in comparison to a DBF operated without the addition of PAC and Fe(3+). Sufficient micropollutant (MP) removal of around 80% was achieved at PAC dosages of 10 mg/L revealing that PAC retained in the filter bed maintained considerable adsorption capacity. In the investigated process combination the contact reactor serves for adsorption as well as for flocculation and allowed for small hydraulic retention times of minimum 10 min while maintaining sufficient MP removal. The flocculation of two different PAC types was shown to be fully concluded after 10-15 min, which determined the flocculation reactor size while both PAC types proved suitable for the application in combination with DBF and showed no significant differences in MP removal. Finally, the capping of PAC dosage during rain water periods, which resulted in lower dosage concentrations, was efficient in limiting PAC consumption during these events without suffering from negative effects on process performance or effluent quality. Copyright © 2016 Elsevier Ltd. All rights reserved.
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.
User Acceptance of Picture Archiving and Communication System in the Emergency Department.
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.
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.
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.
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.
Reed, G; Reed, D H
1999-05-01
When planning a picture archiving and communications system (PACS) implementation and determining which equipment will be implemented in earlier and later phases, collection and analysis of selected data will aid in setting implementation priorities. If baseline data are acquired relative to performance objectives, the same information used for implementation planning can be used to measure performance improvement and outcomes. The main categories of data to choose from are: (1) financial data; (2) productivity data; (3) operational parameters; (4) clinical data; and (5) information about customer satisfaction. In the authors' experience, detailed workflow data have not proved valuable in measuring PACS performance and outcomes. Reviewing only one category of data in planning will not provide adequate basis for targeting operational improvements that will lead to the most significant gains. Quality improvement takes into account all factors in production: human capacity, materials, operating capital and assets. Once we have identified key areas of focus for quality improvement in each phase, we can translate objectives into implementation requirements and finally into detailed functional and performance requirements. Here, Integration Resources reports its experience measuring PACS performance relative to phased implementation strategies for three large medical centers. Each medical center had its own objectives for overcoming image management, physical/geographical, and functional/technical barriers. The report outlines (1) principal financial and nonfinancial measures used as performance indicators; (2) implementation strategies chosen by each of the three medical centers; and (3) the results of those strategies as compared with baseline data.
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.
Huda, Fauzia Akhter; Ahmed, Anisuddin; Ford, Evelyn Rebecca; Johnston, Heidi Bart
2015-09-28
Abortion related deaths as a proportion of maternal mortality appears to have fallen dramatically in Bangladesh from 5 % in 2001 to 1 % in 2010. Yet complications from menstrual regulation (MR) and unsafe abortion continue to cause deleterious health, economic and social consequences for women in the country. This quasi experimental design study with a baseline (January to December 2008) and an endline survey (August to October 2009) was conducted in 69 public, private, and NGO sector health facilities in Jessore district of Bangladesh with the objective of adapting and implementing a set of process indicators, specifically to supplement the indicators for monitoring emergency obstetric care interventions. At the baseline, we collected retrospective data from all 69 health facilities that provided MR, legal abortion or post-abortion care (PAC), by reviewing their last one year's records. Three months after introducing the safe menstrual regulation and abortion care (SMRAC) model, endline data was collected. Signal function (critical services that facilities must perform in order to prevent and treat abortion complications) analysis was used to characterize facilities as providing basic care, comprehensive care, or neither. Facility mapping, and records on services provided and complications treated were used to further characterize service availability and to describe service use and quality. No facilities fulfilled criteria for 'comprehensive' care at either the baseline or end line while only one met the 'basic' criteria during the endline of the project. Recommended uterine evacuation technology, manual vacuum aspiration (MVA) was used for 100.0 % of MR clients but only for 8.0 % or fewer PAC patients. MR clients were 37.5 times more likely than PAC patients to leave facilities with a contraceptive method (75.0 % vs. 2.0 %). Persistent use of older uterine evacuation technologies was observed when recommended techniques were widely available in the facilities. Notable gaps were identified in providing post-abortion contraceptive services for women treated for PAC. By systematic implementation of the SMRAC model, health systems can track and measure progress and gaps in their implementation and identify strategies for further reduction of abortion-related morbidity and mortality in Bangladesh.
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
Chu, Wenhai; Yao, Dechang; Gao, Naiyun; Bond, Tom; Templeton, Michael R
2015-12-01
Pilot-scale tests were performed to reduce the formation of a range of carbonaceous and nitrogenous disinfection by-products (C-, N-DBPs), by removing or transforming their precursors, with an integrated permanganate oxidation and powdered activated carbon adsorption (PM-PAC) treatment process before conventional water treatment processes (coagulation-sedimentation-filtration, abbreviated as CPs). Compared with the CPs, PM-PAC significantly enhanced the removal of DOC, DON, NH3(+)-N, and algae from 52.9%, 31.6%, 71.3%, and 83.6% to 69.5%, 61.3%, 92.5%, and 97.5%, respectively. PM pre-oxidation alone and PAC pre-adsorption alone did not substantially reduce the formation of dichloroacetonitrile, trichloroacetonitrile, N-nitrosodimethylamine and dichloroacetamide. However, the PM-PAC integrated process significantly reduced the formation of both C-DBPs and N-DBPs by 60-90% for six C-DBPs and 64-93% for six N-DBPs, because PM oxidation chemically altered the molecular structures of nitrogenous organic compounds and increased the adsorption capacity of the DBP precursors, thus highlighting a synergistic effect of PM and PAC. PM-PAC integrated process is a promising drinking water technology for the reduction of a broad spectrum of C-DBPs and N-DBPs. Copyright © 2015 Elsevier Ltd. All rights reserved.
Evaluation of new data processing algorithms for planar gated ventriculography (MUGA)
Fair, Joanna R.; Telepak, Robert J.
2009-01-01
Before implementing one of two new LVEF radionuclide gated ventriculogram (MUGA) systems, the results from 312 consecutive parallel patient studies were evaluated. Each gamma‐camera acquisition was simultaneously processed by semi‐automatic Medasys Pinnacle and by fully automatic and semiautomatic Philips nuclear medicine computer systems. The Philips systems yielded LVEF results within ±5LVEF percentage points of the Medasys system in fewer than half of the studies. The remaining values were higher or lower than those from the long‐used Medasys system. These differences might have changed cancer patient chemotherapy clinical decisions. As a result, our institution elected not to implement either new system. PACS: 87.57.U‐ Nuclear medicine imaging
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.
Smoking cessation interventions in the pre-admission clinic: assessing two approaches.
Sachs, Robyn; Wild, T Cameron; Thomas, Laura; Hammal, Fadi; Finegan, Barry A
2012-07-01
Brief intervention (BI) to encourage patients who smoke to quit is effective and should occur at every patient interaction. If smokers receive a motivational interview in addition to BI and are offered pharmacotherapy to treat nicotine withdrawal, cessation rates may be improved. We compared the uptake, implementation, and effectiveness of these two approaches in the delivery of a smoking cessation intervention during assessments in a pre-admission clinic (PAC). The study was performed in the PAC at two tertiary care hospitals. At both hospitals, PAC patients were screened for smoking status, and current smokers were offered the opportunity to participate in a cessation program. Those who agreed were asked to consent to participate in an evaluation of program effectiveness that included a telephone interview about smoking status six months after hospital discharge. A cohort design was used to compare cessation outcomes across PACs during a one-year period of patient recruitment. The primary outcome measure was a self-reported continuous quit rate six months following hospitalization. Secondary outcomes included the number of patients willing to participate and the completeness of the delivery of program components. A BI delivered at one PAC consisted of brief advice and self-help materials, including handing the patient a business card with an available 1-800 Quit line (a telephone smoking cessation help line). The other PAC offered an intensive intervention (II) that included augmenting the BI with an in-hospital and post-discharge motivational interview and access to nicotine replacement therapy (NRT) during admission. At follow-up, we were able to contact 147 of the 288 smokers who agreed to participate in the evaluation of the program, and the self-reported quit rates for the BI and II interventions were 11.4% and 19.5%, respectively. More than 1,200 current smokers were identified and approached at both PACs during the 12-month patient recruitment period, and 60% of those were willing to accept the offered smoking cessation intervention (either BI or II). Implementation of II was uneven, particularly the delivery of the in-hospital motivational interview and prescription of NRT. Uptake of the 1-800 Quit service after discharge was inadequate. The PAC is a feasible location to identify smokers and offer a cessation intervention. There are considerable logistical barriers to the development of an II intervention program as described. A program that incorporates elements of BI and II could offer a practical approach to the implementation of a hospital-wide smoking cessation intervention.
Hadoop-based implementation of processing medical diagnostic records for visual patient system
NASA Astrophysics Data System (ADS)
Yang, Yuanyuan; Shi, Liehang; Xie, Zhe; Zhang, Jianguo
2018-03-01
We have innovatively introduced Visual Patient (VP) concept and method visually to represent and index patient imaging diagnostic records (IDR) in last year SPIE Medical Imaging (SPIE MI 2017), which can enable a doctor to review a large amount of IDR of a patient in a limited appointed time slot. In this presentation, we presented a new approach to design data processing architecture of VP system (VPS) to acquire, process and store various kinds of IDR to build VP instance for each patient in hospital environment based on Hadoop distributed processing structure. We designed this system architecture called Medical Information Processing System (MIPS) with a combination of Hadoop batch processing architecture and Storm stream processing architecture. The MIPS implemented parallel processing of various kinds of clinical data with high efficiency, which come from disparate hospital information system such as PACS, RIS LIS and HIS.
Incorporation of a clinical history into the interpretation process in a PACS environment
NASA Astrophysics Data System (ADS)
Cooperstein, Lawrence A.; Good, Barbara C.; Miketic, Linda M.; Tabor, Ellen K.; Yousem, Samuel A.; King, Jill L.; Gennari, Rose C.; Felice, Marc A.; Sidorovich, Kathleen
1990-08-01
In a large-scale, multi-reader study to investigate questions surrounding the issue of the implementation of picture archiving and communications systems (PACS) into the modern radiology environment, we examined the effect that the incorporation of a clinical history into the reading process would have on levels of diagnostic accuracy. Because we wanted to test the inclusion of the clinical history in an environment as close to that of the clinical situation as possible, we defined "history" to be a concise, objective, and potentially computer-extractable version of what appears in the patient records, including a statement from the referring physician when this is available. In a series of studies, four radiologists interpreted 247 posteroanterior normal and abnormal chest images on conventional film both with and without accompanying patient histories; five radiologists read the same number of images presented on a high-resolution video workstation with and without clinical histories. There were no significant differences (p = .05) in diagnostic accuracy rates with or without clinical history for either the film or the workstation in cases of interstitial disease, nodules, or pneumothorax. Diagnostic accuracy for the radiologists as a group was not affected by the presence of the clinical history. We concluded that for the interpretation of these abnormalities, the incorporation of clinical history with images in the PACS environment should not be a major goal.
PACS strategy for imaging centers.
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.
Farhadi, Akram; Ahmadi, Maryam
2013-12-01
Picture Archiving and Communications System (PACS) was originally developed for radiology services over 20 years ago to capture medical images electronically. Medical diagnosis methods are based on images such as clinical radiographs, ultrasounds, CT scans, MRIs, or other imaging modalities. Information obtained from these images is correlated with patient information. So with regards to the important role of PACS in hospitals, we aimed to evaluate the PACS and survey the information security needed in the Radiological Information system. First, we surveyed the different aspects of PACS that should be in any health organizations based on Department of Health standards and prepared checklists for assessing the PACS in different hospitals. Second, we surveyed the security controls that should be implemented in PACS. Checklists reliability is affirmed by professors of Tehran Science University. Then, the final data are inputted in SPSS software and analyzed. The results indicate that PACS in hospitals can transfer patient demographic information but they do not show route of information. These systems are not open source. They don't use XML-based standard and HL7 standard for exchanging the data. They do not use DS digital signature. They use passwords and the user can correct or change the medical information. PACS can detect alternation rendered. The survey of results demonstrates that PACS in all hospitals has the same features. These systems have the patient demographic data but they do not have suitable flexibility to interface network or taking reports. For the privacy of PACS in all hospitals, there were passwords for users and the system could show the changes that have been made; but there was no water making or digital signature for the users.
A case for automated tape in clinical imaging.
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.
Migration of medical image data archived using mini-PACS to full-PACS.
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.
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
A Framework for Integration of Heterogeneous Medical Imaging Networks
Viana-Ferreira, Carlos; Ribeiro, Luís S; Costa, Carlos
2014-01-01
Medical imaging is increasing its importance in matters of medical diagnosis and in treatment support. Much is due to computers that have revolutionized medical imaging not only in acquisition process but also in the way it is visualized, stored, exchanged and managed. Picture Archiving and Communication Systems (PACS) is an example of how medical imaging takes advantage of computers. To solve problems of interoperability of PACS and medical imaging equipment, the Digital Imaging and Communications in Medicine (DICOM) standard was defined and widely implemented in current solutions. More recently, the need to exchange medical data between distinct institutions resulted in Integrating the Healthcare Enterprise (IHE) initiative that contains a content profile especially conceived for medical imaging exchange: Cross Enterprise Document Sharing for imaging (XDS-i). Moreover, due to application requirements, many solutions developed private networks to support their services. For instance, some applications support enhanced query and retrieve over DICOM objects metadata. This paper proposes anintegration framework to medical imaging networks that provides protocols interoperability and data federation services. It is an extensible plugin system that supports standard approaches (DICOM and XDS-I), but is also capable of supporting private protocols. The framework is being used in the Dicoogle Open Source PACS. PMID:25279021
A framework for integration of heterogeneous medical imaging networks.
Viana-Ferreira, Carlos; Ribeiro, Luís S; Costa, Carlos
2014-01-01
Medical imaging is increasing its importance in matters of medical diagnosis and in treatment support. Much is due to computers that have revolutionized medical imaging not only in acquisition process but also in the way it is visualized, stored, exchanged and managed. Picture Archiving and Communication Systems (PACS) is an example of how medical imaging takes advantage of computers. To solve problems of interoperability of PACS and medical imaging equipment, the Digital Imaging and Communications in Medicine (DICOM) standard was defined and widely implemented in current solutions. More recently, the need to exchange medical data between distinct institutions resulted in Integrating the Healthcare Enterprise (IHE) initiative that contains a content profile especially conceived for medical imaging exchange: Cross Enterprise Document Sharing for imaging (XDS-i). Moreover, due to application requirements, many solutions developed private networks to support their services. For instance, some applications support enhanced query and retrieve over DICOM objects metadata. This paper proposes anintegration framework to medical imaging networks that provides protocols interoperability and data federation services. It is an extensible plugin system that supports standard approaches (DICOM and XDS-I), but is also capable of supporting private protocols. The framework is being used in the Dicoogle Open Source PACS.
Perspectives of Post-Acute Transition of Care for Cardiac Surgery Patients
Stoicea, Nicoleta; You, Tian; Eiterman, Andrew; Hartwell, Clifton; Davila, Victor; Marjoribanks, Stephen; Florescu, Cristina; Bergese, Sergio Daniel; Rogers, Barbara
2017-01-01
Post-acute care (PAC) facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes, specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR) services, caregiver burden, and the financial impact of care. The objective of this review is to examine existing models of cardiac transitional care, identify major challenges and social factors that affect PAC, and analyze the impact of current transitional care efforts and strategies implemented to improve health outcomes in this patient population. We intend to discuss successful methods to address the following aspects: hospital-PAC linkages, improved discharge planning, caregiver burden, and CR access and utilization through patient-centered programs. Regular home visits by healthcare providers result in decreased hospital readmission rates for patients utilizing home healthcare while improved hospital-PAC linkages reduced hospital readmissions by 25%. We conclude that widespread adoption of improvements in transitional care will play a key role in patient recovery and decrease hospital readmission, morbidity, and mortality. PMID:29230400
Perspectives of Post-Acute Transition of Care for Cardiac Surgery Patients.
Stoicea, Nicoleta; You, Tian; Eiterman, Andrew; Hartwell, Clifton; Davila, Victor; Marjoribanks, Stephen; Florescu, Cristina; Bergese, Sergio Daniel; Rogers, Barbara
2017-01-01
Post-acute care (PAC) facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes, specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR) services, caregiver burden, and the financial impact of care. The objective of this review is to examine existing models of cardiac transitional care, identify major challenges and social factors that affect PAC, and analyze the impact of current transitional care efforts and strategies implemented to improve health outcomes in this patient population. We intend to discuss successful methods to address the following aspects: hospital-PAC linkages, improved discharge planning, caregiver burden, and CR access and utilization through patient-centered programs. Regular home visits by healthcare providers result in decreased hospital readmission rates for patients utilizing home healthcare while improved hospital-PAC linkages reduced hospital readmissions by 25%. We conclude that widespread adoption of improvements in transitional care will play a key role in patient recovery and decrease hospital readmission, morbidity, and mortality.
NASA Astrophysics Data System (ADS)
Cao, Xinhua; Xu, Xiaoyin; Voss, Stephan
2017-03-01
In this paper, we describe an enhanced DICOM Secondary Capture (SC) that integrates Image Quantification (IQ) results, Regions of Interest (ROIs), and Time Activity Curves (TACs) with screen shots by embedding extra medical imaging information into a standard DICOM header. A software toolkit of DICOM IQSC has been developed to implement the SC-centered information integration of quantitative analysis for routine practice of nuclear medicine. Primary experiments show that the DICOM IQSC method is simple and easy to implement seamlessly integrating post-processing workstations with PACS for archiving and retrieving IQ information. Additional DICOM IQSC applications in routine nuclear medicine and clinic research are also discussed.
User Acceptance of Picture Archiving and Communication System in the Emergency Department
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
The development and validation of the Physical Appearance Comparison Scale-3 (PACS-3).
Schaefer, Lauren M; Thompson, J Kevin
2018-05-21
Appearance comparison processes are implicated in the development of body-image disturbance and disordered eating. The Physical Appearance Comparison Scale-Revised (PACS-R) assesses the simple frequency of appearance comparisons; however, research has suggested that other aspects of appearance comparisons (e.g., comparison direction) may moderate the association between comparisons and their negative outcomes. In the current study, the PACS-R was revised to examine aspects of comparisons with relevance to body-image and eating outcomes. Specifically, the measure was modified to examine (a) dimensions of physical appearance relevant to men and women (i.e., weight-shape, muscularity, and overall physical appearance), (b) comparisons with proximal and distal targets, (c) upward versus downward comparisons, and (d) the acute emotional impact of comparisons. The newly revised measure, labeled the PACS-3, along with existing measures of appearance comparison, body satisfaction, eating pathology, and self-esteem, was completed by 1,533 college men and women. Exploratory and confirmatory factor analyses were conducted to examine the factor structure of the PACS-3. In addition, the reliability, convergent validity, and incremental validity of the PACS-3 scores were examined. The final PACS-3 comprises 27 items and 9 subscales: Proximal: Frequency, Distal: Frequency, Muscular: Frequency, Proximal: Direction, Distal: Direction, Muscular: Direction, Proximal: Effect, Distal: Effect, and Muscular: Effect. the PACS-3 subscale scores demonstrated good reliability and convergent validity. Moreover, the PACS-3 subscales greatly improved the prediction of body satisfaction and disordered eating relative to existing measures of appearance comparison. Overall, the PACS-3 improves upon existing scales and offers a comprehensive assessment of appearance-comparison processes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Investigating healthcare IT innovations: a "conceptual blending" approach.
Cranfield, Steven; Hendy, Jane; Reeves, Barnaby; Hutchings, Andrew; Collin, Simon; Fulop, Naomi
2015-01-01
The purpose of this paper is to better understand how and why adoption and implementation of healthcare IT innovations occur. The authors examine two IT applications, computerised physician order entry (CPOE) and picture archiving and communication systems (PACS) at the meso and micro levels, within the context of the National Programme for IT in the English National Health Service (NHS). To analyse these multi-level dynamics, the authors blend Rogers' diffusion of innovations theory (DoIT) with Webster's sociological critique of technological innovation in medicine and healthcare systems to illuminate a wider range of interacting factors. Qualitative data collected between 2004 and 2006 uses semi-structured, in-depth interviews with 72 stakeholders across four English NHS hospital trusts. Overall, PACS was more successfully implemented (fully or partially in three out of four trusts) than CPOE (implemented in one trust only). Factors such as perceived benefit to users and attributes of the application - in particular speed, ease of use, reliability and flexibility and levels of readiness - were highly relevant but their influence was modulated through interaction with complex structural and relational issues. Results reveal that combining contextual system level theories with DoIT increases understanding of real-life processes underpinning implementation of IT innovations within healthcare. They also highlight important drivers affecting success of implementation, including socio-political factors, the social body of practice and degree of "co-construction" between designers and end-users. The originality of the study partly rests on its methodological innovativeness and its value on critical insights afforded into understanding complex IT implementation programmes.
Removal of phenol by powdered activated carbon prepared from coal gasification tar residue.
Wang, Xiong-Lei; Shen, Jun; Niu, Yan-Xia; Wang, Yu-Gao; Liu, Gang; Sheng, Qing-Tao
2018-03-01
Coal gasification tar residue (CGTR) is a kind of environmentally hazardous byproduct generated in fixed-bed coal gasification process. The CGTR extracted by ethyl acetate was used to prepare powdered activated carbon (PAC), which is applied later for adsorption of phenol. The results showed that the PAC prepared under optimum conditions had enormous mesoporous structure, and the iodine number reached 2030.11 mg/g, with a specific surface area of 1981 m 2 /g and a total pore volume of 0.92 ml/g. Especially, without loading other substances, the PAC, having a strong magnetism, can be easily separated after it adsorbs phenol. The adsorption of phenol by PAC was studied as functions of contact time, temperature, PAC dosage, solution concentration and pH. The results showed a fast adsorption speed and a high adsorption capacity of PAC. The adsorption process was exothermic and conformed to the Freundlich models. The adsorption kinetics fitted better to the pseudo-second-order model. These results show that CGTR can be used as a potential adsorbent of phenols in wastewater.
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.
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”.
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.
Architecture for a PACS primary diagnosis workstation
NASA Astrophysics Data System (ADS)
Shastri, Kaushal; Moran, Byron
1990-08-01
A major factor in determining the overall utility of a medical Picture Archiving and Communications (PACS) system is the functionality of the diagnostic workstation. Meyer-Ebrecht and Wendler [1] have proposed a modular picture computer architecture with high throughput and Perry et.al [2] have defined performance requirements for radiology workstations. In order to be clinically useful, a primary diagnosis workstation must not only provide functions of current viewing systems (e.g. mechanical alternators [3,4]) such as acceptable image quality, simultaneous viewing of multiple images, and rapid switching of image banks; but must also provide a diagnostic advantage over the current systems. This includes window-level functions on any image, simultaneous display of multi-modality images, rapid image manipulation, image processing, dynamic image display (cine), electronic image archival, hardcopy generation, image acquisition, network support, and an easy user interface. Implementation of such a workstation requires an underlying hardware architecture which provides high speed image transfer channels, local storage facilities, and image processing functions. This paper describes the hardware architecture of the Siemens Diagnostic Reporting Console (DRC) which meets these requirements.
Wang, Wenqiang
2018-01-01
To exploit the adsorption capacity of commercial powdered activated carbon (PAC) and to improve the efficiency of Cr(VI) removal from aqueous solutions, the adsorption of Cr(VI) by commercial PAC and the countercurrent two-stage adsorption (CTA) process was investigated. Different adsorption kinetics models and isotherms were compared, and the pseudo-second-order model and the Langmuir and Freundlich models fit the experimental data well. The Cr(VI) removal efficiency was >80% and was improved by 37% through the CTA process compared with the conventional single-stage adsorption process when the initial Cr(VI) concentration was 50 mg/L with a PAC dose of 1.250 g/L and a pH of 3. A calculation method for calculating the effluent Cr(VI) concentration and the PAC dose was developed for the CTA process, and the validity of the method was confirmed by a deviation of <5%. Copyright © 2017. Published by Elsevier Ltd.
Computers in imaging and health care: now and in the future.
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.
Changes in the use of postacute care during the initial Medicare payment reforms.
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.
Continuing quality improvement procedures for a clinical PACS.
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.
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.
NASA Astrophysics Data System (ADS)
Shi, Liehang; Sun, Jianyong; Yang, Yuanyuan; Ling, Tonghui; Wang, Mingqing; Zhang, Jianguo
2017-03-01
Purpose: Due to the generation of a large number of electronic imaging diagnostic records (IDR) year after year in a digital hospital, The IDR has become the main component of medical big data which brings huge values to healthcare services, professionals and administration. But a large volume of IDR presented in a hospital also brings new challenges to healthcare professionals and services as there may be too many IDRs for each patient so that it is difficult for a doctor to review all IDR of each patient in a limited appointed time slot. In this presentation, we presented an innovation method which uses an anatomical 3D structure object visually to represent and index historical medical status of each patient, which is called Visual Patient (VP) in this presentation, based on long term archived electronic IDR in a hospital, so that a doctor can quickly learn the historical medical status of the patient, quickly point and retrieve the IDR he or she interested in a limited appointed time slot. Method: The engineering implementation of VP was to build 3D Visual Representation and Index system called VP system (VPS) including components of natural language processing (NLP) for Chinese, Visual Index Creator (VIC), and 3D Visual Rendering Engine.There were three steps in this implementation: (1) an XML-based electronic anatomic structure of human body for each patient was created and used visually to index the all of abstract information of each IDR for each patient; (2)a number of specific designed IDR parsing processors were developed and used to extract various kinds of abstract information of IDRs retrieved from hospital information systems; (3) a 3D anatomic rendering object was introduced visually to represent and display the content of VIO for each patient. Results: The VPS was implemented in a simulated clinical environment including PACS/RIS to show VP instance to doctors. We setup two evaluation scenario in a hospital radiology department to evaluate whether radiologists accept the VPS and how the VP impact the radiologists' efficiency and accuracy in reviewing historic medical records of the patients. We got a statistical results showing that more than 70% participated radiologist would like to use the VPS in their radiological imaging services. In comparison testing of using VPS and RIS/PACS in reviewing historic medical records of the patients, we got a statistical result showing that the efficiency of using VPS was higher than that of using PACS/RIS. New Technologies and Results to be presented: This presentation presented an innovation method to use an anatomical 3D structure object, called VP, visually to represent and index historical medical records such as IDR of each patient and a doctor can quickly learn the historical medical status of the patient through VPS. The evaluation results showed that VPS has better performance than RIS-integrated PACS in efficiency of reviewing historic medical records of the patients. Conclusions: In this presentation, we presented an innovation method called VP to use an anatomical 3D structure object visually to represent and index historical IDR of each patient and briefed an engineering implementation to build a VPS to implement the major features and functions of VP. We setup two evaluation scenarios in a hospital radiology department to evaluate VPS and achieved evaluation results showed that VPS has better performance than RIS-integrated PACS in efficiency of reviewing historic medical records of the patients.
Wilson and Domainwall Kernels on Oakforest-PACS
NASA Astrophysics Data System (ADS)
Kanamori, Issaku; Matsufuru, Hideo
2018-03-01
We report the performance of Wilson and Domainwall Kernels on a new Intel Xeon Phi Knights Landing based machine named Oakforest-PACS, which is co-hosted by University of Tokyo and Tsukuba University and is currently fastest in Japan. This machine uses Intel Omni-Path for the internode network. We compare performance with several types of implementation including that makes use of the Grid library. The code is incorporated with the code set Bridge++.
Data grid: a distributed solution to PACS
NASA Astrophysics Data System (ADS)
Zhang, Xiaoyan; Zhang, Jianguo
2004-04-01
In a hospital, various kinds of medical images acquired from different modalities are generally used and stored in different department and each modality usually attaches several workstations to display or process images. To do better diagnosis, radiologists or physicians often need to retrieve other kinds of images for reference. The traditional image storage solution is to buildup a large-scale PACS archive server. However, the disadvantages of pure centralized management of PACS archive server are obvious. Besides high costs, any failure of PACS archive server would cripple the entire PACS operation. Here we present a new approach to develop the storage grid in PACS, which can provide more reliable image storage and more efficient query/retrieval for the whole hospital applications. In this paper, we also give the performance evaluation by comparing the three popular technologies mirror, cluster and grid.
Implementation of an ASP model offsite backup archive for clinical images utilizing Internet 2
NASA Astrophysics Data System (ADS)
Liu, Brent J.; Chao, Sander S.; Documet, Jorge; Lee, Jasper; Lee, Michael; Topic, Ian; Williams, Lanita
2005-04-01
With the development of PACS technology and an increasing demand by medical facilities to become filmless, there is a need for a fast and efficient method of providing data backup for disaster recovery and downtime scenarios. At the Image Processing Informatics Lab (IPI), an ASP Backup Archive was developed using a fault-tolerant server with a T1 connection to serve the PACS at the St. John's Health Center (SJHC) Santa Monica, California. The ASP archive server has been in clinical operation for more than 18 months, and its performance was presented at this SPIE Conference last year. This paper extends the ASP Backup Archive to serve the PACS at the USC Healthcare Consultation Center II (HCC2) utilizing an Internet2 connection. HCC2 is a new outpatient facility that recently opened in April 2004. The Internet2 connectivity between USC's HCC2 and IPI has been established for over one year. There are two novelties of the current ASP model: 1) Use of Internet2 for daily clinical operation, and 2) Modifying the existing backup archive to handle two sites in the ASP model. This paper presents the evaluation of the ASP Backup Archive based on the following two criteria: 1) Reliability and performance of the Internet2 connection between HCC2 and IPI using DICOM image transfer in a clinical environment, and 2) Ability of the ASP Fault-Tolerant backup archive to support two separate clinical PACS sites simultaneously. The performances of using T1 and Internet2 at the two different sites are also compared.
Forsman, Päivi; Alatossava, Tapani
1991-01-01
The genomes of four Lactobacillus delbrueckii subsp. lactis bacteriophages were characterized by restriction endonuclease mapping, Southern hybridization, and heteroduplex analysis. The phages were isolated from different cheese processing plants in Finland between 1950 and 1972. All four phages had a small isometric head and a long noncontractile tail. Two different types of genome (double-stranded DNA) organization existed among the different phages, the pac type and the cos type, corresponding to alternative types of phage DNA packaging. Three phages belonged to the pac type, and a fourth was a cos-type phage. The pac-type phages were genetically closely related. In the genomes of the pac-type phages, three putative insertion/deletions (0.7 to 0.8 kb, 1.0 kb, and 1.5 kb) and one other region (0.9 kb) containing clustered base substitutions were discovered and localized. At the phenotype level, three main differences were observed among the pac-type phages. These concerned two minor structural proteins and the efficiency of phage DNA packaging. The genomes of the pac-type phages showed only weak homology with that of the cos-type phage. Phage-related DNA, probably a defective prophage, was located in the chromosome of the host strain sensitive to the cos-type phage. This DNA exhibited homology under stringent conditions to the pac-type phages. Images PMID:16348513
French, Katy E; Albright, Heidi W; Frenzel, John C; Incalcaterra, James R; Rubio, Augustin C; Jones, Jessica F; Feeley, Thomas W
2013-12-01
The value and impact of process improvement initiatives are difficult to quantify. We describe the use of time-driven activity-based costing (TDABC) in a clinical setting to quantify the value of process improvements in terms of cost, time and personnel resources. Difficulty in identifying and measuring the cost savings of process improvement initiatives in a Preoperative Assessment Center (PAC). Use TDABC to measure the value of process improvement initiatives that reduce the costs of performing a preoperative assessment while maintaining the quality of the assessment. Apply the principles of TDABC in a PAC to measure the value, from baseline, of two phases of performance improvement initiatives and determine the impact of each implementation in terms of cost, time and efficiency. Through two rounds of performance improvements, we quantified an overall reduction in time spent by patient and personnel of 33% that resulted in a 46% reduction in the costs of providing care in the center. The performance improvements resulted in a 17% decrease in the total number of full time equivalents (FTE's) needed to staff the center and a 19% increase in the numbers of patients assessed in the center. Quality of care, as assessed by the rate of cancellations on the day of surgery, was not adversely impacted by the process improvements. © 2013 Published by Elsevier Inc.
NASA Astrophysics Data System (ADS)
Deckard, Michael; Ratib, Osman M.; Rubino, Gregory
2002-05-01
Our project was to design and implement a ceiling-mounted multi monitor display unit for use in a high-field MRI surgical suite. The system is designed to simultaneously display images/data from four different digital and/or analog sources with: minimal interference from the adjacent high magnetic field, minimal signal-to-noise/artifact contribution to the MRI images and compliance with codes and regulations for the sterile neuro-surgical environment. Provisions were also made to accommodate the importing and exporting of video information via PACS and remote processing/display for clinical and education uses. Commercial fiber optic receivers/transmitters were implemented along with supporting video processing and distribution equipment to solve the video communication problem. A new generation of high-resolution color flat panel displays was selected for the project. A custom-made monitor mount and in-suite electronics enclosure was designed and constructed at UCLA. Difficulties with implementing an isolated AC power system are discussed and a work-around solution presented.
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.
Effective Reuse of Electroplating Rinse Wastewater by Combining PAC with H2O2/UV Process.
Yen, Hsing Yuan; Kang, Shyh-Fang; Lin, Chen Pei
2015-04-01
This study evaluated the performance of treating electroplating rinse wastewater by powder activated carbon (PAC) adsorption, H2O2/UV oxidation, and their combination to remove organic compounds and heavy metals. The results showed that neither the process of PAC adsorption nor H2O2/UV oxidation could reduce COD to 100 mg/L, as enforced by the Taiwan Environmental Protection Agency. On the other hand, the water sample treated by the combined approach of using PAC (5 g/L) pre-adsorption and H2O2/UV post-oxidation (UV of 64 W, H2O2 of 100 mg/L, oxidation time of 90 min), COD and DOC were reduced to 8.2 mg/L and 3.8 mg/L, respectively. Also, the combined approach reduced heavy metals to meet the effluent standards and to satisfy the in-house water reuse criteria for the electroplating factory. The reaction constant analysis indicated that the reaction proceeded much more rapidly for the combined process. Hence, it is a more efficient, economic and environmentally friendly process.
Physical activity assessment and counseling in Quebec family medicine groups.
Baillot, Aurélie; Baillargeon, Jean-Patrice; Paré, Alex; Poder, Thomas G; Brown, Christine; Langlois, Marie-France
2018-05-01
To determine how often primary health care providers (PHCPs) in family medicine groups (FMGs) assess physical activity (PA) levels, provide PA counseling (PAC), and refer patients to exercise professionals; to describe patients' PA levels, physical fitness, and satisfaction regarding their PA management in FMGs; to describe available PA materials in FMGs and PHCPs' PAC self-efficacy and PA knowledge; and to identify characteristics of patients and PHCPs that determine the assessment of PA and PAC provided by PHCPs. Cross-sectional study using questionnaires and a medical chart audit. Ten FMGs within the Integrated University Health Network of the Centre hospitalier universitaire de Sherbrooke in Quebec. Forty FPs, 24 nurses, and 439 patients. Assessment of PA level and PAC provided by PHCPs. Overall, 51.9% of the patients had had their PA level assessed during the past 18 months, but only 21.6% received PAC from at least 1 of the PHCPs. Similar percentages were found among the inactive (n = 244) and more active (n = 195) patients. The median PAC self-efficacy score of PHCPs was 70.2% (interquartile range 52.0% to 84.7%) and the median PA knowledge score was 45.8% (interquartile range 41.7% to 54.2%), with no significant differences between nurses and FPs. In multivariate analysis, 34% of the variance in PAC provided was explained by assessment of PA level, overweight or obese status, type 2 diabetes or prediabetes, less FP experience, lower patient annual family income, more nurse encounters, and a higher patient physical component summary of quality of life. The rates of assessment of PA and provision of PAC in Quebec FMGs were low, even though most of the patients were inactive. Initiatives to support PHCPs and more resources to assess PA levels and provide PAC should be implemented. Copyright© the College of Family Physicians of Canada.
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.
Using the New Postacute Care Quality Measures to Demonstrate the Value of Occupational Therapy.
Sandhu, Sharmila; Furniss, Jeremy; Metzler, Christina
As the health care system continues to evolve toward one based on quality not quantity, demonstrating the value of occupational therapy has never been more important. Providing high-quality services, achieving optimal outcomes, and identifying and promoting occupational therapy's distinct value are the responsibilities of all practitioners. In relation to the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, the Centers for Medicare and Medicaid Services (CMS) is implementing new functional items and related outcome performance measures across postacute care (PAC) settings. Practitioners can demonstrate the role and value of occupational therapy services through their participation in data collection and the interpretation of the resulting performance measures. In this column, we review the objectives of the IMPACT Act, introduce the new self-care and mobility items and outcome performance measures being implemented in PAC settings, and describe ways to use these new data to advocate for occupational therapy. We also discuss American Occupational Therapy Association initiatives to provide materials and guidance for occupational therapy practitioners to contribute to PAC data collection. Copyright © 2018 by the American Occupational Therapy Association, Inc.
Cranberry Proanthocyanidins - Protein complexes for macrophage activation.
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.
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.
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.
Strengthening your ties to referring physicians through RIS/PACS integration.
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.
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.
Martinez, R; Rozenblit, J; Cook, J F; Chacko, A K; Timboe, H L
1999-05-01
In the Department of Defense (DoD), US Army Medical Command is now embarking on an extremely exciting new project--creating a virtual radiology environment (VRE) for the management of radiology examinations. The business of radiology in the military is therefore being reengineered on several fronts by the VRE Project. In the VRE Project, a set of intelligent agent algorithms determine where examinations are to routed for reading bases on a knowledge base of the entire VRE. The set of algorithms, called the Meta-Manager, is hierarchical and uses object-based communications between medical treatment facilities (MTFs) and medical centers that have digital imaging network picture archiving and communications systems (DIN-PACS) networks. The communications is based on use of common object request broker architecture (CORBA) objects and services to send patient demographics and examination images from DIN-PACS networks in the MTFs to the DIN-PACS networks at the medical centers for diagnosis. The Meta-Manager is also responsible for updating the diagnosis at the originating MTF. CORBA services are used to perform secure message communications between DIN-PACS nodes in the VRE network. The Meta-Manager has a fail-safe architecture that allows the master Meta-Manager function to float to regional Meta-Manager sites in case of server failure. A prototype of the CORBA-based Meta-Manager is being developed by the University of Arizona's Computer Engineering Research Laboratory using the unified modeling language (UML) as a design tool. The prototype will implement the main functions described in the Meta-Manager design specification. The results of this project are expected to reengineer the process of radiology in the military and have extensions to commercial radiology environments.
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
Aryanto, Kadek Y E; Broekema, André; Oudkerk, Matthijs; van Ooijen, Peter M A
2012-01-01
To present an adapted Clinical Trial Processor (CTP) test set-up for receiving, anonymising and saving Digital Imaging and Communications in Medicine (DICOM) data using external input from the original database of an existing clinical study information system to guide the anonymisation process. Two methods are presented for an adapted CTP test set-up. In the first method, images are pushed from the Picture Archiving and Communication System (PACS) using the DICOM protocol through a local network. In the second method, images are transferred through the internet using the HTTPS protocol. In total 25,000 images from 50 patients were moved from the PACS, anonymised and stored within roughly 2 h using the first method. In the second method, an average of 10 images per minute were transferred and processed over a residential connection. In both methods, no duplicated images were stored when previous images were retransferred. The anonymised images are stored in appropriate directories. The CTP can transfer and process DICOM images correctly in a very easy set-up providing a fast, secure and stable environment. The adapted CTP allows easy integration into an environment in which patient data are already included in an existing information system.
Li, Gang; Gao, Hong; Li, Yansheng; Yang, Huixin
2011-06-01
Using ion exchange resin as transfer media, regenerate powdered activated carbon (PAC) adsorbed inorganic ions by cavitation to enhance the transfer; we studied how the regeneration time and the mass ratio of resin and PAC influence the regeneration rate respectively through re-adsorption. The result showed that the effective regeneration of PAC saturated with inorganic ions was above 90% using ion exchange resin as media and transfer carrier, the quantity of PAC did not reduced but activated in the process. Copyright © 2011 The Research Centre for Eco-Environmental Sciences, Chinese Academy of Sciences. Published by Elsevier B.V. All rights reserved.
Current status of the UCSF second-generation PACS
NASA Astrophysics Data System (ADS)
Huang, H. K.; Arenson, Ronald L.; Wong, Albert W. K.; Bazzill, Todd M.; Lou, Shyhliang A.; Andriole, Katherine P.; Wang, Jun; Zhang, Jianguo; Wong, Stephen T. C.
1996-05-01
This paper describes the current status of the second generation PACS at UCSF commenced in October 1992. The UCSF PACS is designed in-house as a hospital-integrated PACS based on an open architecture concept using industrial standards including UNIX operating system, C programming language, X-Window user interface, TCP/IP communication protocol, DICOM 3.0 image standard and HL7 health data format. Other manufacturer's PACS components which conform with these standards can be easily integrated into the system. Relevant data from HIS and RIS is automatically incorporated into the PACS using HL7 data format and TCP/IP communication protocol. The UCSF system also takes advantage of state-of-the-art communication, storage, and software technologies in ATM, multiple storage media, automatic programming, multilevel processes for a better cost-performance system. The primary PACS network is the 155 Mbits/sec OC3 ATM with the Ethernet as the back-up. The UCSF PACS also connects Mt. Zion Hospital and San Francisco VA Medical Center in the San Francisco Bay area via an ATM wide area network with a T1 line as the back-up. Currently, five MR and five CT scanners from multiple sites, two computed radiography systems, two film digitizers, one US PACS module, the hospital HIS and the department RIS have been connected to the PACS network. The image data is managed by a mirrored database (Sybase). The PACS controller, with its 1.3 terabyte optical disk library, acquires 2.5 gigabytes digital data daily. Four 2K, five, 1,600-line multiple monitor display workstations are on line in neuroradiology, pediatric radiology and intensive care units for clinical use. In addition, the PACS supports over 100 Macintosh users in the department and selected hospital sites for both images and textual retrieval through a client/server mechanism. We are also developing a computation and visualization node in the PACS network for advancing radiology research.
Learn from experience: insights of 200+ PACS customers.
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.
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
Biache, Coralie; Ouali, Salma; Cébron, Aurélie; Lorgeoux, Catherine; Colombano, Stéfan; Faure, Pierre
2017-05-05
A bioslurry batch experiment was carried out over five months on three polycyclic aromatic compound (PAC) contaminated soils to study the PAC (PAH and polar-PAC) behavior during soil incubation and to evaluate the impact of PAC contamination on the abundance of microbial communities and functional PAH-degrading populations. Organic matter characteristics and reactivity, assessed through solvent extractable organic matter and PAC contents, and soil organic matter mineralization were monitored during 5 months. Total bacteria and fungi, and PAH-ring hydroxylating dioxygenase genes were quantified. Results showed that PAHs and polar-PACs were degraded with different degradation dynamics. Differences in degradation rates were observed among the three soils depending on PAH distribution and availability. Overall, low molecular weight compounds were preferentially degraded. Degradation selectivity between isomers and structurally similar compounds was observed which could be used to check the efficiency of bioremediation processes. Bacterial communities were dominant over fungi and were most likely responsible for PAC degradation. Abundance of PAH-degrading bacteria increased during incubations, but their proportion in the bacterial communities tended to decrease. The accumulation of some oxygenated-PACs during the bioslurry experiment underlines the necessity to monitor these compounds during application of remediation treatment on PAH contaminated soils. Copyright © 2017 Elsevier B.V. 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.
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.
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.
Li, Xin; Wang, Jun; Zhang, Xiaojian; Chen, Chao
2015-06-01
Powdered activated carbon (PAC) adsorption of two fishy odorants, trans,trans-2,4-heptadienal (HDE) and trans,trans-2,4-decadienal (DDE), was investigated. Both the pseudo first-order and the pseudo second-order kinetic models well described the kinetics curves, and DDE was more readily removed by PAC. In isotherm tests, both Freundlich and Modified Freundlich isotherms fitted the experimental data well. PAC exhibited a higher adsorption capacity for DDE than for HDE, which could be ascribed to the difference in their hydrophobicity. The calculated thermodynamic parameters (ΔG0, ΔH0, and ΔS0) indicated an exothermic and spontaneous adsorption process. PAC dosage, pH, and natural organic matter (NOM) presence were found to influence the adsorption process. With increasing PAC dosage, the pseudo first-order and pseudo second-order rate constants both increased. The value of pH had little influence on HDE or DDE molecules but altered the surface charge of PAC, and the maximum adsorption capacity occurred at pH9. The presence of NOM, especially the fraction with molecular weight less than 1k Dalton, hindered the adsorption. The study showed that preloaded NOM impaired the adsorption capacity of HDE or DDE more severely than simultaneously fed NOM did. Copyright © 2015. Published by Elsevier B.V.
Assessing Attachment in Psychotherapy: Validation of the Patient Attachment Coding System (PACS).
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.
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.
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.
Digital processing of radiographic images from PACS to publishing.
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.
Lega, Bradley; Burke, John; Jacobs, Joshua; Kahana, Michael J.
2016-01-01
Phase–amplitude coupling (PAC) has been proposed as a neural mechanism for coordinating information processing across brain regions. Here we sought to characterize PAC in the human hippocampus, and in temporal and frontal cortices, during the formation of new episodic memories. Intracranial recordings taken as 56 neurosurgical patients studied and recalled lists of words revealed significant hippocampal PAC, with slow-theta activity (2.5–5 Hz) modulating gamma band activity (34–130 Hz). Furthermore, a significant number of hippocampal electrodes exhibited greater PAC during successful than unsuccessful encoding, with the gamma activity at these sites coupled to the trough of the slow-theta oscillation. These same conditions facilitate LTP in animal models, providing a possible mechanism of action for this effect in human memory. Uniquely in the hippocampus, phase preference during item encoding exhibited a biphasic pattern. Overall, our findings help translate between the patterns identified during basic memory tasks in animals and those present during complex human memory encoding. We discuss the unique properties of human hippocampal PAC and how our findings relate to influential theories of information processing based on theta–gamma interactions. PMID:25316340
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.
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.
Rasouli, Yaser; Abbasi, Mohsen; Hashemifard, Seyed Abdollatif
2017-08-01
In this research, four types of low cost and high performance ceramic microfiltration (MF) membranes have been employed in an in-line adsorption-MF process for oily wastewater treatment. Mullite, mullite-alumina, mullite-alumina-zeolite and mullite-zeolite membranes were fabricated as ceramic MF membranes by low cost kaolin clay, natural zeolite and α-alumina powder. Powdered activated carbon (PAC) and natural zeolite powder in concentrations of 100-800 mg L -1 were used as adsorbent agent in the in-line adsorption-MF process. Performance of the hybrid adsorption-MF process for each concentration of PAC and natural zeolite powder was investigated by comparing quantity of permeation flux (PF) and total organic carbon (TOC) rejection during oily wastewater treatment. Results showed that by application of 400 mg L -1 PAC in the adsorption-MF process with mullite and mullite-alumina membranes, TOC rejection was enhanced up to 99.5% in comparison to the MF only process. An increasing trend was observed in PF by application of 100-800 mg L -1 PAC. Also, results demonstrated that the adsorption-MF process with natural zeolite powder has higher performance in comparison to the MF process for all membranes except mullite-alumina membranes in terms of PF. In fact, significant enhancement of PF and TOC rejection up to 99.9% were achieved by employing natural zeolite powder in the in-line adsorption-MF hybrid process.
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.
PACS quality control and automatic problem notifier
NASA Astrophysics Data System (ADS)
Honeyman-Buck, Janice C.; Jones, Douglas; Frost, Meryll M.; Staab, Edward V.
1997-05-01
One side effect of installing a clinical PACS Is that users become dependent upon the technology and in some cases it can be very difficult to revert back to a film based system if components fail. The nature of system failures range from slow deterioration of function as seen in the loss of monitor luminance through sudden catastrophic loss of the entire PACS networks. This paper describes the quality control procedures in place at the University of Florida and the automatic notification system that alerts PACS personnel when a failure has happened or is anticipated. The goal is to recover from a failure with a minimum of downtime and no data loss. Routine quality control is practiced on all aspects of PACS, from acquisition, through network routing, through display, and including archiving. Whenever possible, the system components perform self and between platform checks for active processes, file system status, errors in log files, and system uptime. When an error is detected or a exception occurs, an automatic page is sent to a pager with a diagnostic code. Documentation on each code, trouble shooting procedures, and repairs are kept on an intranet server accessible only to people involved in maintaining the PACS. In addition to the automatic paging system for error conditions, acquisition is assured by an automatic fax report sent on a daily basis to all technologists acquiring PACS images to be used as a cross check that all studies are archived prior to being removed from the acquisition systems. Daily quality control is preformed to assure that studies can be moved from each acquisition and contrast adjustment. The results of selected quality control reports will be presented. The intranet documentation server will be described with the automatic pager system. Monitor quality control reports will be described and the cost of quality control will be quantified. As PACS is accepted as a clinical tool, the same standards of quality control must be established as are expected on other equipment used in the diagnostic process.
NASA Astrophysics Data System (ADS)
Ott, Stephan; Herschel Science Ground Segment Consortium
2010-05-01
The Herschel Space Observatory, the fourth cornerstone mission in the ESA science program, was launched 14th of May 2009. With a 3.5 m telescope, it is the largest space telescope ever launched. Herschel's three instruments (HIFI, PACS, and SPIRE) perform photometry and spectroscopy in the 55 - 672 micron range and will deliver exciting science for the astronomical community during at least three years of routine observations. Since 2nd of December 2009 Herschel has been performing and processing observations in routine science mode. The development of the Herschel Data Processing System started eight years ago to support the data analysis for Instrument Level Tests. To fulfil the expectations of the astronomical community, additional resources were made available to implement a freely distributable Data Processing System capable of interactively and automatically reducing Herschel data at different processing levels. The system combines data retrieval, pipeline execution and scientific analysis in one single environment. The Herschel Interactive Processing Environment (HIPE) is the user-friendly face of Herschel Data Processing. The software is coded in Java and Jython to be platform independent and to avoid the need for commercial licenses. It is distributed under the GNU Lesser General Public License (LGPL), permitting everyone to access and to re-use its code. We will summarise the current capabilities of the Herschel Data Processing System and give an overview about future development milestones and plans, and how the astronomical community can contribute to HIPE. The Herschel Data Processing System is a joint development by the Herschel Science Ground Segment Consortium, consisting of ESA, the NASA Herschel Science Center, and the HIFI, PACS and SPIRE consortium members.
Adelman, K; Salmon, B; Baines, J D
2001-03-13
The product of the herpes simplex virus type 1 U(L)28 gene is essential for cleavage of concatemeric viral DNA into genome-length units and packaging of this DNA into viral procapsids. To address the role of U(L)28 in this process, purified U(L)28 protein was assayed for the ability to recognize conserved herpesvirus DNA packaging sequences. We report that DNA fragments containing the pac1 DNA packaging motif can be induced by heat treatment to adopt novel DNA conformations that migrate faster than the corresponding duplex in nondenaturing gels. Surprisingly, these novel DNA structures are high-affinity substrates for U(L)28 protein binding, whereas double-stranded DNA of identical sequence composition is not recognized by U(L)28 protein. We demonstrate that only one strand of the pac1 motif is responsible for the formation of novel DNA structures that are bound tightly and specifically by U(L)28 protein. To determine the relevance of the observed U(L)28 protein-pac1 interaction to the cleavage and packaging process, we have analyzed the binding affinity of U(L)28 protein for pac1 mutants previously shown to be deficient in cleavage and packaging in vivo. Each of the pac1 mutants exhibited a decrease in DNA binding by U(L)28 protein that correlated directly with the reported reduction in cleavage and packaging efficiency, thereby supporting a role for the U(L)28 protein-pac1 interaction in vivo. These data therefore suggest that the formation of novel DNA structures by the pac1 motif confers added specificity on recognition of DNA packaging sequences by the U(L)28-encoded component of the herpesvirus cleavage and packaging machinery.
Bolliet, Christophe; Kriech, Anthony J; Juery, Catherine; Vaissiere, Mathieu; Brinton, Michael A; Osborn, Linda V
2015-01-01
In this study we investigated the impact of temperature on emissions as related to various bitumen applications and processes used in commercial products. Bitumen emissions are very complex and can be influenced in quantity and composition by differences in crude source, refining processes, application temperature, and work practices. This study provided a controlled laboratory environment to study five bitumen test materials from three European refineries; three paving grade, one used for primarily roofing and some paving applications, and one oxidized industrial specialty bitumen. Emissions were generated at temperatures between 140°C and 230°C based on typical application temperatures of each product. Emissions were characterized by aerodynamic particle size, total organic matter (TOM), simulated distillation, 40 individual PACs, and fluorescence (FL-PACs) spectroscopy. Results showed that composition of bitumen emissions is influenced by temperature under studied experimental conditions. A distinction between the oxidized bitumen with flux oil (industrial specialty bitumen) and the remaining bitumens was observed. Under typical temperatures used for paving (150°C-170°C), the TOM and PAC concentrations in the emissions were low. However, bitumen with flux oil produced significantly higher emissions at 230°C, laden with high levels of PACs. Flux oil in this bitumen mixture enhanced release of higher boiling-ranged compounds during application conditions. At 200°C and below, concentrations of 4-6 ring PACs were ≤6.51 μg/m(3) for all test materials, even when flux oil was used. Trends learned about emission temperature-process relationships from this study can be used to guide industry decisions to reduce worker exposure during processing and application of hot bitumen.
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.
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.
PACS administrators' and radiologists' perspective on the importance of features for PACS selection.
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.
Medical image informatics infrastructure design and applications.
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.
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.
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.
Costs of postabortion care in public sector health facilities in Malawi: a cross-sectional survey.
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.
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.
NASA Astrophysics Data System (ADS)
Andriessen, J. H. T. H.; van der Horst-Bruinsma, I. E.; ter Haar Romeny, B. M.
1989-05-01
The present phase of the clinical evaluation within the Dutch PACS project mainly focuses on the development and evaluation of a PACSystem for a few departments in the Utrecht University hospital (UUH). A report on the first clinical experiences and a detailed cost/savings analysis of the PACSystem in the UUH are presented elsewhere. However, an assessment of the wider fmancial and organizational implications for hospitals and for the health sector is also needed. To this end a model for (financial) cost assessment of PACSystems is being developed by BAZIS. Learning from the actual pilot implementation in UUH we realized that general Technology Assessment (TA) also calls for an extra-polation of the medical and organizational effects. After a short excursion into the various approaches towards TA, this paper discusses the (inter) organizational dimensions relevant to the development of the necessary exttapolationmodels.
NASA Astrophysics Data System (ADS)
Falkensammer, Peter; Soegner, Peter I.; zur Nedden, Dieter
2002-05-01
The integration of RIS-PACS systems in radiology units are intended to reduce time consumption in radiology workflow and thus to increase radiologist productivity. Along with the RIS-PACS integration at the University Hospital Innsbruck we analyzed workflow from patient admission to release of final reports before implementation. The follow up study after six months of the implementation is currently in work. In this study we compared chest to skeletal x-ray examinations in 969 patients before the implementation. Drawing the admission-to-release-of-final-report period showed a two-peak diagram with the first peak corresponding to a release of final results on the same day and the second peak to a release on the following day. In the chest x-ray group, 57% were released the same day (mean value 4:02 hours) and 43% the next day (mean value 21:47 hours). Looking at the skeletal x-rays 40% were released the same day (mean value 3:58 hours) and 60% were released the next day (mean value 21:05 hours). Summarizing the results we should say, that the average chest x-ray requires less time than an skeletal x-ray, due to the fact that a greater percentage of reports is released the same day. The most important result is, that the most time consuming workstep is the exchange of data media between radiologist and secretary with at least 5 hours.
CONTROL OF ORGANIC DRINKING WATER QUALITY BY PRECIPITATIVE PROCESSES
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...
The role of the primary auditory cortex in the neural mechanism of auditory verbal hallucinations
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
Cires, María José; Wong, Ximena; Carrasco-Pozo, Catalina; Gotteland, Martin
2017-01-01
Proanthocyanidins (PACs) are polymers of flavan-3-ols abundant in many vegetable foods and beverages widely consumed in the human diet. There is increasing evidence supporting the beneficial impact of dietary PACs in the prevention and nutritional management of non-communicable chronic diseases. It is considered that PACs with a degree of polymerization >3 remain unabsorbed in the gastrointestinal (GI) tract and accumulate in the colonic lumen. Accordingly, the GI tract may be considered as a key organ for the healthy-promoting effects of dietary PACs. PACs form non-specific complexes with salivary proteins in mouth, originating the sensation of astringency, and with dietary proteins, pancreatic enzymes, and nutrient transporters in the intestinal lumen, decreasing the digestion and absorption of carbohydrates, proteins, and lipids. They also exert antimicrobial activities, interfering with cariogenic or ulcerogenic pathogens in the mouth (Streptococcus mutans) and stomach (Helicobacter pylori), respectively. Through their antioxidant and antiinflammatory properties, PACs decrease inflammatory processes in animal model of gastric and colonic inflammation. Interestingly, they exert prebiotic activities, stimulating the growth of Lactobacillus spp. and Bifidobacterium spp. as well as some butyrate-producing bacteria in the colon. Finally, PACs are also metabolized by the gut microbiota, producing metabolites, mainly aromatic acids and valerolactones, which accumulate in the colon and/or are absorbed into the bloodstream. Accordingly, these compounds could display biological activities on the colonic epithelium or in extra-intestinal tissues and, therefore, contribute to part of the beneficial effects of dietary PACs. PMID:28097121
NASA Astrophysics Data System (ADS)
Shani, Uri; Kol, Tomer; Shachor, Gal
2004-04-01
Managing medical digital information objects, and in particular medical images is an enterprise-grade problem. Firstly, there is the sheer amount of digital data that is generated in the proliferation of digital (and film-free) medical imaging. Secondly, the managing software ought to enjoy high availability, recoverability and manageability that are found only in the most business-critical systems. Indeed, such requirements are borrowed from the business enterprise world. Moreover, the solution for the medical information management problem should too employ the same software tools, middlewares and architectures. It is safe to say that all first-line medical PACS products strive to provide a solution for all these challenging requirements. The DICOM standard has been a prime enabler of such solutions. DICOM created the interconnectivity, which made it possible for a PACS service to manage millions of exams consisting of trillions of images. With the more comprehensive IHE architecture, the enterprise is expanded into a multi-facility regional conglomerate, which presents extreme demands from the data management system. HIPPA legislations add considerable challenges per security, privacy and other legal issues, which aggravate the situation. In this paper, we firstly present what in our view should be the general requirements for a first-line medical PACS, taken from an enterprise medical imaging storage and management solution perspective. While these requirements can be met by homegrown implementations, we suggest looking at the existing technologies, which have emerged in the recent years to meet exactly these challenges in the business world. We present an evolutionary process, which led to the design and implementation of a medical object management subsystem. This is indeed an enterprise medical imaging solution that is built upon respective technological components. The system answers all these challenges simply by not reinventing wheels, but rather reusing the best "wheels" for the job. Relying on such middleware components allowed us to concentrate on added value for this specific problem domain.
Ball, Geoff D C; Mushquash, Aislin R; Keaschuk, Rachel A; Ambler, Kathryn A; Newton, Amanda S
2017-01-13
Pediatric obesity has become increasingly prevalent over recent decades. In view of the psychosocial and physical health risks, and the high likelihood that children with obesity will grow to become adults with obesity, there is a clear need to develop evidence-based interventions that can be delivered in the health care system to optimize the health and well-being of children with obesity and their families. The aim of this paper is to describe the development, implementation, and planned evaluation of a parent-based weight management intervention designed for parents of 8-12 year olds with obesity. The principles of Intervention Mapping (IM) were used to develop an intervention called Parents as Agents of Change (PAC © ). From 2006 to 2009, an environmental scan plus qualitative (individual interviews with parents and children), quantitative (medical record reviews), and literature review data were collected to gain broad insight into family factors related to pediatric obesity and its management. Theoretical frameworks and empirical evidence guided curriculum development, which was founded primarily on the tenets of family systems theory and cognitive behavioral theory. PAC was developed as a manualized, 16-session, group-based, health care professional-led intervention for parents to address individual, family, and environmental factors related to the management of pediatric obesity. The intervention was refined based on feedback from local and international experts, and has been implemented successfully in a multi-disciplinary weight management centre in a children's hospital. IM provided a practical framework to guide the systematic development of a pediatric weight management intervention for parents of children with obesity. This logical, step-by-step process blends theory and practice and is broadly applicable in the context of obesity management intervention development and evaluation. Following intervention development, the PAC intervention was evaluated within a randomized clinical trial. Trial registration NCT01267097; clinicaltrials.gov.
Meta-manager: a requirements analysis.
Cook, J F; Rozenblit, J W; Chacko, A K; Martinez, R; Timboe, H L
1999-05-01
The digital imaging network-picture-archiving and communications system (DIN-PACS) will be implemented in ten sites within the Great Plains Regional Medical Command (GPRMC). This network of PACS and teleradiology technology over a shared T1 network has opened the door for round the clock radiology coverage of all sites. However, the concept of a virtual radiology environment poses new issues for military medicine. A new workflow management system must be developed. This workflow management system will allow us to efficiently resolve these issues including quality of care, availability, severe capitation, and quality of the workforce. The design process of this management system must employ existing technology, operate over various telecommunication networks and protocols, be independent of platform operating systems, be flexible and scaleable, and involve the end user at the outset in the design process for which it is developed. Using the unified modeling language (UML), the specifications for this new business management system were created in concert between the University of Arizona and the GPRMC. These specifications detail a management system operating through a common object request brokered architecture (CORBA) environment. In this presentation, we characterize the Meta-Manager management system including aspects of intelligence, interfacility routing, fail-safe operations, and expected improvements in patient care and efficiency.
[A solution for display and processing of DICOM images in web PACS].
Xue, Wei-jing; Lu, Wen; Wang, Hai-yang; Meng, Jian
2009-03-01
Use the technique of Java Applet to realize the supporting of DICOM image in ordinary Web browser, thereby to expand the processing function of medical image. First analyze the format of DICOM file and design a class which can acquire the pixels, then design two Applet classes, of which one is used to disposal the DICOM image, the other is used to display DICOM image that have been disposaled in the first Applet. They all embedded in the View page, and they communicate by Applet Context object. The method designed in this paper can make users display and process DICOM images directly by using ordinary Web browser, which makes Web PACS not only have the advantages of B/S model, but also have the advantages of the C/S model. Java Applet is the key for expanding the Web browser's function in Web PACS, which provides a guideline to sharing of medical images.
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
Rondina, Matthew T; Grissom, Colin K; Men, Shaohua; Harris, Estelle S; Schwertz, Hansjorg; Zimmerman, Guy A; Weyrich, Andrew S
2012-06-01
Flow cytometry is often used to measure in vivo platelet activation in critically-ill patients. Variability in blood sampling techniques, which may confound these measurements, remains poorly characterized. Platelet activation was measured by flow cytometry performed on arterial and venous blood from 116 critically-ill patients. We determined how variability in vascular sampling site, processing times, and platelet counts influenced levels of platelet-monocyte aggregates (PMA), PAC-1 binding (for glycoprotein (GP) IIbIIIa), and P-selectin (P-SEL) expression. Levels of PMA, but not PAC-1 binding or P-SEL expression, were significantly affected by variability in vascular sampling site. Average PMA levels were approximately 60% higher in whole blood drawn from an arterial vessel compared to venous blood (16.2±1.8% vs. 10.7±1.2%, p<0.05). Levels of PMA in both arterial and venous blood increased significantly during ex vivo processing delays (1.7% increase for every 10 minute delay, p<0.05). In contrast, PAC-1 binding and P-SEL expression were unaffected by processing delays. Levels of PMA, but not PAC-1 binding or P-SEL expression, were correlated with platelet count quartiles (9.4±1.6% for the lowest quartile versus 15.4±1.6% for the highest quartile, p<0.05). In critically-ill patients, variability in vascular sampling site, processing times, and platelet counts influence levels of PMA, but not PAC-1 binding or P-SEL expression. These data demonstrate the need for rigorous adherence to blood sampling protocols, particularly when levels of PMA, which are most sensitive to variations in blood collection, are measured for detection of in vivo platelet activation. Copyright © 2011 Elsevier Ltd. All rights reserved.
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
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.
Integration in PACS of DICOM with TCP/IP, SQL, and X Windows
NASA Astrophysics Data System (ADS)
Reijns, Gerard L.
1994-05-01
The DICOM standard (Digital Imaging and Communications in Medicine) has been developed in order to obtain compatibility at the higher OSI levels. This paper describes the implementation of DICOM into our developed low cost PACS, which uses as much as possible standard software and standard protocols such as SQL, X Windows and TCP/IP. We adopted the requirement that all messages on the communication network have to be DICOM compatible. The translation between DICOM messages and SQL commands, which drive the relational data base, has been accommodated in our PACS supervisor. The translation takes only between 10 and 20 milliseconds. Images, that will be used the current day are stored in a distributed, parallel operating image base for reasons of performance. Extensive use has been made of X Windows to visualize images. A maximum of 12 images can simultaneously be displayed, of which one selected image can be manipulated (e.g., magnified, rotated, etc.), without affecting the other displayed images. The emphasis of the future work will be on performance measurements and modeling of our PACS and bringing the results of both methods in agreement with each other.
Economic impact of off-line PC viewer for private folder management
NASA Astrophysics Data System (ADS)
Song, Koun-Sik; Shin, Myung J.; Lee, Joo Hee; Auh, Yong H.
1999-07-01
We developed a PC-based clinical workstation and implemented at Asan Medical Center in Seoul, Korea, Hardwares used were Pentium-II, 8M video memory, 64-128 MB RAM, 19 inch color monitor, and 10/100Mbps network adaptor. One of the unique features of this workstation is management tool for folders reside both in PACS short-term storage unit and local hard disk. Users can copy the entire study or part of the study to local hard disk, removable storages, or CD recorder. Even the images in private folders in PACS short-term storage can be copied to local storage devices. All images are saved as DICOM 3.0 file format with 2:1 lossless compression. We compared the prices of copy films and storage medias considering the possible savings of expensive PACS short- term storage and network traffic. Price savings of copy film is most remarkable in MR exam. Price savings arising from minimal use of short-term unit was 50,000 dollars. It as hard to calculate the price savings arising from the network usage. Off-line PC viewer is a cost-effective way of handling private folder management under the PACS environment.
Relations of age and personality dimensions to cognitive ability factors.
Costa, P T; Fozard, J L; McCrae, R R; Bosśe, R
1976-11-01
The relation between three cognitive ability factors - Information Processing Ability (IPA), Manual Dexterity (MD), and Pattern Analysis Capability (PAC) - and three personality dimensions - Anxiety, Extraversion, and Openness to Experience - were examined in three age groups. Subjects were 969 male volunteers ranging in age from 25 to 82. Subjects high in anixety scored lower on all three cognitive factors; subjects open to experience scored higher on IPA and PAC; and introverted subjects scored higher on PAC. Most of these effects remained when the education and socio-economic status were held constant in covariance analyses. Older subjects performed less well than younger ones on MD and PAC, but not on IPA. While personality has some influence on cognitive performance, the declines with age in performance on some cognitive tasks are not mediated by personality.
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.
Utilizing data grid architecture for the backup and recovery of clinical image data.
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.
Huang, Camillan
2003-01-01
Technology has created a new dimension for visual teaching and learning with web-delivered interactive media. The Virtual Labs Project has embraced this technology with instructional design and evaluation methodologies behind the simPHYSIO suite of simulation-based, online interactive teaching modules in physiology for the Stanford students. In addition, simPHYSIO provides the convenience of anytime web-access and a modular structure that allows for personalization and customization of the learning material. This innovative tool provides a solid delivery and pedagogical backbone that can be applied to developing an interactive simulation-based training tool for the use and management of the Picture Archiving and Communication System (PACS) image information system. The disparity in the knowledge between health and IT professionals can be bridged by providing convenient modular teaching tools to fill the gaps in knowledge. An innovative teaching method in the whole PACS is deemed necessary for its successful implementation and operation since it has become widely distributed with many interfaces, components, and customizations. This paper will discuss the techniques for developing an interactive-based teaching tool, a case study of its implementation, and a perspective for applying this approach to an online PACS training tool. Copyright 2002 Elsevier Science Ltd.
Low Cost Desktop Image Analysis Workstation With Enhanced Interactive User Interface
NASA Astrophysics Data System (ADS)
Ratib, Osman M.; Huang, H. K.
1989-05-01
A multimodality picture archiving and communication system (PACS) is in routine clinical use in the UCLA Radiology Department. Several types workstations are currently implemented for this PACS. Among them, the Apple Macintosh II personal computer was recently chosen to serve as a desktop workstation for display and analysis of radiological images. This personal computer was selected mainly because of its extremely friendly user-interface, its popularity among the academic and medical community and its low cost. In comparison to other microcomputer-based systems the Macintosh II offers the following advantages: the extreme standardization of its user interface, file system and networking, and the availability of a very large variety of commercial software packages. In the current configuration the Macintosh II operates as a stand-alone workstation where images are imported from a centralized PACS server through an Ethernet network using a standard TCP-IP protocol, and stored locally on magnetic disk. The use of high resolution screens (1024x768 pixels x 8bits) offer sufficient performance for image display and analysis. We focused our project on the design and implementation of a variety of image analysis algorithms ranging from automated structure and edge detection to sophisticated dynamic analysis of sequential images. Specific analysis programs were developed for ultrasound images, digitized angiograms, MRI and CT tomographic images and scintigraphic images.
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.
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
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
Chi, Shu-Ching; Yeh, Lily; Lu, Meei-Shiow; Lin, Pei-Yu
2015-12-01
Post-acute care (PAC) service is becoming increasingly important in Taiwan as a core focus of government policies that are designed to ensure continuity of care. In order to improve PAC nursing education and quality of care, the present study applies a modified Delphi method to identify the core competences of nurses who provide PAC services to acute stroke patients. We surveyed 18 experts in post-acute care and long-term care anonymously using a 29-question questionnaire in order to identify the essential professional skills that are required to perform PAC effectively. The results of this survey indicate that the core competences of PAC may be divided into two categories: Case Management and Care Management. Case Management includes Direct Care, Communication, Health Care Education, Nursing Consulting, and Family Assessment & Health Care. Care Management includes Interdisciplinary Teamwork, Patient Care Management, and Resource Integration. The importance and practicality of each item was evaluated using a 7-point Likert scale. The experts required 2 rounds to reach a consensus about the importance and 3 rounds to determine the practicality of PAC core competences. This process highlighted the differing points of view that are held by professionals in the realms of nursing, medicine, and national health policy. The PAC in-job training program in its current form inadequately cul-tivates core competence in Care Management. The results of the present study may be used to inform the development of PAC nurse orientation training programs and continuing education courses.
NASA Astrophysics Data System (ADS)
Ukawa, Akira
1998-05-01
The CP-PACS computer is a massively parallel computer consisting of 2048 processing units and having a peak speed of 614 GFLOPS and 128 GByte of main memory. It was developed over the four years from 1992 to 1996 at the Center for Computational Physics, University of Tsukuba, for large-scale numerical simulations in computational physics, especially those of lattice QCD. The CP-PACS computer has been in full operation for physics computations since October 1996. In this article we describe the chronology of the development, the hardware and software characteristics of the computer, and its performance for lattice QCD simulations.
Paperless protocoling of CT and MRI requests at an outpatient imaging center.
Bassignani, Matthew J; Dierolf, David A; Roberts, David L; Lee, Steven
2010-04-01
We created our imaging center (IC) to move outpatient imaging from our busy inpatient imaging suite off-site to a location that is more inviting to ambulatory patients. Nevertheless, patients scanned at our IC still represent the depth and breadth of illness complexity seen with our tertiary care population. Thus, we protocol exams on an individualized basis to ensure that the referring clinician's question is fully answered by the exam performed. Previously, paper based protocoling was a laborious process for all those involved where the IC business office would fax the requests to various reading rooms for protocoling by the subspecialist radiologists who are 3 miles away at the main hospital. Once protocoled, reading room coordinators would fax back the protocoled request to the IC technical area in preparation for the next day's scheduled exams. At any breakdown in this process (e.g., lost paperwork), patient exams were delayed and clinicians and patients became upset. To improve this process, we developed a paper free process whereby protocoling is accomplished through scanning of exam requests into our PACS. Using the common worklist functionality found in most PACS, we created "protocoling worklists" that contain these scanned documents. Radiologists protocol these studies in the PACS worklist (with the added benefit of having all imaging and report data available), and subsequently, the technologists can see and act on the protocols they find in PACS. This process has significantly decreased interruptions in our busy reading rooms and decreased rework of IC staff.
Frequency-specific attentional modulation in human primary auditory cortex and midbrain.
Riecke, Lars; Peters, Judith C; Valente, Giancarlo; Poser, Benedikt A; Kemper, Valentin G; Formisano, Elia; Sorger, Bettina
2018-07-01
Paying selective attention to an audio frequency selectively enhances activity within primary auditory cortex (PAC) at the tonotopic site (frequency channel) representing that frequency. Animal PAC neurons achieve this 'frequency-specific attentional spotlight' by adapting their frequency tuning, yet comparable evidence in humans is scarce. Moreover, whether the spotlight operates in human midbrain is unknown. To address these issues, we studied the spectral tuning of frequency channels in human PAC and inferior colliculus (IC), using 7-T functional magnetic resonance imaging (FMRI) and frequency mapping, while participants focused on different frequency-specific sounds. We found that shifts in frequency-specific attention alter the response gain, but not tuning profile, of PAC frequency channels. The gain modulation was strongest in low-frequency channels and varied near-monotonically across the tonotopic axis, giving rise to the attentional spotlight. We observed less prominent, non-tonotopic spatial patterns of attentional modulation in IC. These results indicate that the frequency-specific attentional spotlight in human PAC as measured with FMRI arises primarily from tonotopic gain modulation, rather than adapted frequency tuning. Moreover, frequency-specific attentional modulation of afferent sound processing in human IC seems to be considerably weaker, suggesting that the spotlight diminishes toward this lower-order processing stage. Our study sheds light on how the human auditory pathway adapts to the different demands of selective hearing. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.
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
Algarni, Alanood S; Hargreaves, Alan J; Dickenson, John M
2017-03-15
The PAC 1 receptor and tissue transglutaminase (TG2) play important roles in neurite outgrowth and modulation of neuronal cell survival. In this study, we investigated the regulation of TG2 activity by the PAC 1 receptor in retinoic acid-induced differentiating N2a neuroblastoma cells. TG2 transamidase activity was determined using an amine incorporation and a peptide cross linking assay. In situ TG2 activity was assessed by visualising the incorporation of biotin-X-cadaverine using confocal microscopy. TG2 phosphorylation was monitored via immunoprecipitation and Western blotting. The role of TG2 in PAC 1 receptor-induced cytoprotection and neurite outgrowth was investigated by monitoring hypoxia-induced cell death and appearance of axonal-like processes, respectively. The amine incorporation and protein crosslinking activity of TG2 increased in a time and concentration-dependent manner following stimulation with pituitary adenylate cyclase-activating polypeptide-27 (PACAP-27). PACAP-27 mediated increases in TG2 activity were abolished by the TG2 inhibitors Z-DON and R283 and by pharmacological inhibition of protein kinase A (KT 5720 and Rp-cAMPs), protein kinase C (Ro 31-8220), MEK1/2 (PD 98059), and removal of extracellular Ca 2+ . Fluorescence microscopy demonstrated PACAP-27 induced in situ TG2 activity. TG2 inhibition blocked PACAP-27 induced attenuation of hypoxia-induced cell death and outgrowth of axon-like processes. TG2 activation and cytoprotection were also observed in human SH-SY5Y cells. Together, these results demonstrate that TG2 activity was stimulated downstream of the PAC 1 receptor via a multi protein kinase dependent pathway. Furthermore, PAC 1 receptor-induced cytoprotection and neurite outgrowth are dependent upon TG2. These results highlight the importance of TG2 in the cellular functions of the PAC 1 receptor. Copyright © 2017 Elsevier Inc. All rights reserved.
Internationalization of healthcare applications: a generic approach for PACS workstations.
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.
An open architecture for medical image workstation
NASA Astrophysics Data System (ADS)
Liang, Liang; Hu, Zhiqiang; Wang, Xiangyun
2005-04-01
Dealing with the difficulties of integrating various medical image viewing and processing technologies with a variety of clinical and departmental information systems and, in the meantime, overcoming the performance constraints in transferring and processing large-scale and ever-increasing image data in healthcare enterprise, we design and implement a flexible, usable and high-performance architecture for medical image workstations. This architecture is not developed for radiology only, but for any workstations in any application environments that may need medical image retrieving, viewing, and post-processing. This architecture contains an infrastructure named Memory PACS and different kinds of image applications built on it. The Memory PACS is in charge of image data caching, pre-fetching and management. It provides image applications with a high speed image data access and a very reliable DICOM network I/O. In dealing with the image applications, we use dynamic component technology to separate the performance-constrained modules from the flexibility-constrained modules so that different image viewing or processing technologies can be developed and maintained independently. We also develop a weakly coupled collaboration service, through which these image applications can communicate with each other or with third party applications. We applied this architecture in developing our product line and it works well. In our clinical sites, this architecture is applied not only in Radiology Department, but also in Ultrasonic, Surgery, Clinics, and Consultation Center. Giving that each concerned department has its particular requirements and business routines along with the facts that they all have different image processing technologies and image display devices, our workstations are still able to maintain high performance and high usability.
Real, Francisco J; Benitez, F Javier; Acero, Juan L; Casas, Francisco
2017-07-03
The removal of three emerging contaminants (ECs) (amitriptyline hydrochloride (AH), methyl salicylate (MS) and 2-phenoxyethanol (PE)) dissolved in several water matrices by means of their adsorption onto powdered activated carbon (PAC) and granular activated carbon (GAC) has been investigated. When dissolved in ultrapure water, adsorption of the ECs followed the trend of AH > MS > PE, with a positive effect of the adsorbent dose. According to the analysis of the adsorption isotherms and adsorption kinetics, PAC showed strongly higher adsorption efficiency in both capacity and velocity of the adsorption, in agreement with its higher mesoporosity. Equilibrium isotherm data were fitted by Langmuir and Freundlich models. Pseudo-second order kinetics modeled very successfully the adsorption process. Finally, the effect of the presence of dissolved organic matter (DOM) in the water matrices (ultrapure water, surface water and two effluents from wastewater treatment plants) on the adsorption of the selected ECs onto PAC was established, as well as its performance on the removal of water quality parameters. Results show a negative effect of the DOM content on the adsorption efficiency. Over 50% of organic matter was removed with high PAC doses, revealing that adsorption onto PAC is an effective technology to remove both micro-pollutants and DOM from water matrices.
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
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.
Security model for picture archiving and communication systems.
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.
Al-Qasem, Abeer; Al-Howail, Huda A; Al-Swailem, Mashael; Al-Mazrou, Amer; Al-Otaibi, Basem; Al-Jammaz, Ibrahim; Al-Khalaf, Huda H; Aboussekhra, Abdelilah
2016-03-01
Colorectal cancer (CRC) is a major cause of cancer morbidity and mortality worldwide. Although response rates and overall survival have been improved in recent years, resistance to multiple drug combinations is inevitable. Therefore, the development of more efficient drugs, with fewer side effects is urgently needed. To this end, we have investigated in the present report the effect of PAC, a novel cucumin analogue, on CRC cells both in vitro and in vivo. We have shown that PAC induces apoptosis, mainly via the internal mitochondrial route, and inhibits cell proliferation through delaying the cell cycle at G2/M phase. Interestingly, the pro-apoptotic effect was mediated through STAT3-dependent down-regulation of cyclin D1 and its downstream target survivin. Indeed, change in the expression level of cyclin D1 modulated the expression of survivin and the response of CRC cells to PAC. Furthermore, using the ChIP assay, we have shown PAC-dependent reduction in the binding of STAT3 to the cyclin D1 promoter in vivo. Additionally, PAC suppressed the epithelial-to-mesenchymal process through down-regulating the mesenchymal markers (N-cadherin, vimentin and Twist1) and inhibiting the invasion/migration abilities of the CRC cells via repressing the pro-migration/invasion protein kinases AKT and ERK1/2. In addition, PAC inhibited tumor growth and repressed the JAK2/STAT3, AKT/mTOR and MEK/ERK pathways as well as their common downstream effectors cyclin D1 and survivin in humanized CRC xenografts. Collectively, these results indicate that PAC has potent anti-CRC effects, and therefore could constitute an effective alternative chemotherapeutic agent, which may consolidate the adjuvant treatment of colon cancer. © 2015 Wiley Periodicals, Inc.
Fink, A; Gebhard, B; Erdwiens, S; Haddenhorst, L; Nowak, S
2016-09-01
The introduction of the International Classification of Functioning, Disabilities and Health of the World Health Organization in 2001 made social participation a major rehabilitation outcome and the ultimate goal of rehabilitation services. There is no available instrument to measure the youth participation in leisure activities apart from asking the youth themselves. The goal of this study was to present a German version of the Children's Assessment of Participation and Enjoyment and Preferences for Activities of Children (CAPE/PAC). The CAPE/PAC questionnaire was translated into German, a cultural adaptation process was designed and a reliability study was conducted. One hundred and fifty-two youths with and without disabilities, with a mean age of 15.2 years (standard deviation 1.7), participated in the study. The participants completed CAPE and PAC twice within 4 weeks. Reliability was examined by intraclass correlation coefficients, standard error of measurement, smallest detectable change and Cronbach's alpha. The absolute values of participation differ between the typically developed youth group and those with impairments; the reliability of the CAPE/PAC is comparable in both groups. Intraclass correlation coefficients ranged from 0.43 to 0.74 for the CAPE and from 0.71 to 0.83 for the PAC in all participants. The alpha values for internal consistency ranged from 0.42 to 0.82 for the CAPE and from 0.65 to 0.92 for the PAC. The German version of the PAC showed satisfactory reliability; however, reliability was not satisfactory for all scores of the CAPE, but comparable with versions in other languages. The need for newly developed participation measurements requires further discussion. © 2016 John Wiley & Sons Ltd.
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.
NASA Astrophysics Data System (ADS)
Povarov, V. P.; Urazov, O. V.; Bakirov, M. B.; Pakhomov, S. S.; Belunik, I. A.
2017-10-01
During the transition period to a market economy, the works producing equipment for the nuclear industry became lame duck companies. The market of heavy industry equipment reduced dramatically, and quality control requirements imposed to goods became lower. Deviations from regulations' requirements and technical specifications for equipment manufacture results in inevitable decrease of reliability during operation but also to failure during check tests. It is not always possible to replace promptly ill-conditioned equipment; in such cases, it is necessary to carry out compensatory measures for restoring working properties up to an acceptable level in order to ensure operational reliability due to the strength improvement of the components of machines and constructions during the whole service life or up to the scheduled date of equipment replacement. This paper is dedicated to development and practical implementation of restorative technology of strengthening ultrasonic treatment used for the metal of the blades of impellers of 16DPA10-28 circulation pumps of 10URS unit pump station located at Novovoronezh NPP-2. The dynamic surface treatment was implemented for compensating the technological defects of the metal of blades. It was revealed that the impact elastic-plastic deformation has a comprehensive compensation effect on the metal of blades in the initial state of delivery and creates the surface-strengthening layer with higher strength properties (strain hardening) of the depth up to 1.5 mm. The surface strain hardening increases the cyclic strength, re-distributes beneficially the residual technological and repair stresses, and heals small surface cracks improving the surface quality. The developed technology was used for treatment of 32 blades of impellers of 10PAC01AP001, 10PAC02AP001, 10PAC03AP001, 10PAC04AP001 circulation pumps. The implemented 100-h full-scale test of the pumps revealed the high efficiency of the developed technology and made it possible to recommend it for application at both the stage of blade manufacture and during the pump operation for prolongation of their service life.
Ge, Cheng-Hao; Sun, Na; Kang, Qi; Ren, Long-Fei; Ahmad, Hafiz Adeel; Ni, Shou-Qing; Wang, Zhibin
2018-03-01
A distinct shift of bacterial community driven by organic matter (OM) and powder activated carbon (PAC) was discovered in the simultaneous anammox and denitrification (SAD) process which was operated in an anti-fouling submerged anaerobic membrane bio-reactor. Based on anammox performance, optimal OM dose (50 mg/L) was advised to start up SAD process successfully. The results of qPCR and high throughput sequencing analysis indicated that OM played a key role in microbial community evolutions, impelling denitrifiers to challenge anammox's dominance. The addition of PAC not only mitigated the membrane fouling, but also stimulated the enrichment of denitrifiers, accounting for the predominant phylum changing from Planctomycetes to Proteobacteria in SAD process. Functional genes forecasts based on KEGG database and COG database showed that the expressions of full denitrification functional genes were highly promoted in R C , which demonstrated the enhanced full denitrification pathway driven by OM and PAC under low COD/N value (0.11). Copyright © 2017 Elsevier Ltd. All rights reserved.
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.
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
CALIPSO: an interactive image analysis software package for desktop PACS workstations
NASA Astrophysics Data System (ADS)
Ratib, Osman M.; Huang, H. K.
1990-07-01
The purpose of this project is to develop a low cost workstation for quantitative analysis of multimodality images using a Macintosh II personal computer. In the current configuration the Macintosh operates as a stand alone workstation where images are imported either from a central PACS server through a standard Ethernet network or recorded through video digitizer board. The CALIPSO software developed contains a large variety ofbasic image display and manipulation tools. We focused our effort however on the design and implementation ofquantitative analysis methods that can be applied to images from different imaging modalities. Analysis modules currently implemented include geometric and densitometric volumes and ejection fraction calculation from radionuclide and cine-angiograms Fourier analysis ofcardiac wall motion vascular stenosis measurement color coded parametric display of regional flow distribution from dynamic coronary angiograms automatic analysis ofmyocardial distribution ofradiolabelled tracers from tomoscintigraphic images. Several of these analysis tools were selected because they use similar color coded andparametric display methods to communicate quantitative data extracted from the images. 1. Rationale and objectives of the project Developments of Picture Archiving and Communication Systems (PACS) in clinical environment allow physicians and radiologists to assess radiographic images directly through imaging workstations (''). This convenient access to the images is often limited by the number of workstations available due in part to their high cost. There is also an increasing need for quantitative analysis ofthe images. During thepast decade
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.
Hierarchical storage of large volume of multidector CT data using distributed servers
NASA Astrophysics Data System (ADS)
Ratib, Osman; Rosset, Antoine; Heuberger, Joris; Bandon, David
2006-03-01
Multidector scanners and hybrid multimodality scanners have the ability to generate large number of high-resolution images resulting in very large data sets. In most cases, these datasets are generated for the sole purpose of generating secondary processed images and 3D rendered images as well as oblique and curved multiplanar reformatted images. It is therefore not essential to archive the original images after they have been processed. We have developed an architecture of distributed archive servers for temporary storage of large image datasets for 3D rendering and image processing without the need for long term storage in PACS archive. With the relatively low cost of storage devices it is possible to configure these servers to hold several months or even years of data, long enough for allowing subsequent re-processing if required by specific clinical situations. We tested the latest generation of RAID servers provided by Apple computers with a capacity of 5 TBytes. We implemented a peer-to-peer data access software based on our Open-Source image management software called OsiriX, allowing remote workstations to directly access DICOM image files located on the server through a new technology called "bonjour". This architecture offers a seamless integration of multiple servers and workstations without the need for central database or complex workflow management tools. It allows efficient access to image data from multiple workstation for image analysis and visualization without the need for image data transfer. It provides a convenient alternative to centralized PACS architecture while avoiding complex and time-consuming data transfer and storage.
Evaluation of Patient and Proxy Responses on the Activity Measure for Post Acute Care
Jette, Alan M.; Ni, Pengsheng; Rasch, Elizabeth K.; Appelman, Jed; Sandel, M. Elizabeth; Terdiman, Joseph; Chan, Leighton
2012-01-01
Background and Purpose Our objective was to examine the agreement between adult patients with stroke and family member or clinician proxies in Activity Measure for Post Acute Care (AM-PAC) summary scores for daily activity, basic mobility, and applied cognitive function. Methods This study involved 67 patients with stroke admitted to a hospital within the Kaiser Permanente of Northern California system and were participants in a parent study on stroke outcomes. Each participant and proxy respondent completed the AM-PAC by personal or telephone interview at the point of hospital discharge and/or during one or more transitions to different post-acute care settings. Results The results suggest that for patients with a stroke proxy AM-PAC data are robust for family or clinician proxy assessment of basic mobility function, clinician proxy assessment of daily activity function, but less robust for family proxy assessment of daily activity function and for all proxy groups’ assessment of applied cognitive function. The pattern of disagreement between patient and proxy was, on average, relatively small and random. There was little evidence of systematic bias between proxy and patient reports of their functional status. The degree of concordance between patient and proxy was similar for those with moderate to severe strokes compared with mild strokes. Conclusions Patient and proxy ratings on the AM-PAC achieved adequate agreement for use in stroke research where using proxy respondents could reduce sample selection bias. The AM-PAC data can be implemented across institutional as well as community care settings while achieving precision and reducing respondent burden. PMID:22343646
Physico-chemical processes for landfill leachate treatment: Experiments and mathematical models
DOE Office of Scientific and Technical Information (OSTI.GOV)
Xing, W.; Ngo, H.H.; Kim, S.H.
2008-07-01
In this study, the adsorption of synthetic landfill leachate onto four kinds of activated carbon has been investigated. From the equilibrium and kinetics experiments, it was observed that coal based PAC presented the highest organic pollutants removal efficiency (54%), followed by coal based GAC (50%), wood based GAC (33%) and wood based PAC (14%). The adsorption equilibrium of PAC and GAC was successfully predicted by Henry-Freundlich adsorption model whilst LDFA + Dual isotherm Kinetics model could describe well the batch adsorption kinetics. The flocculation and flocculation-adsorption experiments were also conducted. The results indicated that flocculation did not perform well onmore » organics removal because of the dominance of low molecular weight organic compounds in synthetic landfill leachate. Consequently, flocculation as pretreatment to adsorption and a combination of flocculation-adsorption could not improve much the organic removal efficiency for the single adsorption process.« less
Amosa, Mutiu Kolade; Jami, Mohammed Saedi; Alkhatib, Ma'an Fahmi R; Majozi, Thokozani
2016-11-01
This study has applied the concept of the hybrid PAC-UF process in the treatment of the final effluent of the palm oil industry for reuse as feedwater for low-pressure boilers. In a bench-scale set-up, a low-cost empty fruit bunch-based powdered activated carbon (PAC) was employed for upstream adsorption of biotreated palm oil mill effluent (BPOME) with the process conditions: 60 g/L dose of PAC, 68 min of mixing time and 200 rpm of mixing speed, to reduce the feedwater strength, alleviate probable fouling of the membranes and thus improve the process flux (productivity). Three polyethersulfone ultrafiltration membranes of molecular weight cut-off (MWCO) of 1, 5 and 10 kDa were investigated in a cross-flow filtration mode, and under constant transmembrane pressures of 40, 80, and 120 kPa. The permeate qualities of the hybrid processes were evaluated, and it was found that the integrated process with the 1 kDa MWCO UF membrane yielded the best water quality that falls within the US EPA reuse standard for boiler-feed and cooling water. It was also observed that the permeate quality is fit for extended reuse as process water in the cement, petroleum and coal industries. In addition, the hybrid system's operation consumed 37.13 Wh m -3 of energy at the highest applied pressure of 120 kPa, which is far lesser than the typical energy requirement range (0.8-1.0 kWh m -3 ) for such wastewater reclamation.
Matsushita, Taku; Morimoto, Ayako; Kuriyama, Taisuke; Matsumoto, Eisuke; Matsui, Yoshihiko; Shirasaki, Nobutaka; Kondo, Takashi; Takanashi, Hirokazu; Kameya, Takashi
2018-07-01
Removal efficiencies of 28 pesticide transformation products (TPs) and 15 parent pesticides during steps in drinking water treatment (coagulation-sedimentation, activated carbon adsorption, and ozonation) were estimated via laboratory-scale batch experiments, and the mechanisms underlying the removal at each step were elucidated via regression analyses. The removal via powdered activated carbon (PAC) treatment was correlated positively with the log K ow at pH 7. The adjusted coefficient of determination (r 2 ) increased when the energy level of the highest occupied molecular orbital (HOMO) was added as an explanatory variable, the suggestion being that adsorption onto PAC particles was largely governed by hydrophobic interactions. The residual error could be partly explained by π-π electron donor-acceptor interactions between the graphene surface of the PAC particles and the adsorbates. The removal via ozonation correlated positively with the energy level of the HOMO, probably because compounds with relatively high energy level HOMOs could more easily transfer an electron to the lowest unoccupied molecular orbital of ozone. Overall, the TPs tended to be more difficult to remove via PAC adsorption and ozonation than their parent pesticides. However, the TPs that were difficult to remove via PAC adsorption did not induce strong mutagenicity after chlorination, and the TPs that were associated with strong mutagenicity after chlorination could be removed via PAC adsorption. Therefore, PAC adsorption is hypothesized to be an effective method of treating drinking water to reduce the possibility of post-chlorination mutagenicity associated with both TPs and their parent pesticides. Copyright © 2018 Elsevier Ltd. All rights reserved.
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.
Human Behavioral Representations with Realistic Personality and Cultural Characteristics
2005-06-01
personality factors as customizations to an underlying formally rational symbolic architecture, PAC uses dimensions of personality, emotion , and culture as...foundations for the cognitive process. The structure of PAC allows it to function as a personality/ emotional layer that can be used stand-alone or...integrated with existing constrained- rationality cognitive architectures. In addition, a set of tools was developed to support the authoring
Petroleum mineral oil refining and evaluation of cancer hazard.
Mackerer, Carl R; Griffis, Larry C; Grabowski, John S; Reitman, Fred A
2003-11-01
Petroleum base oils (petroleum mineral oils) are manufactured from crude oils by vacuum distillation to produce several distillates and a residual oil that are then further refined. Aromatics including alkylated polycyclic aromatic compounds (PAC) are undesirable constituents of base oils because they are deleterious to product performance and are potentially carcinogenic. In modern base oil refining, aromatics are reduced by solvent extraction, catalytic hydrotreating, or hydrocracking. Chronic exposure to poorly refined base oils has the potential to cause skin cancer. A chronic mouse dermal bioassay has been the standard test for estimating carcinogenic potential of mineral oils. The level of alkylated 3-7-ring PAC in raw streams from the vacuum tower must be greatly reduced to render the base oil noncarcinogenic. The processes that can reduce PAC levels are known, but the operating conditions for the processing units (e.g., temperature, pressure, catalyst type, residence time in the unit, unit engineering design, etc.) needed to achieve adequate PAC reduction are refinery specific. Chronic dermal bioassays provide information about whether conditions applied can make a noncarcinogenic oil, but cannot be used to monitor current production for quality control or for conducting research or developing new processes since this test takes at least 78 weeks to conduct. Three short-term, non-animal assays all involving extraction of oil with dimethylsulfoxide (DMSO) have been validated for predicting potential carcinogenic activity of petroleum base oils: a modified Ames assay of a DMSO extract, a gravimetric assay (IP 346) for wt. percent of oil extracted into DMSO, and a GC-FID assay measuring 3-7-ring PAC content in a DMSO extract of oil, expressed as percent of the oil. Extraction with DMSO concentrates PAC in a manner that mimics the extraction method used in the solvent refining of noncarcinogenic oils. The three assays are described, data demonstrating the validation of the assays are shown, and test results of currently manufactured base oils are summarized to illustrate the general lack of cancer hazard for the base oils now being manufactured.
Suh, Siri
2014-05-01
Boundary work refers to the strategies deployed by professionals in the arenas of the public, the law and the workplace to define and defend jurisdictional authority. Little attention has been directed to the role of documents in negotiating professional claims. While boundary work over induced abortion has been extensively documented, few studies have examined jurisdictional disputes over the treatment of abortion complications, or post-abortion care (PAC). This study explores how medical providers deploy medical records in boundary work over the treatment of complications of spontaneous and induced abortion in Senegal, where induced abortion is prohibited under any circumstance. Findings are based on an institutional ethnography of Senegal's national PAC program over a period of 13 months between 2010 and 2011. Data collection methods included in-depth interviews with 36 health care professionals, observation of PAC services at three hospitals, a review of abortion records at each hospital, and a case review of illegal abortions prosecuted by the state. Findings show that health providers produce a particular account of the type of abortion treated through a series of practices such as the patient interview and the clinical exam. Providers obscure induced abortion in medical documents in three ways: the use of terminology that does not differentiate between induced and spontaneous abortion in PAC registers, the omission of data on the type of abortion altogether in PAC registers, and reporting the total number but not the type of abortions treated in hospital data transmitted to state health authorities. The obscuration of suspected induced abortion in the record permits providers to circumvent police inquiry at the hospital. PAC has been implemented in approximately 50 countries worldwide. This study demonstrates the need for additional research on how medical professionals negotiate conflicting medical and legal obligations in the daily practice of treating abortion complications. Copyright © 2014 Elsevier Ltd. All rights reserved.
Celebrini, Richard G.; Eng, Janice J.; Miller, William C.; Ekegren, Christina L.; Johnston, James D.; MacIntyre, Donna L.
2015-01-01
There is a need to investigate the effect of specific movement strategies in reducing biomechanical risk factors for ACL injury in young female athletes. The purpose of this study was 1) to determine the feasibility of implementing a novel movement strategy (Core-PAC) into a team warm-up prior to soccer training based on subject compliance and integration of the Core-PAC into the warm-up and 2) to determine whether the Core-PAC would improve peak knee flexion angles and peak abduction moments at the knee during a side-cut (SC) and an unanticipated side-cut (USC) prior to kicking a soccer ball, and a side-hop (SH) task after immediate instruction and after a four-week training program. A convenience sample of ten 14–16 year old female soccer players were instructed in the Core-PAC immediately after baseline testing and during a training program consisting of a 20-minute warm-up, two-times per week. The Core-PAC was understood and accepted by the subjects and incorporated into their warm-up activities with good compliance. After the immediate instruction, there were significant increases in peak knee flexion angles of a mean 6.4° during the SC (p = 0.001), 3.5° during the USC (p = 0.007), and 5.8° during the SH (p < 0.001) tasks. Peak knee abduction moments decreased by a mean of 0.25 Nm/kg during the SC (p < 0.03), 0.17 Nm/kg during the USC (p = 0.05), and 0.27 Nm/kg during the SH (p = 0.04) tasks. After the 4-week training program, some individuals showed improvement. The results of this study suggest that the Core-PAC may be one method of modifying high-risk movements for ACL injury such as side-cutting and single-leg landing. PMID:22210470
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
Suh, Siri
2014-01-01
Boundary work refers to the strategies deployed by professionals in the arenas of the public, the law and the workplace to define and defend jurisdictional authority. Little attention has been directed to the role of documents in negotiating professional claims. While boundary work over induced abortion has been extensively documented, few studies have examined jurisdictional disputes over the treatment of abortion complications, or post-abortion care (PAC). This study explores how medical providers deploy medical records in boundary work over the treatment of complications of spontaneous and induced abortion in Senegal, where induced abortion is prohibited under any circumstance. Findings are based on an institutional ethnography of Senegal’s national PAC program over a period of 13 months between 2010 and 2011. Data collection methods included in-depth interviews with 36 health care professionals, observation of PAC services at three hospitals, a review of abortion records at each hospital, and a case review of illegal abortions prosecuted by the state. Findings show that health providers produce a particular account of the type of abortion treated through a series of practices such as the patient interview and the clinical exam. Providers obscure induced abortion in medical documents in three ways: the use of terminology that does not differentiate between induced and spontaneous abortion in PAC registers, the omission of data on the type of abortion altogether in PAC registers, and reporting the total number but not the type of abortions treated in hospital data transmitted to state health authorities. The obscuration of suspected induced abortion in the record permits providers to circumvent police inquiry at the hospital. PAC has been implemented in nearly 50 countries worldwide. This study demonstrates the need for additional research on how medical professionals negotiate conflicting medical and legal obligations in the daily practice of treating abortion complications. PMID:24608117
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.
Performance of biological magnetic powdered activated carbon for drinking water purification.
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.
PacCYP707A2 negatively regulates cherry fruit ripening while PacCYP707A1 mediates drought tolerance.
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
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
Degradation of black liquor from bioethanol process using coagulation and Fenton-like methods
NASA Astrophysics Data System (ADS)
Muryanto, Muryanto; Sari, Ajeng Arum; Abimanyu, Haznan
2017-01-01
Black liquor is one of the main by-products of the pretreatment process in bioethanol production from oil palm empty fruit bunches. Black liquor wastewater releases black coloured effluent with high chemical oxygen demand (COD) and low dissolved oxygen (DO). It had a distinctive dark coloration, high alkalinity (pH=13), high organic content (COD > 50,000 ppm) and a high solid content (TSS > 5,000 ppm). Lignin destruction can be done by using high oxidation from OH radical system such as advanced oxidation processes (AOPs). Thereafter, the high concentration of COD, color, and TSS can be removed. The general aim of the present investigation was to determine degradation of black liquor wastewater by using a combined coagulation and Fenton-like methods. In this research, we use Poly Aluminum Chloride (PAC) as a coagulant and FeCl3.6H2O and H2O2 for Fenton-like's reagent. The process was conducted in jar test at 200 rpm for 30 minutes and after that slowly mixed for 2 hours and left for sedimentation 24 hours. 50 ml black liquor was added with variation dose of 1-5% PAC, and 10 % Fenton-like reagent. Hydroxyl radical was generated by the Fenton-like's reagent (ratio FeCl3.6H2O : H2O2 was varied). The highest decolorization of black liquor 70 % was obtained under 5% PAC coagulant. The pH of the wastewater was reduced from 13.00 to 8.07 after the addition of the coagulant. The decolorization of original black liquor was approximately 58% through the Fenton-like process. The combination of PAC and Fenton-like reagent has able to enhance the decolorization of black liquor up to 97%.
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.
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.
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.
A modular method for evaluating the performance of picture archiving and communication systems.
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.
Influence of Drugs Carried in Lipid Nanoparticles in Coronary Disease of Rabbit Transplanted Heart.
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.
2012-01-01
Background Penicillin acylases (PACs) are enzymes of industrial relevance in the manufacture of β-lactam antibiotics. Development of a PAC with a longer half-life under the reaction conditions used is essential for the improvement of the operational stability of the process. A gene encoding a homologue to Escherichia coli PAC was found in the genome of the thermophilic bacterium Thermus thermophilus (Tth) HB27. Because of the nature of this PAC and its complex maturation that is crucial to reach its functional heterodimeric final conformation, the overexpression of this enzyme in a heterologous mesophilic host was a challenge. Here we describe the purification and characterization of the PAC protein from Tth HB27 overexpressed in Escherichia coli. Results Fusions to a superfolder green fluorescent protein and differential membrane solubilization assays indicated that the native enzyme remains attached through its amino-terminal end to the outer side of the cytoplasmic membrane of Tth cells. In order to overexpress this PAC in E. coli cells, a variant of the protein devoid of its membrane anchoring segment was constructed. The effect of the co-expression of chaperones and calcium supplementation of the culture medium was investigated. The total production of PAC was enhanced by the presence of DnaK/J and GrpE and even more by trigger factor and GroEL/ES. In addition, 10 mM calcium markedly improved both PAC specific and volumetric activities. Recombinant PAC was affinity-purified and proper maturation of the protein was confirmed by SDS-PAGE and MALDI-TOF analysis of the subunits. The recombinant protein was tested for activity towards several penicillins, cephalosporins and homoserine lactones. Hydrophobic acyl-chain penicillins were preferred over the rest of the substrates. Penicillin K (octanoyl penicillin) was the best substrate, with the highest specificity constant value (16.12 mM-1.seg-1). The optimum pH was aprox. 4 and the optimum temperature was 75 °C. The half-life of the enzyme at this temperature was 9.2 h. Conclusions This is the first report concerning the heterologous expression of a pac gene from a thermophilic microorganism in the mesophilic host E. coli. The recombinant protein was identified as a penicillin K-deacylating thermozyme. PMID:22876915
Torres, Leticia L; Ferreras, Eloy R; Cantero, Angel; Hidalgo, Aurelio; Berenguer, José
2012-08-09
Penicillin acylases (PACs) are enzymes of industrial relevance in the manufacture of β-lactam antibiotics. Development of a PAC with a longer half-life under the reaction conditions used is essential for the improvement of the operational stability of the process. A gene encoding a homologue to Escherichia coli PAC was found in the genome of the thermophilic bacterium Thermus thermophilus (Tth) HB27. Because of the nature of this PAC and its complex maturation that is crucial to reach its functional heterodimeric final conformation, the overexpression of this enzyme in a heterologous mesophilic host was a challenge. Here we describe the purification and characterization of the PAC protein from Tth HB27 overexpressed in Escherichia coli. Fusions to a superfolder green fluorescent protein and differential membrane solubilization assays indicated that the native enzyme remains attached through its amino-terminal end to the outer side of the cytoplasmic membrane of Tth cells. In order to overexpress this PAC in E. coli cells, a variant of the protein devoid of its membrane anchoring segment was constructed. The effect of the co-expression of chaperones and calcium supplementation of the culture medium was investigated. The total production of PAC was enhanced by the presence of DnaK/J and GrpE and even more by trigger factor and GroEL/ES. In addition, 10 mM calcium markedly improved both PAC specific and volumetric activities. Recombinant PAC was affinity-purified and proper maturation of the protein was confirmed by SDS-PAGE and MALDI-TOF analysis of the subunits. The recombinant protein was tested for activity towards several penicillins, cephalosporins and homoserine lactones. Hydrophobic acyl-chain penicillins were preferred over the rest of the substrates. Penicillin K (octanoyl penicillin) was the best substrate, with the highest specificity constant value (16.12 mM-1.seg-1). The optimum pH was aprox. 4 and the optimum temperature was 75 °C. The half-life of the enzyme at this temperature was 9.2 h. This is the first report concerning the heterologous expression of a pac gene from a thermophilic microorganism in the mesophilic host E. coli. The recombinant protein was identified as a penicillin K-deacylating thermozyme.
Controlling fertilization and cAMP signaling in sperm by optogenetics.
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.
Crystal structure of human proteasome assembly chaperone PAC4 involved in proteasome formation.
Kurimoto, Eiji; Satoh, Tadashi; Ito, Yuri; Ishihara, Eri; Okamoto, Kenta; Yagi-Utsumi, Maho; Tanaka, Keiji; Kato, Koichi
2017-05-01
The 26S proteasome is a large protein complex, responsible for degradation of ubiquinated proteins in eukaryotic cells. Eukaryotic proteasome formation is a highly ordered process that is assisted by several assembly chaperones. The assembly of its catalytic 20S core particle depends on at least five proteasome-specific chaperones, i.e., proteasome-assembling chaperons 1-4 (PAC1-4) and proteasome maturation protein (POMP). The orthologues of yeast assembly chaperones have been structurally characterized, whereas most mammalian assembly chaperones are not. In the present study, we determined a crystal structure of human PAC4 at 1.90-Å resolution. Our crystallographic data identify a hydrophobic surface that is surrounded by charged residues. The hydrophobic surface is complementary to that of its binding partner, PAC3. The surface also exhibits charge complementarity with the proteasomal α4-5 subunits. This will provide insights into human proteasome-assembling chaperones as potential anticancer drug targets. © 2017 The Protein Society.
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.
Zhan, Xiao; Gao, Bao-yu; Liu, Bin; Xu, Chun-hua; Yue, Qin-yan
2010-05-01
Two types of inorganic polymer coagulants, polyferric chloride (PFC) and polyaluminum chloride (PAC), were chosen to treat the Yellow River water. Different dosages were investigated in order to investigate the turbidity, UV24, DOC and permanganate index removal efficiency and their coagulation mechanisms based on the Zeta potentials. The natural organic matter removal by the combination of coagulation and adsorption with powder activated carbon were analyzed based on different coagulant and adsorbent dosages and dosing orders. The effects of combination of coagulation and adsorption on the residual chlorine decay were analyzed. The results showed that the two coagulants had high turbidity removal efficiency ( > 90%). The UV254, DOC, permanganate index removal efficiency were 29.2%, 26.1% and 27.9% respectively for PAC coagulation and were 32.3%, 23.3% and 32.9% respectively for PFC. Electric neutralization played an important role in the PAC coagulation process while both adsorption bridging and electric neutralization performed when PFC was used. The removal percentage of organic matter increased with the increase coagulant and adsorbent. The adsorption after coagulation process gave the better UV254 and DOC removal efficiency than the coagulation after adsorption. The UV254 and DOC removal efficiency were 95.2% and 99.9% for PAC coagulation after adsorption and were 90.1% and 99.9% for PFC coagulation first. But adding powder activated carbon can improve floc settlement performance and maintained persistent disinfection effect.
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
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.
Problem of data quality and the limitations of the infrastructure approach
NASA Astrophysics Data System (ADS)
Behlen, Fred M.; Sayre, Richard E.; Rackus, Edward; Ye, Dingzhong
1998-07-01
The 'Infrastructure Approach' is a PACS implementation methodology wherein the archive, network and information systems interfaces are acquired first, and workstations are installed later. The approach allows building a history of archived image data, so that most prior examinations are available in digital form when workstations are deployed. A limitation of the Infrastructure Approach is that the deferred use of digital image data defeats many data quality management functions that are provided automatically by human mechanisms when data is immediately used for the completion of clinical tasks. If the digital data is used solely for archiving while reports are interpreted from film, the radiologist serves only as a check against lost films, and another person must be designated as responsible for the quality of the digital data. Data from the Radiology Information System and the PACS were analyzed to assess the nature and frequency of system and data quality errors. The error level was found to be acceptable if supported by auditing and error resolution procedures requiring additional staff time, and in any case was better than the loss rate of a hardcopy film archive. It is concluded that the problem of data quality compromises but does not negate the value of the Infrastructure Approach. The Infrastructure Approach should best be employed only to a limited extent, and that any phased PACS implementation should have a substantial complement of workstations dedicated to softcopy interpretation for at least some applications, and with full deployment following not long thereafter.
Distributed PACS using distributed file system with hierarchical meta data servers.
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.
NASA Astrophysics Data System (ADS)
Smith, Edward M.; Wandtke, John; Robinson, Arvin E.
1999-07-01
The selection criteria for the archive were based on the objectives of the Medical Information, Communication and Archive System (MICAS), a multi-vendor incremental approach to PACS. These objectives include interoperability between all components, seamless integration of the Radiology Information System (RIS) with MICAS and eventually other hospital databases, all components must demonstrate DICOM compliance prior to acceptance and automated workflow that can be programmed to meet changes in the healthcare environment. The long-term multi-modality archive is being implemented in 3 or more phases with the first phase designed to provide a 12 to 18 month storage solution. This decision was made because the cost per GB of storage is rapidly decreasing and the speed at which data can be retrieved is increasing with time. The open-solution selected allows incorporation of leading edge, 'best of breed' hardware and software and provides maximum jukeboxes, provides maximum flexibility of workflow both within and outside of radiology. The selected solution is media independent, supports multiple jukeboxes, provides expandable storage capacity and will provide redundancy and fault tolerance at minimal cost. Some of the required attributes of the archive include scalable archive strategy, virtual image database with global query and object-oriented database. The selection process took approximately 10 months with Cemax-Icon being the vendor selected. Prior to signing a purchase order, Cemax-Icon performed a site survey, agreed upon the acceptance test protocol and provided a written guarantee of connectivity between their archive and the imaging modalities and other MICAS components.
Hall, Roland I.; Wolfe, Brent B.; Wiklund, Johan A.; Edwards, Thomas W. D.; Farwell, Andrea J.; Dixon, D. George
2012-01-01
Background The extent to which Alberta oil sands mining and upgrading operations have enhanced delivery of bitumen-derived contaminants via the Athabasca River and atmosphere to the Peace-Athabasca Delta (200 km to the north) is a pivotal question that has generated national and international concern. Accounts of rare health disorders in residents of Fort Chipewyan and deformed fish in downstream ecosystems provided impetus for several recent expert-panel assessments regarding the societal and environmental consequences of this multi-billion-dollar industry. Deciphering relative contributions of natural versus industrial processes on downstream supply of polycyclic aromatic compounds (PACs) has been identified as a critical knowledge gap. But, this remains a formidable scientific challenge because loading from natural processes remains unknown. And, industrial activity occurs in the same locations as the natural bitumen deposits, which potentially confounds contemporary upstream-downstream comparisons of contaminant levels. Methods/Principal Findings Based on analyses of lake sediment cores, we provide evidence that the Athabasca Delta has been a natural repository of PACs carried by the Athabasca River for at least the past two centuries. We detect no measureable increase in the concentration and proportion of river-transported bitumen-associated indicator PACs in sediments deposited in a flood-prone lake since onset of oil sands development. Results also reveal no evidence that industrial activity has contributed measurably to sedimentary concentration of PACs supplied by atmospheric transport. Conclusions/Significance Findings suggest that natural erosion of exposed bitumen in banks of the Athabasca River and its tributaries is a major process delivering PACs to the Athabasca Delta, and the spring freshet is a key period for contaminant mobilization and transport. This baseline environmental information is essential for informed management of natural resources and human-health concerns by provincial and federal regulatory agencies and industry, and for designing effective long-term monitoring programs for the lower Athabasca River watershed. PMID:23049946
DOE Office of Scientific and Technical Information (OSTI.GOV)
Chai, X; Liu, L; Xing, L
Purpose: Visualization and processing of medical images and radiation treatment plan evaluation have traditionally been constrained to local workstations with limited computation power and ability of data sharing and software update. We present a web-based image processing and planning evaluation platform (WIPPEP) for radiotherapy applications with high efficiency, ubiquitous web access, and real-time data sharing. Methods: This software platform consists of three parts: web server, image server and computation server. Each independent server communicates with each other through HTTP requests. The web server is the key component that provides visualizations and user interface through front-end web browsers and relay informationmore » to the backend to process user requests. The image server serves as a PACS system. The computation server performs the actual image processing and dose calculation. The web server backend is developed using Java Servlets and the frontend is developed using HTML5, Javascript, and jQuery. The image server is based on open source DCME4CHEE PACS system. The computation server can be written in any programming language as long as it can send/receive HTTP requests. Our computation server was implemented in Delphi, Python and PHP, which can process data directly or via a C++ program DLL. Results: This software platform is running on a 32-core CPU server virtually hosting the web server, image server, and computation servers separately. Users can visit our internal website with Chrome browser, select a specific patient, visualize image and RT structures belonging to this patient and perform image segmentation running Delphi computation server and Monte Carlo dose calculation on Python or PHP computation server. Conclusion: We have developed a webbased image processing and plan evaluation platform prototype for radiotherapy. This system has clearly demonstrated the feasibility of performing image processing and plan evaluation platform through a web browser and exhibited potential for future cloud based radiotherapy.« less
Brief History of Cherokee Schools 1804-1976.
ERIC Educational Resources Information Center
DuPree, T. J.
1976-01-01
Presenting a brief history of Mississippi's Cherokee Schools (1804-1976), this article emphasizes the gradual implementation of innovative programs since 1970 under guidance by the Policy Advisory Committees (PAC) which are composed of a majority of parents and a minority of professionals. Specifically, this article elaborates upon the educational…
Procaspase-activating compound-1 induces apoptosis in Trypanosoma cruzi.
de Castro, Emanuella; Reus, Thamile Luciane; de Aguiar, Alessandra Melo; Ávila, Andrea Rodrigues; de Arruda Campos Brasil de Souza, Tatiana
2017-12-01
Some therapeutics for parasitic, cardiac and neurological diseases activate apoptosis. Therefore, the study of apoptotic proteins in pathogenic organisms is relevant. However, the molecular mechanism of apoptosis in unicellular organisms remain elusive, despite morphological evidence of its occurrence. In Trypanosoma cruzi, the causative agent of Chagas disease, metacaspase 3 (TcMCA3), seems to have a key role in parasite apoptosis. Accordingly, this work provides data concerning TcMCA3 regulation through its interaction with procaspase-activating compound 1 (PAC-1), a procaspase 3 activator. Indeed, PAC-1 reduced T. cruzi epimastigote viability with an IC 50 of 14.12 µM and induced loss of mitochondrial potential and exposure of phosphatidylserine, features of the apoptotic process. Notwithstanding, those PAC-1-inducible effects were not conserved in metacyclic trypomastigotes. Moreover, PAC-1 reduced the viability of mammalian cells with a greater IC 50 (25.70 µM) compared to T. cruzi epimastigotes, indicating distinct modes of binding between caspases and metacaspases. To shed light on the selectivity of metacaspases and caspases, we determined the structural features related to the PAC-1 binding sites in both types of proteins. These data are important for improving the understanding of the apoptosis pathway in T. cruzi so that TcMCA3 could be better targeted with future pharmaceuticals.
Liu, Xiaolin; Lauer, Kathryn K; Ward, Barney D; Rao, Stephen M; Li, Shi-Jiang; Hudetz, Anthony G
2012-10-01
Current theories suggest that disrupting cortical information integration may account for the mechanism of general anesthesia in suppressing consciousness. Human cognitive operations take place in hierarchically structured neural organizations in the brain. The process of low-order neural representation of sensory stimuli becoming integrated in high-order cortices is also known as cognitive binding. Combining neuroimaging, cognitive neuroscience, and anesthetic manipulation, we examined how cognitive networks involved in auditory verbal memory are maintained in wakefulness, disrupted in propofol-induced deep sedation, and re-established in recovery. Inspired by the notion of cognitive binding, an functional magnetic resonance imaging-guided connectivity analysis was utilized to assess the integrity of functional interactions within and between different levels of the task-defined brain regions. Task-related responses persisted in the primary auditory cortex (PAC), but vanished in the inferior frontal gyrus (IFG) and premotor areas in deep sedation. For connectivity analysis, seed regions representing sensory and high-order processing of the memory task were identified in the PAC and IFG. Propofol disrupted connections from the PAC seed to the frontal regions and thalamus, but not the connections from the IFG seed to a set of widely distributed brain regions in the temporal, frontal, and parietal lobes (with exception of the PAC). These later regions have been implicated in mediating verbal comprehension and memory. These results suggest that propofol disrupts cognition by blocking the projection of sensory information to high-order processing networks and thus preventing information integration. Such findings contribute to our understanding of anesthetic mechanisms as related to information and integration in the brain. Copyright © 2011 Wiley Periodicals, Inc.
A two-dimensional contaminant fate and transport model for the lower Athabasca River
DOE Office of Scientific and Technical Information (OSTI.GOV)
Brownlee, B.G.; Booty, W.G.; MacInnis, G.A.
1995-12-31
The lower Athabasca River flows through the Athabasca Oil Sands deposits in northeastern Alberta. Two oil sands mining/extraction/upgrading plants operate near the river downstream from Fort McMurray. Process water is stored in large tailings ponds. One of the plants (Suncor) has a licensed discharge (mostly cooling water) to the river. This effluent contains low concentrations ({<=} 1 {micro}g/L) of various polycyclic aromatic compounds (PACs). Several tributary streams which cut through oil sands deposits are potential sources of hydrocarbons to the Athabasca. The authors have found that river suspended sediments give positive responses in a number of toxicity tests, using bothmore » direct and indirect (organic-solvent extract) methods. Several environmental impact assessments are required as a result of industry expansion. To provide an assessment tool for PACs, the authors are developing a two-dimensional contaminant fate and transport model for a 120-km portion of the Athabasca River downstream from Fort McMurray. Hydraulic calibration of the model was done using sodium and chloride from a major tributary as tracers. Two groups of compounds are being modelled: (1) PACs from the Suncor effluent, and (2) PACs from natural/background sources. PAC concentrations in the river were typically < 1 ng/L, requiring large volume extractions and highly sensitive analysis. Processes such as sediment-water partitioning and biodegradation are being estimated from field experiments using river water and suspended sediment. Photodegradation is likely unimportant in this turbid river due to low penetration of 280--350 nm light. Initially, volatilization will be modelled using estimated or literature values for Henry`s constants, but may require more refined estimates from laboratory experiments.« less
Business Model for the Security of a Large-Scale PACS, Compliance with ISO/27002:2013 Standard.
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.
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.
Doxycycline exerted neuroprotective activity by enhancing the activation of neuropeptide GPCR PAC1.
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.
Bastawrous, Sarah; Carney, Benjamin
2017-06-01
In the current digital and filmless age of radiology, rates of unread radiology exams remain low, however, may still exist in unique environments. Veterans Affairs (VA) health care systems may experience higher rates of unread exams due to coexistence of Veterans Health Information Systems and Technology Architecture (VistA) imaging and commercial picture archiving and communication systems (PACS). The purpose of this patient safety initiative was to identify any unread exams and causes leading to unread exams. Following approval by departmental quality assurance committee, a comprehensive review was performed of all radiology exams within VistA imaging from July 1, 2009 to June 30, 2014 to identify unread radiology exams. Over the 5-year period, the total unread exam rate was calculated to be 0.17%, with the highest yearly unread exam rate of 0.25%. The leading majority of unread exam type was plain radiographs. Analysis revealed unfinished dictations, unassociated accession numbers, technologist errors, and inefficient radiologist work lists as top contributors to unread exams. Once unread radiology exams were discovered and the causes identified, valuable process changes were implemented within our department to ensure simultaneous tracking of all unread exams in VistA imaging as well as the commercial PACS.
Noordstar, Johannes J; Stuive, Ilse; Herweijer, Hester; Holty, Lian; Oudenampsen, Chantal; Schoemaker, Marina M; Reinders-Messelink, Heleen A
2014-12-01
The relationship between perceived athletic competence (PAC) and physical activity (PA) in children with developmental coordination disorder (DCD) is still unclear. This study investigated differences in PAC and PA between, and within, a group of children with DCD that were clinically referred (n = 31) and a group of control children (n = 38), aged 7-12 years. All children were categorized in four groups: (1) children with DCD/low PAC, (2) children with DCD/normal to high PAC, (3) control children/low PAC, and (4) control children/normal to high PAC. PAC was assessed with the Self-Perception Profile for Children, and PA was assessed with the Modifiable Activity Questionnaire. Children with DCD participated less in unorganized PA, but not in organized PA, compared with control children. Normal to high PAC was found in more than half of the children (64.5%) with DCD. Children with DCD/low PAC and children with DCD/normal to high PAC participated significantly less in unorganized physical activity compared with control children/normal to high PAC, but not compared with control children/low PAC. The results indicate that there are large individual differences in PAC in children with DCD. Copyright © 2014 Elsevier Ltd. All rights reserved.
Improving medical imaging report turnaround times: the role of technolgy.
Marquez, Luis O; Stewart, Howard
2005-01-01
At Southern Ohio Medical Center (SOMC), the medical imaging department and the radiologists expressed a strong desire to improve workflow. The improved workflow was a major motivating factor toward implementing a new RIS and speech recognition technology. The need to monitor workflow in a real-time fashion and to evaluate productivity and resources necessitated that a new solution be found. A decision was made to roll out both the new RIS product and speech recognition to maximize the resources to interface and implement the new solution. Prior to implementation of the new RIS, the medical imaging department operated in a conventional electronic-order-entry to paper request manner. The paper request followed the study through exam completion to the radiologist. SOMC entered into a contract with its PACS vendor to participate in beta testing and clinical trials for a new RIS product for the US market. Backup plans were created in the event the product failed to function as planned--either during the beta testing period or during clinical trails. The last piece of the technology puzzle to improve report turnaround time was voice recognition technology. Speech recognition enhanced the RIS technology as soon as it was implemented. The results show that the project has been a success. The new RIS, combined with speech recognition and the PACS, makes for a very effective solution to patient, exam, and results management in the medical imaging department.
Towards a theory of PACS deployment: an integrative PACS maturity framework.
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.
Potential time savings to radiology department personnel in a PACS-based environment
NASA Astrophysics Data System (ADS)
Saarinen, Allan O.; Wilson, M. C.; Iverson, Scott C.; Loop, John W.
1990-08-01
A purported benefit of digital imaging and archiving of radiographic procedures is the presumption of time savings to radiologists, radiology technologists, and radiology departmentpersonnel involved with processingfilms and managing theflimfile room. As part of the University of Washington's evaluation of Picture Archiving and Communication Systems (PACS)for the U.S. Army Medical Research and Development Command, a study was performed which evaluated the current operationalpractices of the film-based radiology department at the University of Washington Medical Center (UWMC). Industrial engineering time and motion studies were conducted to document the length of time requiredforfilm processing in various modalities, the proportion of the total exam time usedforfilm processing, the amount of time radiologists spent searchingfor and looking at images, and the amount of time file room personnel spent collating reports, making loans, updatingfilm jacket information, and purging files. This evaluation showed that better than one-half of the tasks in the file room may be eliminated with PACS and radiologists may save easily 10 percent of the time they spend reading films by no longer having to searchforfilms. Radiology technologists may also save as much as 10 percent of their time with PACS, although this estimate is subject to significant patient mix aberrations and measurement error. Given that the UWMC radiology department operates efficiently, similar improvements are forecast for other radiology departments and larger improvements areforecastfor less efficient departments.
Medical imaging, PACS, and imaging informatics: retrospective.
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.
Kelly, Erin N.; Short, Jeffrey W.; Schindler, David W.; Hodson, Peter V.; Ma, Mingsheng; Kwan, Alvin K.; Fortin, Barbra L.
2009-01-01
For over a decade, the contribution of oil sands mining and processing to the pollution of the Athabasca River has been controversial. We show that the oil sands development is a greater source of contamination than previously realized. In 2008, within 50 km of oil sands upgrading facilities, the loading to the snowpack of airborne particulates was 11,400 T over 4 months and included 391 kg of polycyclic aromatic compounds (PAC), equivalent to 600 T of bitumen, while 168 kg of dissolved PAC was also deposited. Dissolved PAC concentrations in tributaries to the Athabasca increased from 0.009 μg/L upstream of oil sands development to 0.023 μg/L in winter and to 0.202 μg/L in summer downstream. In the Athabasca, dissolved PAC concentrations were mostly <0.025 μg/L in winter and 0.030 μg/L in summer, except near oil sands upgrading facilities and tailings ponds in winter (0.031–0.083 μg/L) and downstream of new development in summer (0.063–0.135 μg/L). In the Athabasca and its tributaries, development within the past 2 years was related to elevated dissolved PAC concentrations that were likely toxic to fish embryos. In melted snow, dissolved PAC concentrations were up to 4.8 μg/L, thus, spring snowmelt and washout during rain events are important unknowns. These results indicate that major changes are needed to the way that environmental impacts of oil sands development are monitored and managed. PMID:19995964
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.
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.
Process-driven selection of information systems for healthcare
NASA Astrophysics Data System (ADS)
Mills, Stephen F.; Yeh, Raymond T.; Giroir, Brett P.; Tanik, Murat M.
1995-05-01
Integration of networking and data management technologies such as PACS, RIS and HIS into a healthcare enterprise in a clinically acceptable manner is a difficult problem. Data within such a facility are generally managed via a combination of manual hardcopy systems and proprietary, special-purpose data processing systems. Process modeling techniques have been successfully applied to engineering and manufacturing enterprises, but have not generally been applied to service-based enterprises such as healthcare facilities. The use of process modeling techniques can provide guidance for the placement, configuration and usage of PACS and other informatics technologies within the healthcare enterprise, and thus improve the quality of healthcare. Initial process modeling activities conducted within the Pediatric ICU at Children's Medical Center in Dallas, Texas are described. The ongoing development of a full enterprise- level model for the Pediatric ICU is also described.
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.
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.
Barton, Zachary J; Rodríguez-López, Joaquín
2017-03-07
We report a method of precisely positioning a Hg-based ultramicroelectrode (UME) for scanning electrochemical microscopy (SECM) investigations of any substrate. Hg-based probes are capable of performing amalgamation reactions with metal cations, which avoid unwanted side reactions and positive feedback mechanisms that can prove problematic for traditional probe positioning methods. However, prolonged collection of ions eventually leads to saturation of the amalgam accompanied by irreversible loss of Hg. In order to obtain negative feedback positioning control without risking damage to the SECM probe, we implement cyclic voltammetry probe approach surfaces (CV-PASs), consisting of CVs performed between incremental motor movements. The amalgamation current, peak stripping current, and integrated stripping charge extracted from a shared CV-PAS give three distinct probe approach curves (CV-PACs), which can be used to determine the tip-substrate gap to within 1% of the probe radius. Using finite element simulations, we establish a new protocol for fitting any CV-PAC and demonstrate its validity with experimental results for sodium and potassium ions in propylene carbonate by obtaining over 3 orders of magnitude greater accuracy and more than 20-fold greater precision than existing methods. Considering the timescales of diffusion and amalgam saturation, we also present limiting conditions for obtaining and fitting CV-PAC data. The ion-specific signals isolated in CV-PACs allow precise and accurate positioning of Hg-based SECM probes over any sample and enable the deployment of CV-PAS SECM as an analytical tool for traditionally challenging conditions.
Neurocognitive mechanisms of perception-action coordination: a review and theoretical integration.
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.
Indexing and retrieving DICOM data in disperse and unstructured archives.
Costa, Carlos; Freitas, Filipe; Pereira, Marco; Silva, Augusto; Oliveira, José L
2009-01-01
This paper proposes an indexing and retrieval solution to gather information from distributed DICOM documents by allowing searches and access to the virtual data repository using a Google-like process. The medical imaging modalities are becoming more powerful and less expensive. The result is the proliferation of equipment acquisition by imaging centers, including the small ones. With this dispersion of data, it is not easy to take advantage of all the information that can be retrieved from these studies. Furthermore, many of these small centers do not have large enough requirements to justify the acquisition of a traditional PACS. A peer-to-peer PACS platform to index and query DICOM files over a set of distributed repositories that are logically viewed as a single federated unit. The solution is based on a public domain document-indexing engine and extends traditional PACS query and retrieval mechanisms. This proposal deals well with complex searching requirements, from a single desktop environment to distributed scenarios. The solution performance and robustness were demonstrated in trials. The characteristics of presented PACS platform make it particularly important for small institutions, including educational and research groups.
Stanley, Todd H; Van Buiten, Charlene B; Baker, Scott A; Elias, Ryan J; Anantheswaran, Ramaswamy C; Lambert, Joshua D
2018-07-30
Roasting is an important cocoa processing step, but has been reported to reduce the polyphenol content in the beans. We investigated the impact of whole-bean roasting on the polyphenol content, aroma-related chemistry, and in vitro pancreatic lipase (PL) inhibitory activity of cocoa under a range of roasting conditions. Total phenolics, (-)-epicatechin, and proanthocyanidin (PAC) dimer - pentamer content was reduced by roasting. By contrast, roasting at 150 °C or greater increased the levels of catechin and PAC hexamers and heptamers. These compounds have greater PL inhibitory potency. Consistent with these changes in PAC composition and this previous data, we found that roasting at 170 °C time-dependently increased PL inhibitory activity. Cocoa aroma-related compounds increased with roasting above 100 °C, whereas deleterious sensory-related compounds formed at more severe temperatures. Our results indicate that cocoa roasting can be optimized to increase the content of larger PACs and anti-PL activity, while maintaining a favorable aroma profile. Copyright © 2018 Elsevier Ltd. All rights reserved.
Bandowe, Benjamin A Musa; Fränkl, Lea; Grosjean, Martin; Tylmann, Wojciech; Mosquera, Pablo V; Hampel, Henrietta; Schneider, Tobias
2018-04-15
The temporal profiles of polycyclic aromatic compounds (PACs) in lake sediments reflect past changes in emissions, transport and deposition of these pollutants and, thus, record natural and anthropogenic processes. We document fluxes of PACs [(polycyclic aromatic hydrocarbons (PAHs), oxygenated PAHs (OPAHs) and azaarenes (AZAs)] deposited in two tropical high-altitude lakes in the Cajas National Park (Ecuadorian Andes, 2°50'S, 79°10'W). In remote and high elevation Laguna Fondococha (4130m a.s.l.), the temporal fluxes of OPAHs and AZAs were similar to those of PAHs suggesting similar sources. A significant increase of PAC deposition after the 1950s reflects Ecuador's economic development. PAH fluxes were relatively low (∑27PAHs (without retene and perylene): 0.86-11.21ngcm -2 yr -1 ) with a composition pattern typical for long-range atmospheric transport (high 9-fluorenone/fluorene ratios) and biomass burning (30% low molecular weight PAHs). PAHs diagnostic of high temperature combustion (industry, traffic) make up 20-25% of total PAHs. Perylene concentrations increase linearly with increasing sediment depth suggesting diagenetic in-situ production. At lower elevations (Laguna Llaviucu, 3140m a.s.l.) and closer to urban areas, PAC fluxes in the past decades were 4-5 times higher than in the remote high-elevation lake. Laguna Llaviucu also showed higher concentrations of high molecular weight pyrogenic PAHs and a greater diversity of AZAs. Individual OPAHs and AZAs reflect mainly combustion activities. In Laguna Llaviucu, which is at a lower elevation (3140m a.s.l.) and closer to the city, molecular ratios suggest short-range atmospheric transport and deposition of PACs. A very foggy climate (170 rainy days per year) with the precipitation maximum at 3500m removes PACs very efficiently (by wet deposition) from the atmosphere at very short distances from emission sources. This partly explains why L. Llaviucu shows higher fluxes of PACs than the higher elevation L. Fondococha. This study presents the first historical record of organic pollutants from environmental archives in Ecuador. Copyright © 2017 Elsevier B.V. All rights reserved.
Competency Based Curriculum. Pre-Vocational Business & Office Cluster. One.
ERIC Educational Resources Information Center
West Virginia State Vocational Curriculum Lab., Cedar Lakes.
This curriculum guide is the first part of a two-part volume developed to assist those who are engaged in implementing prevocational exploration programs concerned with business and office occupations. It consists of experiential learning pacs that sample a variety of competencies performed by various workers employed in the business and office…
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.
Factors Affecting Radiologist's PACS Usage.
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.
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.
Radiology on handheld devices: image display, manipulation, and PACS integration issues.
Raman, Bhargav; Raman, Raghav; Raman, Lalithakala; Beaulieu, Christopher F
2004-01-01
Handheld personal digital assistants (PDAs) have undergone continuous and substantial improvements in hardware and graphics capabilities, making them a compelling platform for novel developments in teleradiology. The latest PDAs have processor speeds of up to 400 MHz and storage capacities of up to 80 Gbytes with memory expansion methods. A Digital Imaging and Communications in Medicine (DICOM)-compliant, vendor-independent handheld image access system was developed in which a PDA server acts as the gateway between a picture archiving and communication system (PACS) and PDAs. The system is compatible with most currently available PDA models. It is capable of both wired and wireless transfer of images and includes custom PDA software and World Wide Web interfaces that implement a variety of basic image manipulation functions. Implementation of this system, which is currently undergoing debugging and beta testing, required optimization of the user interface to efficiently display images on smaller PDA screens. The PDA server manages user work lists and implements compression and security features to accelerate transfer speeds, protect patient information, and regulate access. Although some limitations remain, PDA-based teleradiology has the potential to increase the efficiency of the radiologic work flow, increasing productivity and improving communication with referring physicians and patients. Copyright RSNA, 2004
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.
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.
NASA Astrophysics Data System (ADS)
Smith, Charles L.; Chu, Wei-Kom; Wobig, Randy; Chao, Hong-Yang; Enke, Charles
1999-07-01
An ongoing PACS project at our facility has been expanded to include providing and managing images used for routine clinical operation of the department of radiation oncology. The intent of our investigation has been to enable out clinical radiotherapy service to enter the tele-medicine environment through the use of a PACS system initially implemented in the department of radiology. The backbone for the imaging network includes five CT and three MR scanners located across three imaging centers. A PC workstation in the department of radiation oncology was used to transmit CT imags to a satellite facility located approximately 60 miles from the primary center. Chest CT images were used to analyze network transmission performance. Connectivity established between the primary department and satellite has fulfilled all image criteria required by the oncologist. Establishing the link tot eh oncologist at the satellite diminished bottlenecking of imaging related tasks at the primary facility due to physician absence. A 30:1 compression ratio using a wavelet-based algorithm provided clinically acceptable images treatment planning. Clinical radiotherapy images can be effectively managed in a wide- area-network to link satellite facilities to larger clinical centers.
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
Electronic workflow for imaging in clinical research.
Hedges, Rebecca A; Goodman, Danielle; Sachs, Peter B
2014-08-01
In the transition from paper to electronic workflow, the University of Colorado Health System's implementation of a new electronic health record system (EHR) forced all clinical groups to reevaluate their practices including the infrastructure surrounding clinical trials. Radiological imaging is an important piece of many clinical trials and requires a high level of consistency and standardization. With EHR implementation, paper orders were manually transcribed into the EHR, digitizing an inefficient work flow. A team of schedulers, radiologists, technologists, research personnel, and EHR analysts worked together to optimize the EHR to accommodate the needs of research imaging protocols. The transition to electronic workflow posed several problems: (1) there needed to be effective communication throughout the imaging process from scheduling to radiologist interpretation. (2) The exam ordering process needed to be automated to allow scheduling of specific research studies on specific equipment. (3) The billing process needed to be controlled to accommodate radiologists already supported by grants. (4) There needed to be functionality allowing exams to finalize automatically skipping the PACS and interpretation process. (5) There needed to be a way to alert radiologists that a specialized research interpretation was needed on a given exam. These issues were resolved through the optimization of the "visit type," allowing a high-level control of an exam at the time of scheduling. Additionally, we added columns and fields to work queues displaying grant identification numbers. The build solutions we implemented reduced the mistakes made and increased imaging quality and compliance.
Integrating powdered activated carbon into wastewater tertiary filter for micro-pollutant removal.
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.
Using all of your CPU's in HIPE
NASA Astrophysics Data System (ADS)
Jacobson, J. D.; Fadda, D.
2012-09-01
Modern computer architectures increasingly feature multi-core CPU's. For example, the MacbookPro features the Intel quad-core i7 processors. Through the use of hyper-threading, where each core can execute two threads simultaneously, the quad-core i7 can support eight simultaneous processing threads. All this on your laptop! This CPU power can now be put into service by scientists to perform data reduction tasks, but only if the software has been designed to take advantage of the multiple processor architectures. Up to now, software written for Herschel data reduction (HIPE), written in Jython and JAVA, is single-threaded and can only utilize a single processor. Users of HIPE do not get any advantage from the additional processors. Why not put all of the CPU resources to work reducing your data? We present a multi-threaded software application that corrects long-term transients in the signal from the PACS unchopped spectroscopy line scan mode. In this poster, we present a multi-threaded software framework to achieve performance improvements from parallel execution. We will show how a task to correct transients in the PACS Spectroscopy Pipeline for the un-chopped line scan mode, has been threaded. This computation-intensive task uses either a one-parameter or a three parameter exponential function, to characterize the transient. The task uses a JAVA implementation of Minpack, translated from the C (Moshier) and IDL (Markwardt) by the authors, to optimize the correction parameters. We also explain how to determine if a task can benefit from threading (Amdahl's Law), and if it is safe to thread. The design and implementation, using the JAVA concurrency package completions service is described. Pitfalls, timing bugs, thread safety, resource control, testing and performance improvements are described and plotted.
Effect of PAC dosage in a pilot-scale PAC-MBR treating micro-polluted surface water.
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.
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.
Xue, Yingying; Qian, Chen; Wang, Zhilong; Xu, Jian-He; Yang, Rude; Qi, Hanshi
2010-01-01
Extractive microbial transformation of L-phenylacetylcarbinol (L-PAC) in nonionic surfactant Triton X-100 micelle aqueous solution was investigated by response surface methodology. Based on the Box-Behnken design, a mathematical model was developed for the predication of mutual interactions between benzaldehyde, Triton X-100, and glucose on L-PAC production. It indicated that the negative or positive effect of nonionic surfactant strongly depended on the substrate concentration. The model predicted that the optimal concentration of benzaldehyde, Triton X-100, and glucose was 1.2 ml, 15 g, and 2.76 g per 100 ml, respectively. Under the optimal condition, the maximum L-PAC production was 27.6 mM, which was verified by a time course of extractive microbial transformation. A discrete fed-batch process for verification of cell activity was also presented.
Altered Circadian Food Anticipatory Activity Rhythms in PACAP Receptor 1 (PAC1) Deficient Mice
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.
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.
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.
Performance evaluation of powdered activated carbon for removing 28 types of antibiotics from water.
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.
Techniques and Tools for Estimating Ionospheric Effects in Interferometric and Polarimetric SAR Data
NASA Technical Reports Server (NTRS)
Rosen, P.; Lavalle, M.; Pi, X.; Buckley, S.; Szeliga, W.; Zebker, H.; Gurrola, E.
2011-01-01
The InSAR Scientific Computing Environment (ISCE) is a flexible, extensible software tool designed for the end-to-end processing and analysis of synthetic aperture radar data. ISCE inherits the core of the ROI_PAC interferometric tool, but contains improvements at all levels of the radar processing chain, including a modular and extensible architecture, new focusing approach, better geocoding of the data, handling of multi-polarization data, radiometric calibration, and estimation and correction of ionospheric effects. In this paper we describe the characteristics of ISCE with emphasis on the ionospheric modules. To detect ionospheric anomalies, ISCE implements the Faraday rotation method using quadpolarimetric images, and the split-spectrum technique using interferometric single-, dual- and quad-polarimetric images. The ability to generate co-registered time series of quad-polarimetric images makes ISCE also an ideal tool to be used for polarimetric-interferometric radar applications.
Treatment of micropollutants in municipal wastewater: ozone or powdered activated carbon?
Margot, Jonas; Kienle, Cornelia; Magnet, Anoÿs; Weil, Mirco; Rossi, Luca; de Alencastro, Luiz Felippe; Abegglen, Christian; Thonney, Denis; Chèvre, Nathalie; Schärer, Michael; Barry, D A
2013-09-01
Many organic micropollutants present in wastewater, such as pharmaceuticals and pesticides, are poorly removed in conventional wastewater treatment plants (WWTPs). To reduce the release of these substances into the aquatic environment, advanced wastewater treatments are necessary. In this context, two large-scale pilot advanced treatments were tested in parallel over more than one year at the municipal WWTP of Lausanne, Switzerland. The treatments were: i) oxidation by ozone followed by sand filtration (SF) and ii) powdered activated carbon (PAC) adsorption followed by either ultrafiltration (UF) or sand filtration. More than 70 potentially problematic substances (pharmaceuticals, pesticides, endocrine disruptors, drug metabolites and other common chemicals) were regularly measured at different stages of treatment. Additionally, several ecotoxicological tests such as the Yeast Estrogen Screen, a combined algae bioassay and a fish early life stage test were performed to evaluate effluent toxicity. Both treatments significantly improved the effluent quality. Micropollutants were removed on average over 80% compared with raw wastewater, with an average ozone dose of 5.7 mg O3 l(-1) or a PAC dose between 10 and 20 mg l(-1). Depending on the chemical properties of the substances (presence of electron-rich moieties, charge and hydrophobicity), either ozone or PAC performed better. Both advanced treatments led to a clear reduction in toxicity of the effluents, with PAC-UF performing slightly better overall. As both treatments had, on average, relatively similar efficiency, further criteria relevant to their implementation were considered, including local constraints (e.g., safety, sludge disposal, disinfection), operational feasibility and cost. For sensitive receiving waters (drinking water resources or recreational waters), the PAC-UF treatment, despite its current higher cost, was considered to be the most suitable option, enabling good removal of most micropollutants and macropollutants without forming problematic by-products, the strongest decrease in toxicity and a total disinfection of the effluent. Copyright © 2013 Elsevier B.V. All rights reserved.
Håkansson, Miranda; Oguttu, Monica; Gemzell-Danielsson, Kristina; Makenzius, Marlene
2018-01-01
Adolescent pregnancy represents a serious public health issue in sub-Saharan Africa, and stigmatising attitudes are contributing factors. This study investigates stigmatising attitudes related to adolescent pregnancy, abortion and contraceptive use among healthcare providers working with postabortion care (PAC) in a low-resource setting in Kenya. A mixed methods approach in a convergent design was utilised to capture attitudes related to abortion and contraceptive use among 86 (f=62; m=19) PAC providers in Kisumu, Kenya. Two Likert-scale questionnaires were used: the 18-item Stigmatising Attitudes, Beliefs and Actions Scale (SABAS) and the 7-item Contraceptive Use Stigma Scale (CUSS). 74 PAC providers responded to the SABAS, 44 to the CUSS and 12 participated in two focus group discussions. Descriptive statistics, psychometric tests of instruments and qualitative content analysis were conducted and reported in accordance with Consolidated Criteria for Reporting Qualitative Research. Cronbach's α coefficients for the total instrument was 0.88 (SABAS) and 0.84 (CUSS). The majority, 92% (68/74) agreed that a woman who has had an abortion should be treated equally to everyone else, 27% (20/74) considered abortion a sin and 30% (22/74) believed she will make abortion a habit. Contraceptive use among adolescent women was associated with promiscuity (39%; 17/44), hence contraceptives should only be available to married women (36%; 16/44), and 20% (9/44) believed that contraceptive use causes infertility. The providers encouraged women's autonomy and their rights to sexual and reproductive health; however, unclear regulations reinforce religious and cultural beliefs, which hampers implementation of evidence-based contraceptive counselling. Stigmatising attitudes towards young women in need of abortion and contraception is common among PAC providers. Their work is characterised by a conflict between human rights and societal norms, thus highlighting the need for interventions targeting PAC providers to reduce stigma and misconceptions related to abortion and contraception among adolescent women.
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.
Predicting clinical image delivery time by monitoring PACS queue behavior.
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.
Ong, Leonard; Elnajjar, Pierre; Nyman, C Gregory; Mair, Thomas; Juluru, Krishna
2017-07-01
We implemented an Image Quality Reporting and Tracking Solution (IQuaRTS), directly linked from the PACS, to improve communication between radiologists and technologists. IQuaRTS launched in May 2015. We compared MRI issues filed in the period before IQuaRTS implementation (May-September 2014) using a manual system with MRI issues filed in the IQuaRTS period (May-September 2015). The unpaired t test was used for analysis. For assessment of overall results in the IQuaRTS period alone, all issues filed across all modalities were included. Summary statistics and charts were generated using Excel and Tableau. For MRI issues, the number of issues filed during the IQuaRTS period was 498 (2.5% of overall MRI examination volume) compared with 78 issues filed during the period before IQuaRTS implementation (0.4% of total examination volume) (p = 0.0001), representing a 625% relative increase. Tickets that documented excellent work were 8%. Other issues included images not pushed to PACS (20%), film library issues (19%), and documentation or labeling (8%). Of the issues filed, 55% were MRI-related and 25% were CT-related. The issues were stratified across six sites within our institution. Staff requiring additional training could be readily identified, and 80% of the issues were resolved within 72 hours. IQuaRTS is a cost-effective online issue reporting tool that enables robust data collection and analytics to be incorporated into quality improvement programs. One limitation of the system is that it must be implemented in an environment where staff are receptive to quality improvement.
Nagels, Jason; MacDonald, David; Parker, David
2015-04-01
A challenge for many clinical users is that a patient may receive a diagnostic imaging (DI) service at a number of hospitals or private imaging clinics. The DI services that patients receive at other locations could be clinically relevant to current treatments, but typically, there is no seamless method for a clinical user to access longitudinal DI results for their patient. Radiologists, and other specialists that are intensive users of image data, require seamless ingestion of foreign exams into the picture archiving and communication system (PACS) to achieve full clinical value. Most commonly, a clinical user will depend on the patient to bring in a CD that contains imaging from another location. However, a number of issues can arise when using this type of solution. Firstly, a CD will not provide the clinical user with the full longitudinal record of the patient. Secondly, a CD often will not contain the report associated with the images. Finally, a CD is not seamless, due to the need to manually import the contents of the CD into the local PACS. In order to overcome these limitations, and provide clinical users with a greater benefit related to a patient's longitudinal DI history, the implementation of foreign exam management (FEM) at the local site level is required. This paper presents the experiences of FEM in practice. By leveraging industry standards and edge devices to support FEM, multiple sites with disparate PACS and radiology information system (RIS) vendors are able to seamlessly ingest foreign exams within their local PACS as if they are local exams.
Prometheus payment model: application to hip and knee replacement surgery.
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.
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.
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.
Computer-aided resource planning and scheduling for radiological services
NASA Astrophysics Data System (ADS)
Garcia, Hong-Mei C.; Yun, David Y.; Ge, Yiqun; Khan, Javed I.
1996-05-01
There exists tremendous opportunity in hospital-wide resource optimization based on system integration. This paper defines the resource planning and scheduling requirements integral to PACS, RIS and HIS integration. An multi-site case study is conducted to define the requirements. A well-tested planning and scheduling methodology, called Constrained Resource Planning model, has been applied to the chosen problem of radiological service optimization. This investigation focuses on resource optimization issues for minimizing the turnaround time to increase clinical efficiency and customer satisfaction, particularly in cases where the scheduling of multiple exams are required for a patient. How best to combine the information system efficiency and human intelligence in improving radiological services is described. Finally, an architecture for interfacing a computer-aided resource planning and scheduling tool with the existing PACS, HIS and RIS implementation is presented.
Geldermann, Ina; Grouls, Christoph; Kuhl, Christiane; Deserno, Thomas M; Spreckelsen, Cord
2013-08-01
Usability aspects of different integration concepts for picture archiving and communication systems (PACS) and computer-aided diagnosis (CAD) were inquired on the example of BoneXpert, a program determining the skeletal age from a left hand's radiograph. CAD-PACS integration was assessed according to its levels: data, function, presentation, and context integration focusing on usability aspects. A user-based study design was selected. Statements of seven experienced radiologists using two alternative types of integration provided by BoneXpert were acquired and analyzed using a mixed-methods approach based on think-aloud records and a questionnaire. In both variants, the CAD module (BoneXpert) was easily integrated in the workflow, found comprehensible and fitting in the conceptual framework of the radiologists. Weak points of the software integration referred to data and context integration. Surprisingly, visualization of intermediate image processing states (presentation integration) was found less important as compared to efficient handling and fast computation. Seamlessly integrating CAD into the PACS without additional work steps or unnecessary interrupts and without visualizing intermediate images may considerably improve software performance and user acceptance with efforts in time.
ProteinAC: a frequency domain technique for analyzing protein dynamics
NASA Astrophysics Data System (ADS)
Bozkurt Varolgunes, Yasemin; Demir, Alper
2018-03-01
It is widely believed that the interactions of proteins with ligands and other proteins are determined by their dynamic characteristics as opposed to only static, time-invariant processes. We propose a novel computational technique, called ProteinAC (PAC), that can be used to analyze small scale functional protein motions as well as interactions with ligands directly in the frequency domain. PAC was inspired by a frequency domain analysis technique that is widely used in electronic circuit design, and can be applied to both coarse-grained and all-atom models. It can be considered as a generalization of previously proposed static perturbation-response methods, where the frequency of the perturbation becomes the key. We discuss the precise relationship of PAC to static perturbation-response schemes. We show that the frequency of the perturbation may be an important factor in protein dynamics. Perturbations at different frequencies may result in completely different response behavior while magnitude and direction are kept constant. Furthermore, we introduce several novel frequency dependent metrics that can be computed via PAC in order to characterize response behavior. We present results for the ferric binding protein that demonstrate the potential utility of the proposed techniques.
Human Prostatic Acid Phosphatase: Structure, Function and Regulation
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
Vallerand, James R; Rhodes, Ryan E; Walker, Gordon J; Courneya, Kerry S
2017-03-28
Most previous research on the correlates of physical activity has examined the aerobic or strength exercise guidelines separately. Such an approach does not allow an examination of the correlates of meeting the combined guidelines versus a single guideline, or one guideline versus the other. Here, we report the prevalence and correlates of meeting the combined and independent exercise guidelines in hematologic cancer survivors (HCS). In a population-based, cross-sectional survey of 606 HCS from Alberta, Canada using a mailed questionnaire, we obtained separate assessments of aerobic and strength exercise behaviors, as well as separate assessments for motivations, regulations, and reflective processes using the multi-process action control framework (M-PAC). Overall, 22% of HCS met the combined exercise guideline, 22% met aerobic-only, 10% met strength-only, and 46% met neither exercise guideline. HCS were more likely to meet the combined guideline over the aerobic-only guideline if they had no children living at home, and over both the aerobic and strength-only guidelines if they had completed university. As hypothesized, those meeting the combined guideline also had a more favorable strength-specific M-PAC profile (i.e., motivations, regulations, and reflective processes) than those meeting the aerobic-only guideline, and a more favorable aerobic-specific M-PAC profile than those meeting the strength-only guideline. Interestingly and unexpectedly, HCS meeting the combined guidelines also reported significantly greater aerobic-specific perceived control, planning, and obligation/regret than those meeting the aerobic-only guideline, and greater strength-specific perceived control, planning, and obligation/regret than those meeting the strength-only guideline. Few HCS are meeting the combined exercise guidelines. M-PAC based variables are strong correlates of meeting the combined guidelines compared to aerobic or strength only guidelines. Strategies to help HCS meet the combined guidelines may need to promote more favorable behavioral regulations and reflective processes for both types of exercise rather than just the type of exercise in which HCS are deficient.
Ivancev-Tumbas, Ivana; Hobby, Ralph; Küchle, Benjamin; Panglisch, Stefan; Gimbel, Rolf
2008-09-01
Ultrafiltration is classified as a low-pressure membrane technology which effectively removes particulate matter and microorganisms and to a certain extent dissolved organic matter (15-25%) and colour. The technology has been optimized and is becoming competitive compared to conventional processes for larger scale plant capacities. In combination with activated carbon it is an effective barrier regarding the removal of synthetic organic chemicals. Growing interest in ultrafiltration raises the question of better usage of the adsorption capacity of powdered activated carbon (PAC) used in combination with this low-pressure membrane technique. This paper presents a pilot plant study of different PAC dosing procedures within a combined hybrid membrane IN/OUT process for removal of p-nitrophenol (PNP) from water (c(0)=1mg/L) under real case conditions (e.g. usage of the same module for the whole duration of the experiment, backwashing with permeate water, no separate saturation of the membrane with substance without presence of carbon). p-Nitrophenol was chosen as an appropriate test substance to assess the efficiency of different operation modes. Dead-end and cross-flow filtration were compared with respect to different PAC dosing procedures: continuous dosing into a continuously stirred tank reactor (CSTR) in front of the module and direct dosing into the pipe in front of the module (continuous, single-pulse and multi-pulse dosing). There was no advantage in cross-flow mode over dead-end referring to PNP concentration in the permeate. Relating to the carbon dosing procedure, the best results were obtained for continuous PAC addition. The option of dosing directly into the pipe has the advantage of no additional tank being necessary. In the case of single-pulse dosing, the formation of a carbon layer on the membrane surface was assumed and an LDF model applied for a simplified estimation of the "breakthrough behaviour" in the thus formed "PAC filter layer".
EST-PAC a web package for EST annotation and protein sequence prediction
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
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.
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.
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.
Coupled LC-GC techniques for the characterisation of polycyclic aromatic compounds in fuel materials
DOE Office of Scientific and Technical Information (OSTI.GOV)
Askey, S.A.; Holden, K.M.L.; Bartle, K.D.
1995-12-31
Exposure to polycyclic aromatic compounds (PAC) has long been identified as of considerable environmental concern. Originating from both natural and anthropogenic sources, many PAC exhibit significant carcinogenic and mutagenic properties. Multi-dimensional chromatographic techniques which provide separation by virtue of chemical class (group-type) or by molecular mass greatly simplifies the analysis of inherently complex fuel materials. In this study, on-line LC-GC techniques in which high resolution gas chromatography (HPLC) have been investigated. Comprehensive characterisation of fuel feedstocks and post-pyrolysis and combustion products was achieved by coupling LC-GC to low resolution ion trap mass spectrometry (ITD-MS) and atomic emission detection (AED). Themore » identification of PAC in diesel and coal materials, as well as urban air and diesel exhaust particulate extracts has provided valuable insight into the source, formation and distribution of such compounds pre- and post processing.« less
EIR: enterprise imaging repository, an alternative imaging archiving and communication system.
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.
Optimizing physicians' instruction of PACS through e-learning: cognitive load theory applied.
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.
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.
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.
Multimedia consultation session recording and playback using Java-based browser in global PACS
NASA Astrophysics Data System (ADS)
Martinez, Ralph; Shah, Pinkesh J.; Yu, Yuan-Pin
1998-07-01
The current version of the Global PACS software system uses a Java-based implementation of the Remote Consultation and Diagnosis (RCD) system. The Java RCD includes a multimedia consultation session between physicians that includes text, static image, image annotation, and audio data. The JAVA RCD allows 2-4 physicians to collaborate on a patient case. It allows physicians to join the session via WWW Java-enabled browsers or stand alone RCD application. The RCD system includes a distributed database archive system for archiving and retrieving patient and session data. The RCD system can be used for store and forward scenarios, case reviews, and interactive RCD multimedia sessions. The RCD system operates over the Internet, telephone lines, or in a private Intranet. A multimedia consultation session can be recorded, and then played back at a later time for review, comments, and education. A session can be played back using Java-enabled WWW browsers on any operating system platform. The JAVA RCD system shows that a case diagnosis can be captured digitally and played back with the original real-time temporal relationships between data streams. In this paper, we describe design and implementation of the RCD session playback.
Rethinking transitions of care: An interprofessional transfer triage protocol in post-acute care.
Patel, Radha V; Wright, Lauri; Hay, Brittany
2017-09-01
Readmissions to hospitals from post-acute care (PAC) units within long-term care settings have been rapidly increasing over the past decade, and are drivers of increased healthcare costs. With an average of $11,000 per admission, there is a need for strategies to reduce 30-day preventable hospital readmission rates. In 2018, incentives and penalties will be instituted for long-term care facilities failing to meet all-cause, all-condition hospital readmission rate performance measures. An interprofessional team (IPT) developed and implemented a Transfer Triage Protocol used in conjunction with the INTERACT programme to enhance clinical decision-making and assess the potential to reduce the facility's 30-day preventable hospital readmission rates by 10% within 6 weeks of implementation. Results from quantitative analysis demonstrated an overall 35.2% reduction in the 30-day preventable hospital readmission rate. Qualitative analysis revealed the need for additional staff education, improved screening and communication upon admission and prior to hospital transfer, and the need for more IPT on-site availability. This pilot study demonstrates the benefits and implications for practice of an IPT to improve the quality of care within PAC and decrease 30-day preventable hospital readmissions.
Mycorrhiza reduces adverse effects of dark septate endophytes (DSE) on growth of conifers.
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.
Biodegradation of crude oil in Arctic subsurface water from the Disko Bay (Greenland) is limited.
Scheibye, Katrine; Christensen, Jan H; Johnsen, Anders R
2017-04-01
Biological degradation is the main process for oil degradation in a subsurface oil plume. There is, however, little information on the biodegradation potential of Arctic, marine subsurface environments. We therefore investigated oil biodegradation in microcosms at 2 °C containing Arctic subsurface seawater from the Disko Bay (Greenland) and crude oil at three concentrations of 2.5-10 mg/L. Within 71 days, the total petroleum hydrocarbon concentration decreased only by 18 ± 18% for an initial concentration of 5 mg/L. The saturated alkanes nC13-nC30 and the isoprenoids iC18-iC21 were biodegraded at all concentrations indicating a substantial potential for biodegradation of these compound classes. Polycyclic aromatic compounds (PACs) disappeared from the oil phase, but dissolution was the main process of removal. Analysis of diagnostic ratios indicated almost no PAC biodegradation except for the C1-naphthalenes. To conclude, the marine subsurface microorganisms from the Disko Bay had the potential for biodegradation of n-alkanes and isoprenoids while the metabolically complex and toxic PACs and their alkylated homologs remained almost unchanged. Copyright © 2016 Elsevier Ltd. All rights reserved.
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.
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.
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.
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.
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.
NASA Astrophysics Data System (ADS)
Liu, Brent; Lee, Jasper; Documet, Jorge; Guo, Bing; King, Nelson; Huang, H. K.
2006-03-01
By implementing a tracking and verification system, clinical facilities can effectively monitor workflow and heighten information security in today's growing demand towards digital imaging informatics. This paper presents the technical design and implementation experiences encountered during the development of a Location Tracking and Verification System (LTVS) for a clinical environment. LTVS integrates facial biometrics with wireless tracking so that administrators can manage and monitor patient and staff through a web-based application. Implementation challenges fall into three main areas: 1) Development and Integration, 2) Calibration and Optimization of Wi-Fi Tracking System, and 3) Clinical Implementation. An initial prototype LTVS has been implemented within USC's Healthcare Consultation Center II Outpatient Facility, which currently has a fully digital imaging department environment with integrated HIS/RIS/PACS/VR (Voice Recognition).
Reid, David G; Bonnet, Susan L; Kemp, Gabre; van der Westhuizen, Jan H
2013-10-01
(13)C NMR is an effective method of characterizing proanthocyanidin (PAC) tannins in quebracho (Schinopsis lorentzii) heartwood and black wattle (Acacia mearnsii) bark, before and after commercial extraction. The B-rings of the constituent flavan-3-ols, catechols (quebracho) or pyrogallols (wattle), are recognized in unprocessed source materials by "marker" signals at ca. 118 or 105ppm, respectively. NMR allows the minimum extraction efficiency to be calculated; ca. 30%, and ca. 80%, for quebracho heartwood and black wattle bark, respectively. NMR can also identify PAC tannin (predominantly robinetinidin), and compare tannin content, in bark from other acacia species; tannin content decreases in the order A. mearnsii, Acacia pycnantha (87% of A. mearnsii), Acacia dealbata and Acacia decurrens (each 74%) and Acacia karroo (30%). Heartwood from an underexploited PAC tannin source, Searsia lancea, taxonomically close to quebracho, shows abundant profisetinidin and catechin PACs. NMR offers the advantage of being applicable to source materials in their native state, and has potential applications in optimizing extraction processes, identification of tannin sources, and characterization of tannin content in cultivar yield improvement programmes. Copyright © 2013 Elsevier Ltd. All rights reserved.
Spanish translation and validation of the Preschool Activity Card Sort.
Stoffel, Ashley; Berg, Christine
2008-05-01
Few standardized assessments exist for children living in the United States who are Hispanic/Latino. This study reports the Spanish translation process for the Preschool Activity Card Sort (PACS), which is a measure of participation in preschool children, and examines content, construct, and concurrent validity. Methods of verifying accuracy of translation included expert review and back translation and supported content validity of the Tarjetas de Actividades Preescolares (TAP). Subsequently, a sample of 37 parents of children between 3 and 6 years of age completed the PACS/TAP by structured interview. Twenty-six parents were Spanish speaking, and 11 were English speaking. A comparison of reported participation by Spanish- and English-speaking children provides initial construct validity of the TAP. Results indicate that the TAP differentiates among children of recent immigrants as compared to preschoolers who were born in the United States on domains of self-care, high and low demand leisure, and educational activities. Results emphasize the importance of considering sociocultural influences when assessing participation. PACS/TAP scores were moderately correlated with Pediatric Evaluation of Disability Inventory scores for the self-care domain, but did not correlate with the mobility or social function domains. The PACS/TAP appears to provide a useful means of understanding preschoolers' participation. Future research is needed to further establish the validity of this assessment.
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.…
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.
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
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.
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.
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
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.
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
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.
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.
Assessing post-abortion care in health facilities in Afghanistan: a cross-sectional study.
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.
PacC and pH–dependent transcriptome of the mycotrophic fungus Trichoderma virens
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
IMPROVING TACONITE PROCESSING PLANT EFFICIENCY BY COMPUTER SIMULATION, Final Report
DOE Office of Scientific and Technical Information (OSTI.GOV)
William M. Bond; Salih Ersayin
2007-03-30
This project involved industrial scale testing of a mineral processing simulator to improve the efficiency of a taconite processing plant, namely the Minorca mine. The Concentrator Modeling Center at the Coleraine Minerals Research Laboratory, University of Minnesota Duluth, enhanced the capabilities of available software, Usim Pac, by developing mathematical models needed for accurate simulation of taconite plants. This project provided funding for this technology to prove itself in the industrial environment. As the first step, data representing existing plant conditions were collected by sampling and sample analysis. Data were then balanced and provided a basis for assessing the efficiency ofmore » individual devices and the plant, and also for performing simulations aimed at improving plant efficiency. Performance evaluation served as a guide in developing alternative process strategies for more efficient production. A large number of computer simulations were then performed to quantify the benefits and effects of implementing these alternative schemes. Modification of makeup ball size was selected as the most feasible option for the target performance improvement. This was combined with replacement of existing hydrocyclones with more efficient ones. After plant implementation of these modifications, plant sampling surveys were carried out to validate findings of the simulation-based study. Plant data showed very good agreement with the simulated data, confirming results of simulation. After the implementation of modifications in the plant, several upstream bottlenecks became visible. Despite these bottlenecks limiting full capacity, concentrator energy improvement of 7% was obtained. Further improvements in energy efficiency are expected in the near future. The success of this project demonstrated the feasibility of a simulation-based approach. Currently, the Center provides simulation-based service to all the iron ore mining companies operating in northern Minnesota, and future proposals are pending with non-taconite mineral processing applications.« less
Oguttu, Monica; Gemzell-Danielsson, Kristina
2018-01-01
Introduction Adolescent pregnancy represents a serious public health issue in sub-Saharan Africa, and stigmatising attitudes are contributing factors. This study investigates stigmatising attitudes related to adolescent pregnancy, abortion and contraceptive use among healthcare providers working with postabortion care (PAC) in a low-resource setting in Kenya. Methods A mixed methods approach in a convergent design was utilised to capture attitudes related to abortion and contraceptive use among 86 (f=62; m=19) PAC providers in Kisumu, Kenya. Two Likert-scale questionnaires were used: the 18-item Stigmatising Attitudes, Beliefs and Actions Scale (SABAS) and the 7-item Contraceptive Use Stigma Scale (CUSS). 74 PAC providers responded to the SABAS, 44 to the CUSS and 12 participated in two focus group discussions. Descriptive statistics, psychometric tests of instruments and qualitative content analysis were conducted and reported in accordance with Consolidated Criteria for Reporting Qualitative Research. Results Cronbach’s α coefficients for the total instrument was 0.88 (SABAS) and 0.84 (CUSS). The majority, 92% (68/74) agreed that a woman who has had an abortion should be treated equally to everyone else, 27% (20/74) considered abortion a sin and 30% (22/74) believed she will make abortion a habit. Contraceptive use among adolescent women was associated with promiscuity (39%; 17/44), hence contraceptives should only be available to married women (36%; 16/44), and 20% (9/44) believed that contraceptive use causes infertility. The providers encouraged women’s autonomy and their rights to sexual and reproductive health; however, unclear regulations reinforce religious and cultural beliefs, which hampers implementation of evidence-based contraceptive counselling. Conclusion Stigmatising attitudes towards young women in need of abortion and contraception is common among PAC providers. Their work is characterised by a conflict between human rights and societal norms, thus highlighting the need for interventions targeting PAC providers to reduce stigma and misconceptions related to abortion and contraception among adolescent women. PMID:29527357
1976-01-01
items. The items tested were the MODI-PAC, a proprietary item of Reming)on Arms Company, a standard 12 - gauge round of No. 4 lead shot, and an...to refrain from testing this item. Therefore, the final selection of items for testing were (1) the MODI-PAC, (2) a standard 12 - gauge shotgun round of...The first item evaluated was the MODI-PAC5. The MOQ1-PAC which standsfor “modified impact “ is a 12 - gauge shotgun shell loaded with approximately 320
NASA Astrophysics Data System (ADS)
Green, Joel D.; DIGIT OTKP Team
2010-01-01
The DIGIT (Dust, Ice, and Gas In Time) Open Time Key Project utilizes the PACS spectrometer (57-210 um) onboard the Herschel Space Observatory to study the colder regions of young stellar objects and protostellar cores, complementary to recent observations from Spitzer and ground-based observatories. DIGIT focuses on 30 embedded sources and 64 disk sources, and includes supporting photometry from PACS and SPIRE, as well as spectroscopy from HIFI, selected from nearby molecular clouds. For the embedded sources, PACS spectroscopy will allow us to address the origin of [CI] and high-J CO lines observed with ISO-LWS. Our observations are sensitive to the presence of cold crystalline water ice, diopside, and carbonates. Additionally, PACS scans are 5x5 maps of the embedded sources and their outflows. Observations of more evolved disk sources will sample low and intermediate mass objects as well as a variety of spectral types from A to M. Many of these sources are extremely rich in mid-IR crystalline dust features, enabling us to test whether similar features can be detected at larger radii, via colder dust emission at longer wavelengths. If processed grains are present only in the inner disk (in the case of full disks) or from the emitting wall surface which marks the outer edge of the gap (in the case of transitional disks), there must be short timescales for dust processing; if processed grains are detected in the outer disk, radial transport must be rapid and efficient. Weak bands of forsterite and clino- and ortho-enstatite in the 60-75 um range provide information about the conditions under which these materials were formed. For the Science Demonstration Phase we are observing an embedded protostar (DK Cha) and a Herbig Ae/Be star (HD 100546), exemplars of the kind of science that DIGIT will achieve over the full program.
Developing policies and procedures for a picture archiving and communication system.
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.
Msaki, Peter; Padovani, Renato
2015-01-01
The objective of this study was to improve the visibility of anatomical details by applying off‐line postimage processing in chest computed radiography (CR). Four spatial domain‐based external image processing techniques were developed by using MATLAB software version 7.0.0.19920 (R14) and image processing tools. The developed techniques were implemented to sample images and their visual appearances confirmed by two consultant radiologists to be clinically adequate. The techniques were then applied to 200 chest clinical images and randomized with other 100 images previously processed online. These 300 images were presented to three experienced radiologists for image quality assessment using standard quality criteria. The mean and ranges of the average scores for three radiologists were characterized for each of the developed technique and imaging system. The Mann‐Whitney U‐test was used to test the difference of details visibility between the images processed using each of the developed techniques and the corresponding images processed using default algorithms. The results show that the visibility of anatomical features improved significantly (0.005≤p≤0.02) with combinations of intensity values adjustment and/or spatial linear filtering techniques for images acquired using 60≤kVp≤70. However, there was no improvement for images acquired using 102≤kVp≤107 (0.127≤p≤0.48). In conclusion, the use of external image processing for optimization can be effective in chest CR, but should be implemented in consultations with the radiologists. PACS number: 87.59.−e, 87.59.−B, 87.59.−bd PMID:26103165
NASA Astrophysics Data System (ADS)
Alzner, Edgar; Murphy, Laura
1986-06-01
The growing digital nature of radiology images led to a recognition that compatibility of communication between imaging, display and data storage devices of different modalities and different manufacturers is necessary. The ACR-NEMA Digital Imaging and Communications Standard Committee was formed to develop a communications standard for radiological images. This standard includes the overall structure of a communication message and the protocols for bi-directional communication using end-to-end connections. The evolution and rationale of the ACR-NEMA Digital Imaging and Communication Standard are described. An overview is provided and sane practical implementation considerations are discussed. PACS will became reality only if the medical community accepts and implements the ACR-NEMA Standard.
Wang, Feng; Gao, Baoyu; Yue, Qinyan; Bu, Fan; Shen, Xue
2017-07-01
Effects of ozonation and powdered activated carbon on removal of dissolved organic matter (DOM) and disinfection by-product (DBP) in reservoir water were intensively investigated in this study. Both the formation of carbonaceous DBP (C-DBP) and nitrogenous DBP (N-DBP) as well as their speciation were analyzed. Results exhibited that the addition of powdered activated carbon (PAC) greatly improved the removal of aromatic protein. Trihalomethanes (THMs) and haloacetonitriles (HANs) were the dominant species in C-DBP and N-DBP. The integrated coagulation and PAC processes could remove more than 70% of THMs and 93% of HANs precursors, while only 10.5 and 45% of capture were achieved by the single coagulation. The added ozone lowered the yields of HANs but synchronously increased the more toxic bromine-containing THMs from 78.5 to 128.1 μg/L. Kinetics parameters for THM formation indicated that the precursor creating the THMs fast could be easily removed by both the coagulation and PAC adsorption.
Kavitha, S; Yukesh Kannah, R; Rajesh Banu, J; Kaliappan, S; Johnson, M
2017-11-01
The present study investigates the synergistic effect of combined bacterial disintegration on mixed microalgal biomass for energy efficient biomethane generation. The rate of microalgal biomass lysis, enhanced biodegradability, and methane generation were used as indices to assess efficiency of the disintegration. A maximal dissolvable organics release and algal biomass lysis rate of about 1100, 950 and 800mg/L and 26, 23 and 18% was achieved in PA+C (protease, amylase+cellulase secreting bacteria), C (cellulase alone) and PA (protease, amylase) microalgal disintegration. During anaerobic fermentation, a greater production of volatile fatty acids (1000mg/L) was noted in PA+C bacterial disintegration of microalgal biomass. PA+C bacterial disintegration improve the amenability of microalgal biomass to biomethanation process with higher biodegradability of about 0.27gCOD/gCOD, respectively. The energy balance analysis of this combined bacterial disintegration of microalgal biomass provides surplus positive net energy (1.14GJ/d) by compensating the input energy requirements. Copyright © 2017 Elsevier Ltd. All rights reserved.
Local area networks in an imaging environment.
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.
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.
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.
Pituitary adenylate cyclase-activating polypeptide promotes eccrine gland sweat secretion.
Sasaki, S; Watanabe, J; Ohtaki, H; Matsumoto, M; Murai, N; Nakamachi, T; Hannibal, J; Fahrenkrug, J; Hashimoto, H; Watanabe, H; Sueki, H; Honda, K; Miyazaki, A; Shioda, S
2017-02-01
Sweat secretion is the major function of eccrine sweat glands; when this process is disturbed (paridrosis), serious skin problems can arise. To elucidate the causes of paridrosis, an improved understanding of the regulation, mechanisms and factors underlying sweat production is required. Pituitary adenylate cyclase-activating polypeptide (PACAP) exhibits pleiotropic functions that are mediated via its receptors [PACAP-specific receptor (PAC1R), vasoactive intestinal peptide (VIP) receptor type 1 (VPAC1R) and VPAC2R]. Although some studies have suggested a role for PACAP in the skin and several exocrine glands, the effects of PACAP on the process of eccrine sweat secretion have not been examined. To investigate the effect of PACAP on eccrine sweat secretion. Reverse transcriptase-polymerase chain reaction and immunostaining were used to determine the expression and localization of PACAP and its receptors in mouse and human eccrine sweat glands. We injected PACAP subcutaneously into the footpads of mice and used the starch-iodine test to visualize sweat-secreting glands. Immunostaining showed PACAP and PAC1R expression by secretory cells from mouse and human sweat glands. PACAP immunoreactivity was also localized in nerve fibres around eccrine sweat glands. PACAP significantly promoted sweat secretion at the injection site, and this could be blocked by the PAC1R-antagonist PACAP6-38. VIP, an agonist of VPAC1R and VPAC2R, failed to induce sweat secretion. This is the first report demonstrating that PACAP may play a crucial role in sweat secretion via its action on PAC1R located in eccrine sweat glands. The mechanisms underlying the role of PACAP in sweat secretion may provide new therapeutic options to combat sweating disorders. © 2016 British Association of Dermatologists.
Detecting phase-amplitude coupling with high frequency resolution using adaptive decompositions
Pittman-Polletta, Benjamin; Hsieh, Wan-Hsin; Kaur, Satvinder; Lo, Men-Tzung; Hu, Kun
2014-01-01
Background Phase-amplitude coupling (PAC) – the dependence of the amplitude of one rhythm on the phase of another, lower-frequency rhythm – has recently been used to illuminate cross-frequency coordination in neurophysiological activity. An essential step in measuring PAC is decomposing data to obtain rhythmic components of interest. Current methods of PAC assessment employ narrowband Fourier-based filters, which assume that biological rhythms are stationary, harmonic oscillations. However, biological signals frequently contain irregular and nonstationary features, which may contaminate rhythms of interest and complicate comodulogram interpretation, especially when frequency resolution is limited by short data segments. New method To better account for nonstationarities while maintaining sharp frequency resolution in PAC measurement, even for short data segments, we introduce a new method of PAC assessment which utilizes adaptive and more generally broadband decomposition techniques – such as the empirical mode decomposition (EMD). To obtain high frequency resolution PAC measurements, our method distributes the PAC associated with pairs of broadband oscillations over frequency space according to the time-local frequencies of these oscillations. Comparison with existing methods We compare our novel adaptive approach to a narrowband comodulogram approach on a variety of simulated signals of short duration, studying systematically how different types of nonstationarities affect these methods, as well as on EEG data. Conclusions Our results show: (1) narrowband filtering can lead to poor PAC frequency resolution, and inaccuracy and false negatives in PAC assessment; (2) our adaptive approach attains better PAC frequency resolution and is more resistant to nonstationarities and artifacts than traditional comodulograms. PMID:24452055
Singh, Ajay P.; Singh, Rakesh K.; Kim, Kyu Kwang; Satyan, K. S.; Nussbaum, Roger; Torres, Monica; Brard, Laurent; Vorsa, Nicholi
2010-01-01
Polyphenolic extracts of the principal flavonoid classes present in cranberry were screened in vitro for cytotoxicity against solid tumor cells lines, identifying two fractions composed principally of proanthocyanidins (PACs) with potential anticancer activity. Matrix-Assisted Laser Desorption/Ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF-MS) analysis of the proanthocyanidins (PACs) fractions indicated the presence of A-type PACs with 1–4 linkages containing between 2–8 epicatechin units with a maximum of 1 epigallocatechin unit. PACs exhibited in vitro cytotoxicity against platinum-resistant human ovarian, neuroblastoma and prostate cancer cell lines (IC50 = 79–479 μg/mL) but were non-cytotoxic to lung fibroblast cells (IC50 > 1000 μg/ml). SKOV-3 ovarian cancer cells treated with PACs exhibited classic apoptotic changes. PACs acted synergistically with paraplatin in SKOV-3 cells. Pretreatment of SKOV-3 cells with PACs (106 μg/ ml) resulted in a significant reduction of the paraplatin IC50 value. Similarly, in a BrdU incorporation assay, co-treatment of SKOV-3 cells with PACs and paraplatin revealed reduced cell proliferation at lower concentrations than with either individually. In SKOV-3 cell cultures co-treated with PAC-1 and paraplatin, an HPLC analysis indicated differential quantitative presence of various PAC oligomers such as DP-8, -9, -11 and -14 indicating either selective binding or uptake. Cranberry proanthocyanidins exhibit cell-line specific cytotoxicity, induce apoptotic markers and augment cytotoxicity of paraplatin in platinum-resistant SKOV-3 ovarian cancer cells. PMID:19172579
Peron, Gregorio; Pellizzaro, Anna; Brun, Paola; Schievano, Elisabetta; Mammi, Stefano; Sut, Stefania; Castagliuolo, Ignazio; Dall'Acqua, Stefano
2017-07-19
Cranberry (Vaccinium macrocarpon Aiton) is used to treat noncomplicated urinary tract infections (UTIs). A-type procyanidins (PAC-A) are considered the active constituents able to inhibit bacterial adhesion to the urinary epithelium. However, the role of PAC-A in UTIs is debated, because of their poor bioavailability, extensive metabolism, limited knowledge about urinary excretion, and contradictory clinical trials. The effects of 35-day cranberry supplementation (11 mg/kg PAC-A, 4 mg/kg PAC-B) were studied in healthy rats using a ultra performance liquid chromatography-mass spectrometry (UPLC-MS)-based metabolomics approach. Microbial PAC metabolites, such as valeric acid and valerolactone derivatives, were related to cranberry consumption. An increased urinary excretion of glucuronidated metabolites was also observed. In a further experiment, urine samples were collected at 2, 4, 8, and 24 h after cranberry intake and their antiadhesive properties were tested against uropathogenic Escherichia coli. The 8 h samples showed the highest activity. Changes in urinary composition were studied by ultra performance liquid chromatography-time-of-flight (UPLC-QTOF), observing the presence of PAC metabolites. The PAC-A2 levels were measured in all collected samples, and the highest amounts, on the order of ng/mL, were found in the samples collected after 4 h. Results indicate that the antiadhesive activity against uropathogenic bacteria observed after cranberry consumption is ascribable to PAC-A metabolites rather than to a direct PAC-A effect, as the measured PAC-A levels in urine was lower than those reported as active in the literature.
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.
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.
Want to Teach about SuperPACs? What We Can Learn from Stephen Colbert
ERIC Educational Resources Information Center
Stoddard, Jeremy
2012-01-01
The emergence of the SuperPACs in American politics is a major issue in the current election. SuperPACs, and the media campaigns they fund, also present a major challenge for media and democratic education. This article explores the issues surrounding SuperPACs and the rise of media in elections and politics in general, and presents some starting…
Picture archiving and communication systems (PACS).
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.
Casson, R J; Newland, H S; Muecke, J; McGovern, S; Abraham, L M; Shein, W K; Selva, D; Aung, T
2007-01-01
Aim To determine the prevalence of preglaucomatous angle‐closure disease in central Myanmar. Methods A population‐based survey of inhabitants ⩾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). Results 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° of closure (range 90–360°). Conclusion 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. PMID:17576708
Cetin, Damla; Hacımuftuoglu, Ahmet; Tatar, Abdulgani; Turkez, Hasan; Togar, Basak
2016-08-01
Paclitaxel (PAC) and cisplatin (CIS) are two established chemotherapeutic drugs used in combination for the treatment of various solid tumors. However, the usage of PAC and CIS are limited because of the incidence of their moderate or severe neurotoxic side effects. In this study, we aimed to assess the protective role of salicylic acid (SA) against neurotoxicity caused by PAC and CIS. For this purpose, newborn Sprague Dawley rats were decapitated in sterile atmosphere and primary cortex neuron cultures were established. On the 10th day SA was added into culture plates. PAC and CIS were added on the 12th day. The cytotoxicity was determined by using the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay. Oxidative alterations were assessed using total antioxidant capacity and total oxidative stress assays in rat primary neuron cell cultures. It was shown that both concentrations of PAC and CIS treatments caused neurotoxicity. Although SA decreased the neurotoxicity by CIS and PAC, it was more effective against the toxicity caused by CIS rather than the toxicity caused by PAC. In conclusion it was clearly revealed that SA decreased the neurotoxic effect of CIS and PAC in vitro.
Natural Organic Matter Removal and Fouling in a Low Pressure Hybrid Membrane Systems
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
Lee, Young Han; Park, Eun Hae; Suh, Jin-Suck
2015-01-01
The objectives are: 1) to introduce a simple and efficient method for extracting region of interest (ROI) values from a Picture Archiving and Communication System (PACS) viewer using optical character recognition (OCR) software and a macro program, and 2) to evaluate the accuracy of this method with a PACS workstation. This module was designed to extract the ROI values on the images of the PACS, and created as a development tool by using open-source OCR software and an open-source macro program. The principal processes are as follows: (1) capture a region of the ROI values as a graphic file for OCR, (2) recognize the text from the captured image by OCR software, (3) perform error-correction, (4) extract the values including area, average, standard deviation, max, and min values from the text, (5) reformat the values into temporary strings with tabs, and (6) paste the temporary strings into the spreadsheet. This principal process was repeated for the number of ROIs. The accuracy of this module was evaluated on 1040 recognitions from 280 randomly selected ROIs of the magnetic resonance images. The input times of ROIs were compared between conventional manual method and this extraction module-assisted input method. The module for extracting ROI values operated successfully using the OCR and macro programs. The values of the area, average, standard deviation, maximum, and minimum could be recognized and error-corrected with AutoHotkey-coded module. The average input times using the conventional method and the proposed module-assisted method were 34.97 seconds and 7.87 seconds, respectively. A simple and efficient method for ROI value extraction was developed with open-source OCR and a macro program. Accurate inputs of various numbers from ROIs can be extracted with this module. The proposed module could be applied to the next generation of PACS or existing PACS that have not yet been upgraded. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.
Nakazawa, Yoshifumi; Matsui, Yoshihiko; Hanamura, Yusuke; Shinno, Koki; Shirasaki, Nobutaka; Matsushita, Taku
2018-07-01
Superfine powdered activated carbon (SPAC; particle diameter ∼1 μm) has greater adsorptivity for organic molecules than conventionally sized powdered activated carbon (PAC). Although SPAC is currently used in the pretreatment to membrane filtration at drinking water purification plants, it is not used in conventional water treatment consisting of coagulation-flocculation, sedimentation, and rapid sand filtration (CSF), because it is unclear whether CSF can adequately remove SPAC from the water. In this study, we therefore investigated the residual SPAC particles in water after CSF treatment. First, we developed a method to detect and quantify trace concentration of carbon particles in the sand filtrate. This method consisted of 1) sampling particles with a membrane filter and then 2) using image analysis software to manipulate a photomicrograph of the filter so that black spots with a diameter >0.2 μm (considered to be carbon particles) could be visualized. Use of this method revealed that CSF removed a very high percentage of SPAC: approximately 5-log in terms of particle number concentrations and approximately 6-log in terms of particle volume concentrations. When waters containing 7.5-mg/L SPAC and 30-mg/L PAC, concentrations that achieved the same adsorption performance, were treated, the removal rate of SPAC was somewhat superior to that of PAC, and the residual particle number concentrations for SPAC and PAC were at the same low level (100-200 particles/mL). Together, these results suggest that SPAC can be used in place of PAC in CSF treatment without compromising the quality of the filtered water in terms of particulate matter contamination. However, it should be noted that the activated carbon particles after sand filtration were smaller in terms of particle size and were charge-neutralized to a lesser extent than the activated carbon particles before sand filtration. Therefore, the tendency of small particles to escape in the filtrate would appear to be related to the fact that their small size leads to a low destabilization rate during the coagulation process and a low collision rate during the flocculation and filtration processes. Copyright © 2018 Elsevier Ltd. All rights reserved.
Abdollahpour, Ibrahim; Nedjat, Saharnaz; Salimi, Yahya
2018-01-01
Now positive aspect of caregiving (PAC) is well-defined as caregiver gains, satisfaction, meaningful life, and enhanced family relationship. The adjusted association of PAC and caregiver burden is not well acknowledged. This study investigated the association of caregiver burden and PAC adjusting for potential confounders. This was a cross-sectional study that recruited 132 caregivers. A linear regression model with PAC was used to estimate the adjusted associations. The caregiver burden was negatively associated with PAC (mean difference in PAC per a 1-unit increase in caregiver burden = -0.12, 95% confidence interval: -0.18 to -0.056; P < .001). This association remained after adjustment for caregivers' age and marital status as well as patients' dependency level. The negative significant association of caregiver burden with PAC reinforces the need for interventional and/or educational programs aiming at decreasing the overall imposed burden. This can play an important role in improving caregivers' general health and quality of life.
Jeong, Sanghyun; Rice, Scott A; Vigneswaran, Saravanamuthu
2014-08-01
Submerged membrane adsorption bio-reactors (SMABR) were investigated as a new pretreatment for seawater reverse osmosis (SWRO) desalination. They were tested with different doses of powder activated carbon (PAC) on-site for a long-term. The biofouling on the membrane was assessed in terms of DNA (cells) and polysaccharide distribution. MBR without PAC addition resulted in severe fouling on membrane. When PAC is added in the MBR, PAC could reduce the organic fouling. Hence the biofilm formation on membrane was reduced without any membrane damage. PAC also helped to remove low molecular weight (LMW) organics responsible for biofouling of RO membrane. A linear correlation between assimilable organic carbon (AOC) and LMW organics was observed. A small amount of PAC (2.4-8.0g of PAC/m(3) of seawater) was sufficient to reduce biofouling. It indicated that SMABR is an environmentally-friendly biological pretreatment to reduce biofouling for SWRO. Copyright © 2014 Elsevier Ltd. All rights reserved.
Electronic hand-drafting and picture management system.
Yang, Tsung-Han; Ku, Cheng-Yuan; Yen, David C; Hsieh, Wen-Huai
2012-08-01
The Department of Health of Executive Yuan in Taiwan (R.O.C.) is implementing a five-stage project entitled Electronic Medical Record (EMR) converting all health records from written to electronic form. Traditionally, physicians record patients' symptoms, related examinations, and suggested treatments on paper medical records. Currently when implementing the EMR, all text files and image files in the Hospital Information System (HIS) and Picture Archiving and Communication Systems (PACS) are kept separate. The current medical system environment is unable to combine text files, hand-drafted files, and photographs in the same system, so it is difficult to support physicians with the recording of medical data. Furthermore, in surgical and other related departments, physicians need immediate access to medical records in order to understand the details of a patient's condition. In order to address these problems, the Department of Health has implemented an EMR project, with the primary goal of building an electronic hand-drafting and picture management system (HDP system) that can be used by medical personnel to record medical information in a convenient way. This system can simultaneously edit text files, hand-drafted files, and image files and then integrate these data into Portable Document Format (PDF) files. In addition, the output is designed to fit a variety of formats in order to meet various laws and regulations. By combining the HDP system with HIS and PACS, the applicability can be enhanced to fit various scenarios and can assist the medical industry in moving into the final phase of EMR.
PACS for Bhutan: a cost effective open source architecture for emerging countries.
Ratib, Osman; Roduit, Nicolas; Nidup, Dechen; De Geer, Gerard; Rosset, Antoine; Geissbuhler, Antoine
2016-10-01
This paper reports the design and implementation of an innovative and cost-effective imaging management infrastructure suitable for radiology centres in emerging countries. It was implemented in the main referring hospital of Bhutan equipped with a CT, an MRI, digital radiology, and a suite of several ultrasound units. They lacked the necessary informatics infrastructure for image archiving and interpretation and needed a system for distribution of images to clinical wards. The solution developed for this project combines several open source software platforms in a robust and versatile archiving and communication system connected to analysis workstations equipped with a FDA-certified version of the highly popular Open-Source software. The whole system was implemented on standard off-the-shelf hardware. The system was installed in three days, and training of the radiologists as well as the technical and IT staff was provided onsite to ensure full ownership of the system by the local team. Radiologists were rapidly capable of reading and interpreting studies on the diagnostic workstations, which had a significant benefit on their workflow and ability to perform diagnostic tasks more efficiently. Furthermore, images were also made available to several clinical units on standard desktop computers through a web-based viewer. • Open source imaging informatics platforms can provide cost-effective alternatives for PACS • Robust and cost-effective open architecture can provide adequate solutions for emerging countries • Imaging informatics is often lacking in hospitals equipped with digital modalities.
NASA Astrophysics Data System (ADS)
Zhang, L.; Cheng, I.; Muir, D.; Charland, J.-P.
2015-02-01
The Athabasca oil sands industry in northern Alberta, Canada, is a possible source of polycyclic aromatic compounds (PACs). Monitored PACs, including polycyclic aromatic hydrocarbons (PAHs), alkylated PAHs, and dibenzothiophenes (DBTs), in precipitation and in air at three near-source sites in the Fort MacKay and Fort McMurray area during January 2011 to May 2012, were used to generate a database of scavenging ratios (Wt) for PACs scavenged by both snow and rain. Higher concentrations in precipitation and air were observed for alkylated PAHs and DBTs compared to the other PACs. The sums of the median precipitation concentrations over the period of data analyzed were 0.48 μ g L-1 for the 18 PAHs, 3.38 μ g L-1 for the 20 alkylated PAHs, and 0.94 μ g L-1 for the 5 DBTs. The sums of the median air concentrations for parent PAHs, alkylated PAHs, and DBTs were 8.37, 67.26, and 11.83 ng m-3, respectively. Median Wt over the measurement period were 6100 - 1.1 × 106 from snow scavenging and 350 - 2.3 × 105 from rain scavenging depending on the PAC species. Median Wt for parent PAHs were within the range of those observed at other urban and suburban locations, but Wt for acenaphthylene in snow samples were 2-7 times higher compared to other urban and suburban locations. Wt for some individual snow and rain samples exceeded literature values by a factor of 10. Wt for benzo(a)pyrene, dibenz(a,h)anthracene, and benzo(g,h,i)perylene in snow samples had reached 107, which is the maximum for PAH snow scavenging ratios reported in the literature. From the analysis of data subsets, Wt for particulate-phase dominant PACs were 14-20 times greater than gas-phase dominant PACs in snow samples and 7-20 times greater than gas-phase dominant PACs in rain samples. Wt from snow scavenging were ~ 9 times greater than from rain scavenging for particulate-phase dominant PACs and 4-9.6 times greater than from rain scavenging for gas-phase dominant PACs. Gas-particle fractions of each PAC, particle size distributions of particulate-phase dominant PACs, and the Henry's law constant of gas-phase dominant PACs explained, to a large extent, the different Wt values among the different PACs and precipitation types. The trend in Wt with increasing alkyl substitutions may be attributed to their physico-chemical properties, such as octanol-air and particle partition coefficients and subcooled vapor pressure, which increases gas-particle partitioning and, subsequently, the particulate mass fraction. This study verified findings from a previous study of Wang et al. (2014) that suggested that snow scavenging is more efficient than rain scavenging of particles for equivalent precipitation amounts, and also provided new knowledge of the scavenging of gas-phase PACs and alkylated PACs by snow and rain.
H-ATLAS: PACS imaging for the Science Demonstration Phase
NASA Astrophysics Data System (ADS)
Ibar, Edo; Ivison, R. J.; Cava, A.; Rodighiero, G.; Buttiglione, S.; Temi, P.; Frayer, D.; Fritz, J.; Leeuw, L.; Baes, M.; Rigby, E.; Verma, A.; Serjeant, S.; Müller, T.; Auld, R.; Dariush, A.; Dunne, L.; Eales, S.; Maddox, S.; Panuzzo, P.; Pascale, E.; Pohlen, M.; Smith, D.; de Zotti, G.; Vaccari, M.; Hopwood, R.; Cooray, A.; Burgarella, D.; Jarvis, M.
2010-11-01
We describe the reduction of data taken with the PACS instrument on board the Herschel Space Observatory in the Science Demonstration Phase of the Herschel-ATLAS (H-ATLAS) survey, specifically data obtained for a 4 × 4 deg2 region using Herschel's fast-scan (60arcsecs-1) parallel mode. We describe in detail a pipeline for data reduction using customized procedures within HIPE from data retrieval to the production of science-quality images. We found that the standard procedure for removing cosmic ray glitches also removed parts of bright sources and so implemented an effective two-stage process to minimize these problems. The pronounced 1/f noise is removed from the timelines using 3.4- and 2.5-arcmin boxcar high-pass filters at 100 and 160μm. Empirical measurements of the point spread function (PSF) are used to determine the encircled energy fraction as a function of aperture size. For the 100- and 160-μm bands, the effective PSFs are ~9 and ~13arcsec (FWHM), and the 90-per cent encircled energy radii are 13 and 18arcsec. Astrometric accuracy is good to <~2arcsec. The noise in the final maps is correlated between neighbouring pixels and rather higher than advertised prior to launch. For a pair of cross-scans, the 5σ point-source sensitivities are 125-165mJy for 9-13 arcsec radius apertures at 100μm and 150-240mJy for 13-18 arcsec radius apertures at 160μm.
Amosa, Mutiu K
2016-08-01
Sorption optimization and mechanism of hardness and alkalinity on bifunctional empty fruit bunch-based powdered activation carbon (PAC) were studied. The PAC possessed both high surface area and ion-exchange properties, and it was utilized in the treatment of biotreated palm oil mill effluent. Batch adsorption experiments designed with Design Expert(®) were conducted in correlating the singular and interactive effects of the three adsorption parameters: PAC dosage, agitation speed and contact time. The sorption trends of the two contaminants were sequentially assessed through a full factorial design with three factor interaction models and a central composite design with polynomial models of quadratic order. Analysis of variance revealed the significant factors on each design response with very high R(2) values indicating good agreement between model and experimental values. The optimum operating conditions of the two contaminants differed due to their different regions of operating interests, thus necessitating the utility of desirability factor to get consolidated optimum operation conditions. The equilibrium data for alkalinity and hardness sorption were better represented by the Langmuir isotherm, while the pseudo-second-order kinetic model described the adsorption rates and behavior better. It was concluded that chemisorption contributed majorly to the adsorption process.
Liu, Y Y; Wang, C; Luo, P F; Xia, Z F
2017-11-20
Objective: To establish 3-{4-[2-hydroxyl-(1-methylethylamino) propoxy] phenyl} propionic acid cetylesters (PAC) modified nanoparticles, and preliminarily explore its cardiomyocyte-targeting function and protection effects on myocardium. Methods: (1) HL-1 myocardial cells were divided into cyanidin-3 (Cy3) marked non-targeted small interference RNA (Cy3-siNC) group and Cy3 marked small interference RNA designed for the nuclear factor kappa B (NF-κB)-p65 gene (Cy3-si435) group according to the random number table, with 3 wells in each group. Cells in Cy3-siNC group were transfected with Cy3-siNC, while cells in Cy3-si435 group were transfected with Cy3-si435. At transfection hour 24, the mRNA expression of NF-κB-p65 of cells was determined by real-time fluorescent quantitative polymerase chain reaction. (2) Multiple emulsificating solvent evaporating method was adopted to prepare PAC modified nanoparticles carried with Cy3-siNC (Cy3-siNC-PAC) and PAC modified nanoparticles carried with Cy3-si435 (Cy3-si435-PAC). The morphology of Cy3-si435-PAC nanoparticles was observed with scanning electron microscope, and the size and potential of Cy3-si435-PAC nanoparticles were detected by nanometer particle size and zeta potential analyzer. The entrapment efficiency and drug loadings of Cy3-si435-PAC nanoparticle were determined with ultraviolet spectrophotometer. The release of Cy3-si435 of Cy3-si435-PAC nanoparticles was determined by dialysis method. (3) Another batch of HL-1 cells were divided into 4 groups according to the random number table, with 9 wells in each group. Cells in negative control group were added with 5 μL phosphate buffer. Cells in 25, 50, and 100 mg/mL Cy3-si435-PAC nanoparticles groups were added with 5 μL 25, 50, and 100 mg/mL Cy3-si435-PAC nanoparticles, respectively. At transfection hour 6, 12, and 24, proliferation activity of cells in 3 wells of each group was detected by methyl thiazolyl tetrazolium method, respectively. (4) Another batch of HL-1 cells were cultured for 24 h, and then treated with 100 μL Cy3-si435-PAC nanoparticles. At transfection hour 0, 4, 8, 12, and 24, the percentage of cells uptaking Cy3-si435-PAC nanoparticles in 3 wells were detected by flow cytometry, respectively. (5) Another batch of HL-1 cells were divided into 2 groups according to the random number table, with 3 wells in each group. Cells in Cy3-siNC-PAC group were added with 100 μL Cy3-siNC-PAC nanoparticles, while cells in Cy3-si435-PAC group were added with 100 μL Cy3-si435-PAC nanoparticles. At transfection hour 24, the mRNA expression of NF-κB-p65 of cells was determined by real-time fluorescent quantitative polymerase chain reaction. (6) Six male C57BL/6J mice were divided into 2 groups according to the random number table, with 3 mice in each group. Mice in Cy3-siNC-lipopolysaccharide (LPS) group and Cy3-si435-LPS group were respectively injected with 500 μL Cy3-siNC-PAC nanoparticles and Cy3-si435-PAC nanoparticles (50 mg/mL) in the tail vein. At injection hour 24, mice in the two groups were intraperitoneally injected with 10 mg/kg LPS to induce myocardial injury. At post injury hour 24, the distribution of nanoparticles in mice was detected with small animal imager. (7) Another 9 male C57BL/6J mice were divided into 3 groups according to the random number table, with 3 mice in each group. Mice in Cy3-siNC-normal saline (NS) group and Cy3-siNC-LPS group were injected with 500 μL 50 mg/mL Cy3-siNC-PAC nanoparticles in the tail vein, while mice in Cy3-si435-LPS group were injected with 500 μL 50 mg/mL Cy3-si435-PAC nanoparticles. At injection hour 24, mice in Cy3-siNC-NS group were intraperitoneally injected with NS, while mice in Cy3-siNC-LPS group and Cy3-si435-LPS group were injected with 10 mg/kg LPS to induce myocardial injury. At post injury hour 24, pathological changes of myocardium of mice in each group were observed with HE staining. Data were processed with t test and one-way analysis of variance. Results: (1) The mRNA expression of NF-κB-p65 of cells in Cy3-si435 group was 0.183±0.004, significantly lower than 1.003±0.092 in Cy3-siNC group ( t =15.46, P <0.01). (2) The form of prepared Cy3-si435-PAC nanoparticles was good, with particle size of 146.0 nm, potential of -29.2 mV, entrapment efficiency of (86.9±1.1) %, drug loadings of (25.4±0.9) %, and stable Cy3-si435 release. (3) At transfection hour 6, 12, and 24, there were no statistically significant differences in proliferation activity of cells in the 4 groups (with F values from 0.129 to 2.512, P values above 0.05). (4) At transfection hour 0, 4, 8, 12, and 24, the percentages of cells uptaking Cy3-si435-PAC nanoparticles were (0.79±0.06)%, (31.04±1.59)%, (51.64±2.67)%, (68.15±2.60)%, and (83.68±4.67)%, respectively. (5) The mRNA expression of NF-κB-p65 of cells in Cy3-si435-PAC group was 0.286±0.015, significantly lower than 1.002±0.073 in Cy3-siNC-PAC group ( t =16.62, P <0.01). (6) At post injury hour 24, uniform distribution of nanoparticles could be observed in cardiomyocytes of mice in Cy3-siNC-LPS group and Cy3-si435-LPS group. (7) The structure of myocardial fibers of mice in Cy3-siNC-NS group was dense, with no inflammatory cells infiltration and uniform distribution of cytoplasm. The structure of myocardial fibers of mice in Cy3-siNC-LPS group were loose, with inflammatory cells infiltration and scattered distribution of cytoplasm. The structure of myocardial fibers of mice in Cy3-si435-LPS group was denser, with no obvious inflammatory cells infiltration and uniform distribution of cytoplasm. Conclusions: Cy3-si435-PAC nanoparticles have good morphology, uniform particle size, normal potential distribution, and no cell cytotoxicity. Cy3-si435-PAC nanoparticles can be effectively uptaked by HL-1 cells and suppress NF-κB-p65 mRNA expression. They also can effectively target to mice cardiomyocytes to reduce inflammatory cells infiltration and alleviate the myocardial injury of mice induced by LPS.
Goyak, Katy O; Kung, Ming H; Chen, Min; Aldous, Keith K; Freeman, James J
2016-12-15
Residual aromatic extracts (RAE) are petroleum substances with variable composition predominantly containing aromatic hydrocarbons with carbon numbers greater than C25. Because of the high boiling nature of RAEs, the aromatics present are high molecular weight, with most above the range of carcinogenic polycyclic aromatic hydrocarbons (PAHs). However, refinery distillations are imperfect; some PAHs and their heteroatom-containing analogs (collectively referred to as polycyclic aromatic content or PAC) may remain in the parent stream and be extracted into the RAE, and overall PAC content is related to the carcinogenic potential of an RAE. We describe here a real-time analytical chemistry-based tool to assess the carcinogenic hazard of RAE via the development of a functional relationship between carcinogenicity and boiling point. Samples representative of steps along the RAE manufacturing process were obtained from five refineries to evaluate relationships between mutagenicity index (MI), PAC ring content and gas chromatographic distillation (GCD) curves. As expected, a positive linear relationship between MI and PAC ring content occurred, most specifically for 3-6 ring PAC (R 2 =0.68). A negative correlation was found between MI and temperature at 5% vaporization by GCD (R 2 =0.72), indicating that samples with greater amounts of lower boiling constituents were more likely to be carcinogenic. The inverse relationship between boiling range and carcinogenicity was further demonstrated by fractionation of select RAE samples (MI=0.50+0.07; PAC=1.70+0.51wt%; n=5) into low and high boiling fractions, where lower boiling fractions were both more carcinogenic than the higher boiling fractions (MI=2.36±0.55 and 0.17±0.11, respectively) and enriched in 3-6 ring PACs (5.20+0.70wt% and 0.97+0.35wt%, respectively). The criteria defining carcinogenicity was established as 479°C for the 5% vaporization points by GCD, with an approximate 95% probability of a future sample having an MI below the recommended limit of 0.4 for RAEs. Overall, these results provide a cost-efficient and real-time tool by which the carcinogenic potential of RAEs can be assessed at the refinery level, ultimately providing a means to readily monitor and minimize the carcinogenic potential of RAEs. Copyright © 2016. Published by Elsevier Ireland Ltd.
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.
Lee, Natalie; Thompson, Nicolas R; Passek, Sandra; Stilphen, Mary; Katzan, Irene L
2017-11-01
The Activity Measure for Post-Acute Care (AM-PAC) is a generic metric of patient-reported functional status. The minimal clinically important difference (MCID) in the AM-PAC score has not been determined. The study objective was to determine the MCID for AM-PAC in people with low back pain. This was a retrospective cohort study. Anchor-based and distribution-based methods were used to estimate the MCID. The Modified Low Back Pain Disability Questionnaire was used as the anchor. Adults who had a primary ICD-9 code for low back pain in at least 1 outpatient physical therapist visit during an episode of care and who completed both the AM-PAC and the Modified Low Back Pain Disability Questionnaire in at least 2 visits during the care episode were included. The MCID was calculated for the AM-PAC basic mobility version as well its adapted version, which the Cleveland Clinic uses for patients 65 years old or older. A total of 1,271 participants were eligible for study. For the AM-PAC basic mobility version, anchor-based methods yielded MCID estimates of between 3.4 and 5.1, whereas distribution-based methods yielded estimates of 1.7 to 4.2. The minimal detectable change (MDC) for the AM-PAC basic mobility version was 3.3. For the adapted AM-PAC basic mobility version, the MCID was estimated to be between 2.9 and 4.0 via anchor-based methods and between 1.2 to 3.5 via distribution-based methods. The MDC for the adapted AM-PAC basic mobility version was 3.5. The estimated MCID was designed for people with low back pain only. The MCID ranged from 3.3 to 5.1 for the AM-PAC basic mobility version and 3.5 to 4 for the adapted version, with the MDC as the lower limit. Changes in the AM-PAC for people with low back pain may be interpreted using the estimated MCID. Future studies are needed to determine the AM-PAC MCID for populations other than those with low back pain. © 2017 American Physical Therapy Association
[Wish and reality in installation of a clinic-wide system for image and documentation access].
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.
Integration of digital gross pathology images for enterprise-wide access.
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
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
Launey, Yoann; Larmet, Raphaëlle; Nesseler, Nicolas; Malledant, Yannick; Palpacuer, Clément; Seguin, Philippe
2016-05-01
Pulmonary artery catheters (PACs) are frequently used for monitoring patient temperatures in the intensive care unit. Nevertheless, data regarding the accuracy of these measurements are lacking, and few data testify to the accuracy of temperatures recorded after the PAC has been in place for several days. The absolute values of such measurements are relevant for critical care because patient temperatures are often used as diagnostic criteria for sepsis and antibiotic therapy. We thus hypothesized that the Edwards Lifesciences PAC would accurately measure blood temperature. To test our hypothesis, we compared temperature measurements obtained from PACs inserted in patients for different lengths of time with measurements of a reference platinum resistance thermometer (PRT). PACs were removed and analyzed in 39 patients in whom PACs were inserted for 0 to 5 days. The PACs were placed in calibration baths, and 10 consecutive measurements at each of 7 different temperatures were obtained (36°C, 36.5°C, 37°C, 38°C, 38.3°C, 39°C, and 40°C). The temperature measurements obtained using PACs were compared with measurements obtained using a PRT. Bland-Altman statistical analyses were performed. Outliers, defined as PAC temperature measurements that varied more than ±0.3°C from PRT measurements, were identified. We considered a catheter unfit for clinical diagnostic or therapeutic use if ≥15% of data pairs were outliers. A total of 2730 data pairs were analyzed. Overall, the bias was -0.15°C; the precision was +0.13°C; and the limits of agreement were -0.45°C to +0.13°C. The bias and limits of agreement did not differ according to the age of the catheter or the temperature tested. One hundred fourteen data pairs (4.2% [95% confidence interval, 2.0%-6.4%]), involving 13 PACs and mostly from 4 PACs, were outliers. We conclude that temperature measurements obtained using the Edwards Lifesciences PACs are thus sufficiently accurate to be used for clinical temperature monitoring in critically ill patients.
Xue, Runmiao; Donovan, Ariel; Zhang, Haiting; Ma, Yinfa; Adams, Craig; Yang, John; Hua, Bin; Inniss, Enos; Eichholz, Todd; Shi, Honglan
2018-02-01
When adding sufficient chlorine to achieve breakpoint chlorination to source water containing high concentration of ammonia during drinking water treatment, high concentrations of disinfection by-products (DBPs) may form. If N-nitrosamine precursors are present, highly toxic N-nitrosamines, primarily N-nitrosodimethylamine (NDMA), may also form. Removing their precursors before disinfection should be a more effective way to minimize these DBPs formation. In this study, zeolites and activated carbon were examined for ammonia and N-nitrosamine precursor removal when incorporated into drinking water treatment processes. The test results indicate that Mordenite zeolite can remove ammonia and five of seven N-nitrosamine precursors efficiently by single step adsorption test. The practical applicability was evaluated by simulation of typical drinking water treatment processes using six-gang stirring system. The Mordenite zeolite was applied at the steps of lime softening, alum coagulation, and alum coagulation with powdered activated carbon (PAC) sorption. While the lime softening process resulted in poor zeolite performance, alum coagulation did not impact ammonia and N-nitrosamine precursor removal. During alum coagulation, more than 67% ammonia and 70%-100% N-nitrosamine precursors were removed by Mordenite zeolite (except 3-(dimethylaminomethyl)indole (DMAI) and 4-dimethylaminoantipyrine (DMAP)). PAC effectively removed DMAI and DMAP when added during alum coagulation. A combination of the zeolite and PAC selected efficiently removed ammonia and all tested seven N-nitrosamine precursors (dimethylamine (DMA), ethylmethylamine (EMA), diethylamine (DEA), dipropylamine (DPA), trimethylamine (TMA), DMAP, and DMAI) during the alum coagulation process. Copyright © 2017. Published by Elsevier B.V.
Improving the Quality of Postabortion Care Services in Togo Increased Uptake of Contraception
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
Williams, Andrew R; Klaver, Elsenoor J; Laan, Lisa C; Ramsay, Aina; Fryganas, Christos; Difborg, Rolf; Kringel, Helene; Reed, Jess D; Mueller-Harvey, Irene; Skov, Søren; van Die, Irma; Thamsborg, Stig M
2017-03-01
Interactions between dendritic cells (DCs) and environmental, dietary and pathogen antigens play a key role in immune homeostasis and regulation of inflammation. Dietary polyphenols such as proanthocyanidins (PAC) may reduce inflammation, and we therefore hypothesized that PAC may suppress lipopolysaccharide (LPS) -induced responses in human DCs and subsequent T helper type 1 (Th1) -type responses in naive T cells. Moreover, we proposed that, because DCs are likely to be exposed to multiple stimuli, the activity of PAC may synergise with other bioactive molecules that have anti-inflammatory activity, e.g. soluble products from the helminth parasite Trichuris suis (TsSP). We show that PAC are endocytosed by monocyte-derived DCs and selectively induce CD86 expression. Subsequently, PAC suppress the LPS-induced secretion of interleukin-6 (IL-6) and IL-12p70, while enhancing secretion of IL-10. Incubation of DCs with PAC did not affect lymphocyte proliferation; however, subsequent interferon-γ production was markedly suppressed, while IL-4 production was unaffected. The activity of PAC was confined to oligomers (degree of polymerization ≥ 4). Co-pulsing DCs with TsSP and PAC synergistically reduced secretion of tumour necrosis factor-α, IL-6 and IL-12p70 while increasing IL-10 secretion. Moreover, both TsSP and PAC alone induced Th2-associated OX40L expression in DCs, and together synergized to up-regulate OX40L. These data suggest that PAC induce an anti-inflammatory phenotype in human DCs that selectively down-regulates Th1 response in naive T cells, and that they also act cooperatively with TsSP. Our results indicate a novel interaction between dietary compounds and parasite products to influence immune function, and may suggest that combinations of PAC and TsSP can have therapeutic potential for inflammatory disorders. © 2016 John Wiley & Sons Ltd.
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
Java-based PACS and reporting system for nuclear medicine
NASA Astrophysics Data System (ADS)
Slomka, Piotr J.; Elliott, Edward; Driedger, Albert A.
2000-05-01
In medical imaging practice, images and reports often need be reviewed and edited from many locations. We have designed and implemented a Java-based Remote Viewing and Reporting System (JaRRViS) for a nuclear medicine department, which is deployed as a web service, at the fraction of the cost dedicated PACS systems. The system can be extended to other imaging modalities. JaRRViS interfaces to the clinical patient databases of imaging workstations. Specialized nuclear medicine applets support interactive displays of data such as 3-D gated SPECT with all the necessary options such as cine, filtering, dynamic lookup tables, and reorientation. The reporting module is implemented as a separate applet using Java Foundation Classes (JFC) Swing Editor Kit and allows composition of multimedia reports after selection and annotation of appropriate images. The reports are stored on the server in the HTML format. JaRRViS uses Java Servlets for the preparation and storage of final reports. The http links to the reports or to the patient's raw images with applets can be obtained from JaRRViS by any Hospital Information System (HIS) via standard queries. Such links can be sent via e-mail or included as text fields in any HIS database, providing direct access to the patient reports and images via standard web browsers.
Ramírez-Bahena, Martha Helena; Peix, Alvaro; Rivas, Raúl; Camacho, María; Rodríguez-Navarro, Dulce N; Mateos, Pedro F; Martínez-Molina, Eustoquio; Willems, Anne; Velázquez, Encarna
2009-08-01
Several strains isolated from the legume Pachyrhizus erosus were characterized on the basis of diverse genetic, phenotypic and symbiotic approaches. These novel strains formed two groups closely related to Bradyrhizobium elkanii according to their 16S rRNA gene sequences. Strains PAC48T and PAC68T, designated as the type strains of these two groups, presented 99.8 and 99.1% similarity, respectively, in their 16S rRNA gene sequences with respect to B. elkanii USDA 76T. In spite of these high similarity values, the analysis of additional phylogenetic markers such as atpD and glnII genes and the 16S-23S intergenic spacer (ITS) showed that strains PAC48T and PAC68T represented two separate novel species of the genus Bradyrhizobium with B. elkanii as their closest relative. Phenotypic differences among the novel strains isolated from Pachyrhizus and B. elkanii were found regarding the assimilation of carbon sources and antibiotic resistance. All these differences were congruent with DNA-DNA hybridization analysis which revealed 21% genetic relatedness between strains PAC48T and PAC68T and 46% and 25%, respectively, between these strains and B. elkanii LMG 6134T. The nodD and nifH genes of strains PAC48T and PAC68T were phylogenetically divergent from those of bradyrhizobia species that nodulate soybean. Soybean was not nodulated by the novel Pachyrhizus isolates. Based on the genotypic and phenotypic data obtained in this study, the new strains represent two novel species for which the names Bradyrhizobium pachyrhizi sp. nov. (type strain PAC48T=LMG 24246T=CECT 7396T) and Bradyrhizobium jicamae sp. nov. (type strain PAC68T=LMG 24556T=CECT 7395T) are proposed.
Long, Rachel M; Lappin-Scott, Hilary M; Stevens, Jamie R
2009-07-01
The degradation of polycyclic aromatic compounds (PACs) has been widely studied. Knowledge of the degradation of PACs by microbial populations can be utilized in the remediation of contaminated sites. To isolate and identify PAC-degrading bacteria for potential use in future bioremediation programmes, we established a series of PAC enrichments under the same experimental conditions from a single sediment sample taken from a highly polluted estuarine site. Enrichment cultures were established using the pollutants: anthracene, phenanthrene and dibenzothiophene as a sole carbon source. The shift in microbial community structure on each of these carbon sources was monitored by analysis of a time series of samples from each culture using 16S rRNA polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE). Significantly, our findings demonstrate that shifts in the constituent species within each degradative community are directly attributable to enrichment with different PACs. Subsequently, we characterized the microorganisms comprising the degradative communities within each enrichment using 16S rRNA sequence data. Our findings demonstrate that the ability to degrade PACs is present in five divisions of the Proteobacteria and Actinobacteria. By determining the precise identity of the PAC-degrading bacterial species isolated from a single sediment sample, and by comparing our findings with previously published research, we demonstrate how bacteria with similar PAC degrading capabilities and 16S rRNA signatures are found in similarly polluted environments in geographically very distant locations, e.g., China, Italy, Japan and Hawaii. Such a finding suggests that geographical barriers do not limit the distribution of key PAC-degrading bacteria; this finding is in accordance with the Baas-Becking hypothesis "everything is everywhere; the environment selects" and may have significant consequences for the global distribution of PAC-degrading bacteria and their use in bioremediation.
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.
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.
A study for watermark methods appropriate to medical images.
Cho, Y; Ahn, B; Kim, J S; Kim, I Y; Kim, S I
2001-06-01
The network system, including the picture archiving and communication system (PACS), is essential in hospital and medical imaging fields these days. Many medical images are accessed and processed on the web, as well as in PACS. Therefore, any possible accidents caused by the illegal modification of medical images must be prevented. Digital image watermark techniques have been proposed as a method to protect against illegal copying or modification of copyrighted material. Invisible signatures made by a digital image watermarking technique can be a solution to these problems. However, medical images have some different characteristics from normal digital images in that one must not corrupt the information contained in the original medical images. In this study, we suggest modified watermark methods appropriate for medical image processing and communication system that prevent clinically important data contained in original images from being corrupted.
Study of adsorption process of iron colloid substances on activated carbon by ultrasound
NASA Astrophysics Data System (ADS)
Machekhina, K. I.; Shiyan, L. N.; Yurmazova, T. A.; Voyno, D. A.
2015-04-01
The paper reports on the adsorption of iron colloid substances on activated carbon (PAC) Norit SA UF with using ultrasound. It is found that time of adsorption is equal to three hours. High-frequency electrical oscillation is 35 kHz. The adsorption capacity of activated carbon was determined and it is equal to about 0.25 mg iron colloid substances /mg PAC. The iron colloid substances size ranging from 30 to 360 nm was determined. The zeta potential of iron colloid substances which consists of iron (III) hydroxide, silicon compounds and natural organic substances is about (-38mV). The process of destruction iron colloid substances occurs with subsequent formation of a precipitate in the form of Fe(OH)3 as a result of the removal of organic substances from the model solution.
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.
The color removal of dye wastewater by magnesium chloride/red mud (MRM) from aqueous solution.
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.
Watson, Kalinda; Farré, Maria José; Knight, Nicole
2015-01-01
The removal of both organic and inorganic disinfection by-product (DBP) precursors prior to disinfection is important in mitigating DBP formation, with halide removal being particularly important in salinity-impacted water sources. A matrix of waters of variable alkalinity, halide concentration and dissolved organic carbon (DOC) concentration were treated with enhanced coagulation (EC) followed by anion exchange (MIEX resin) or powdered activated carbon (PAC) and the subsequent disinfection by-product formation potentials (DBP-FPs) assessed and compared to DBP-FPs for untreated samples. Halide and DOC removal were also monitored for both treatment processes. Bromide and iodide adsorption by MIEX treatment ranged from 0 to 53% and 4-78%, respectively. As expected, EC and PAC treatments did not remove halides. DOC removal by EC/PAC was 70 ± 10%, while EC/MIEX enabled a DOC removal of 66 ± 12%. Despite the halide removals achieved by MIEX, increases in brominated disinfection by-product (Br-DBP) formation were observed relative to untreated samples, when favourable Br:DOC ratios were created by the treatment. However, the increases in formation were less than what was observed for the EC/PAC treated waters, which caused large increases in Br-DBP formation when high Br-DBP-forming water quality conditions occurred. The formation potential of fully chlorinated DBPs decreased after treatment in all cases.
Wong, Daniel Fu Keung; Ng, Ting Kin; Zhuang, Xiao Yu
2018-05-21
This study endeavors to advance the current literature by examining the gender differences in the caregiving experiences and the stress-buffering role of positive aspects of caregiving (PAC) among Chinese spousal caregivers of frail elders in Hong Kong. Forty-nine husband caregivers and 121 wife caregivers of frail elders in Hong Kong (N = 170) responded to the Positive Aspects of Caregiving (PAC) scale, the Zarit Burden Interview (ZBI), the 21-item Depression, Anxiety, and Stress Scales (DASS-21), and demographic questions. These spousal caregivers were diverse in age, and their care receivers were diverse in terms of age and health condition. As predicted, there were significant gender differences in the moderating effects of PAC on the relationships of caregiving burden to depression, anxiety, and overall psychological distress. While PAC significantly buffered the effects of caregiving burden on depression, anxiety, and overall psychological distress for wife caregivers, the moderating effects of PAC were not significant for husband caregivers. Unexpectedly, wife caregivers reported lower PAC, higher caregiving burden, and higher psychological distress. As these findings suggest that PAC is lower but more beneficial for Chinese wife caregivers than Chinese husband caregivers, helping professionals are recommended to use strengths-based interventions that target PAC when working with Chinese wife caregivers.
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.
Informatics in radiology (infoRAD): A complete continuous-availability PACS archive server.
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
Tracking PACS usage with open source tools.
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.
Wong, Stephen T C; Tjandra, Donny; Wang, Huili; Shen, Weimin
2003-09-01
Few information systems today offer a flexible means to define and manage the automated part of radiology processes, which provide clinical imaging services for the entire healthcare organization. Even fewer of them provide a coherent architecture that can easily cope with heterogeneity and inevitable local adaptation of applications and can integrate clinical and administrative information to aid better clinical, operational, and business decisions. We describe an innovative enterprise architecture of image information management systems to fill the needs. Such a system is based on the interplay of production workflow management, distributed object computing, Java and Web techniques, and in-depth domain knowledge in radiology operations. Our design adapts the approach of "4+1" architectural view. In this new architecture, PACS and RIS become one while the user interaction can be automated by customized workflow process. Clinical service applications are implemented as active components. They can be reasonably substituted by applications of local adaptations and can be multiplied for fault tolerance and load balancing. Furthermore, the workflow-enabled digital radiology system would provide powerful query and statistical functions for managing resources and improving productivity. This paper will potentially lead to a new direction of image information management. We illustrate the innovative design with examples taken from an implemented system.
[Adsorption of perfluorooctanesulfonate (PFOS) onto modified activated carbons].
Tong, Xi-Zhen; Shi, Bao-You; Xie, Yue; Wang, Dong-Sheng
2012-09-01
Modified coal and coconut shell based powdered activated carbons (PACs) were prepared by FeCl3 and medium power microwave treatment, respectively. Batch experiments were carried out to evaluate the characteristics of adsorption equilibrium and kinetics of perfluorooctanesulfonate (PFOS) onto original and modified PACs. Based on pore structure and surface functional groups characterization, the adsorption behaviors of modified and original PACs were compared. The competitive adsorption of humic acid (HA) and PFOS on original and modified coconut shell PACs were also investigated. Results showed that both Fe3+ and medium power microwave treatments changed the pore structure and surface functional groups of coal and coconut shell PACs, but the changing effects were different. The adsorption of PFOS on two modified coconut shell-based PACs was significantly improved. While the adsorption of modified coal-based activated carbons declined. The adsorption kinetics of PFOS onto original and modified coconut shell-based activated carbons were the same, and the time of reaching adsorption equilibrium was about 6 hours. In the presence of HA, the adsorption of PFOS by modified PAC was reduced but still higher than that of the original.
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.
NASA Technical Reports Server (NTRS)
Grantham, William D.; Person, Lee H., Jr.; Brown, Philip W.; Becker, Lawrence E.; Hunt, George E.; Rising, J. J.; Davis, W. J.; Willey, C. S.; Weaver, W. A.; Cokeley, R.
1985-01-01
Piloted simulation studies have been conducted to evaluate the effectiveness of two pitch active control systems (PACS) on the flying qualities of a wide-body transport airplane when operating at negative static margins. These two pitch active control systems consisted of a simple 'near-term' PACS and a more complex 'advanced' PACS. Eight different flight conditions, representing the entire flight envelope, were evaluated with emphasis on the cruise flight conditions. These studies were made utilizing the Langley Visual/Motion Simulator (VMS) which has six degrees of freedom. The simulation tests indicated that (1) the flying qualities of the baseline aircraft (PACS off) for the cruise and other high-speed flight conditions were unacceptable at center-of-gravity positions aft of the neutral static stability point; (2) within the linear static stability flight envelope, the near-term PACS provided acceptable flying qualities for static stabilty margins to -3 percent; and (3) with the advanced PACS operative, the flying qualities were demonstrated to be good (satisfactory to very acceptable) for static stabilty margins to -20 percent.
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.
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.
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.
The Logistics Of Installing Pacs In An Existing Medical Center
NASA Astrophysics Data System (ADS)
Saarinen, Allan O.; Goodsitt, Mitchell M.; Loop, John W.
1989-05-01
A largely overlooked issue in the Picture Archiving and Communication Systems (PACS) area is the tremendous amount of site planning activity required to install such a system in an existing medical center. Present PACS equipment requires significant hospital real estate, specialized electrical power, cabling, and environmental controls to operate properly. Marshaling the hospital resources necessary to install PACS equipment requires many different players. The site preparation costs are nontrivial and usually include a number of hidden expenses. This paper summarizes the experience of the University of Washington Department of Radiology in installing an extensive digital imaging network (DIN) and PACS throughout the Department and several clinics in the hospital. The major logistical problems encountered at the University are discussed, a few recommendations are made, and the installation costs are documented. Overall, the University's site preparation costs equalled about seven percent (7%) of the total PACS equipment expenditure at the site.
Scavenging ratio of polycyclic aromatic compounds in rain and snow at the Athabasca oil sands region
NASA Astrophysics Data System (ADS)
Zhang, L.; Cheng, I.; Muir, D.; Charland, J.-P.
2014-07-01
Athabasca oil sands industry in northern Alberta, Canada is a possible source of polycyclic aromatic compounds (PACs). Monitored PACs, including polycyclic aromatic hydrocarbons (PAHs), alkylated PAHs, and dibenzothiophenes, in precipitation and in air at three near-source sites in the Fort MacKay and Fort McMurray area during May 2011 to August 2012 were analyzed to generate a database of scavenging (or washout) ratios (Wt) for PACs scavenged by both snow and rain. Median precipitation and air concentrations of parent PAHs over the May 2011 to August 2012 period ranged from 0.3-184.9 (chrysene) ng L-1 and 0.01-3.9 (naphthalene) ng m-3, respectively, which were comparable to literature values. Higher concentrations in precipitation and air were observed for alkylated PAHs and dibenzothiophenes. The median precipitation and air concentrations were 11.3-646.7 (C3-fluoranthene/pyrene) ng L-1 and 0.21-16.9 (C3-naphthalene) ng m-3, respectively, for alkylated PAHs, and 8.5-530.5 (C4-dibenzothiophene) ng L-1 and 0.13-6.6 (C2-dibenzothiophene) ng m-3 for dibenzothiophenes and their alkylated derivatives. Median Wt over the measurement period were 6100-1.1 × 106 from snow scavenging and 350-2.3 × 105 from rain scavenging depending on the PAC species. Median Wt for parent PAHs were within the range of those observed at other urban and suburban locations. But Wt for acenaphthylene in snow samples was 2-7 times higher. Some individual snow and rain samples exceeded literature values by a factor of 10. Wt for benzo(a)pyrene, dibenz(a,h)anthracene, and benzo(g,h,i)perylene in snow samples had reached 107, which is the maximum for PAH snow scavenging ratios reported in literature. From the analysis of data subsets, Wt for particulate-phase dominant PACs were 14-20 times greater than gas-phase dominant PACs in snow samples and 7-20 times greater than gas-phase dominant PACs in rain samples. Wt from snow scavenging was ∼9 times greater than rain scavenging for particulate-phase dominant PACs and 4-9.6 times greater than rain scavenging for gas-phase dominant PACs. Gas-particle fractions of each PAC, particle size distributions of particulate-phase dominant PACs, and Henry's Law constant of gas-phase dominant PACs explained, to a large extent, the different Wt values among the different PACs and precipitation types. This study verified findings from a previous study of Wang et al. (2014) which suggested that snow scavenging is more efficient than rain scavenging of particles for equivalent precipitation amount, and also provided new knowledge on the scavenging of gas-phase PACs by snow and rain.
Hultman, Charles Scott; Gilland, Wendell G; Weir, Samuel
2015-06-01
Inefficient patient throughput in a surgery practice can result in extended new patient backlogs, excessively long cycle times in the outpatient clinics, poor patient satisfaction, decreased physician productivity, and loss of potential revenue. This project assesses the efficacy of multiple throughput interventions in an academic, plastic surgery practice at a public university. We implemented a Patient Access and Efficiency (PAcE) initiative, funded and sponsored by our health care system, to improve patient throughput in the outpatient surgery clinic. Interventions included: (1) creation of a multidisciplinary team, led by a project redesign manager, that met weekly; (2) definition of goals, metrics, and target outcomes; 3) revision of clinic templates to reflect actual demand; 4) working down patient backlog through group visits; 5) booking new patients across entire practice; 6) assigning a physician's assistant to the preoperative clinic; and 7) designating a central scheduler to coordinate flow of information. Main outcome measures included: patient satisfaction using Press-Ganey surveys; complaints reported to patient relations; time to third available appointment; size of patient backlog; monthly clinic volumes with utilization rates and supply/demand curves; "chaos" rate (cancellations plus reschedules, divided by supply, within 48 hours of booked clinic date); patient cycle times with bottleneck analysis; physician productivity measured by work Relative Value Units (wRVUs); and downstream financial effects on billing, collection, accounts receivable (A/R), and payer mix. We collected, managed, and analyzed the data prospectively, comparing the pre-PAcE period (6 months) with the PAcE period (6 months). The PAcE initiative resulted in multiple improvements across the entire plastic surgery practice. Patient satisfaction increased only slightly from 88.5% to 90.0%, but the quarterly number of complaints notably declined from 17 to 9. Time to third available new patient appointment dropped from 52 to 38 days, whereas the same metric for a preoperative appointment plunged from 46 to 16 days. The size of the new patient backlog fell from 169 to 110 patients, and total monthly clinic volume climbed from 574 to 766 patients. Our "chaos" rate dropped from 12.3% to 1.8%. Mean patient cycle time in the clinic decreased dramatically from 127 to 44 minutes. Mean monthly productivity for the practice increased from 2479 to 2702 RVUs. Although our collection rate did not change, days in A/R dropped from 66 to 57 days. Mean monthly charges increased from U.S. $535,213 to U.S. $583,193, and mean monthly collections improved from U.S. $181,967 to U.S. $210,987. Payer mix remained unchanged. Implementation of a PAcE initiative, focusing on outpatient clinic throughput, yields significant improvements in access to care, patient satisfaction as measured by complaints, physician productivity, and financial performance. An academic, university-based, plastic surgery practice can use throughput interventions to deliver timely care and to enhance financial viability.
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.
Rane, Hallie S.; Bernardo, Stella M.; Howell, Amy B.; Lee, Samuel A.
2014-01-01
Objectives Candida albicans is a common cause of nosocomial urinary tract infections (UTIs) and is responsible for increased morbidity and healthcare costs. Moreover, the US Centers for Medicare & Medicaid Services no longer reimburse for hospital-acquired catheter-associated UTIs. Thus, development of specific approaches for the prevention of Candida urinary infections is needed. Cranberry juice-derived proanthocyanidins (PACs) have efficacy in the prevention of bacterial UTIs, partially due to anti-adherence properties, but there are limited data on their use for the prevention and/or treatment of Candida UTIs. Therefore, we sought to systematically assess the in vitro effect of cranberry-derived PACs on C. albicans biofilm formation in artificial urine. Methods C. albicans biofilms in artificial urine were coincubated with cranberry PACs at serially increasing concentrations and biofilm metabolic activity was assessed using the XTT assay in static microplate and silicone disc models. Results Cranberry PAC concentrations of ≥16 mg/L significantly reduced biofilm formation in all C. albicans strains tested, with a paradoxical effect observed at high concentrations in two clinical isolates. Further, cranberry PACs were additive in combination with traditional antifungals. Cranberry PACs reduced C. albicans adherence to both polystyrene and silicone. Supplementation of the medium with iron reduced the efficacy of cranberry PACs against biofilms. Conclusions These findings indicate that cranberry PACs have excellent in vitro activity against C. albicans biofilm formation in artificial urine. We present preliminary evidence that cranberry PAC activity against C. albicans biofilm formation is due to anti-adherence properties and/or iron chelation. PMID:24114570
Rane, Hallie S; Bernardo, Stella M; Howell, Amy B; Lee, Samuel A
2014-02-01
Candida albicans is a common cause of nosocomial urinary tract infections (UTIs) and is responsible for increased morbidity and healthcare costs. Moreover, the US Centers for Medicare & Medicaid Services no longer reimburse for hospital-acquired catheter-associated UTIs. Thus, development of specific approaches for the prevention of Candida urinary infections is needed. Cranberry juice-derived proanthocyanidins (PACs) have efficacy in the prevention of bacterial UTIs, partially due to anti-adherence properties, but there are limited data on their use for the prevention and/or treatment of Candida UTIs. Therefore, we sought to systematically assess the in vitro effect of cranberry-derived PACs on C. albicans biofilm formation in artificial urine. C. albicans biofilms in artificial urine were coincubated with cranberry PACs at serially increasing concentrations and biofilm metabolic activity was assessed using the XTT assay in static microplate and silicone disc models. Cranberry PAC concentrations of ≥16 mg/L significantly reduced biofilm formation in all C. albicans strains tested, with a paradoxical effect observed at high concentrations in two clinical isolates. Further, cranberry PACs were additive in combination with traditional antifungals. Cranberry PACs reduced C. albicans adherence to both polystyrene and silicone. Supplementation of the medium with iron reduced the efficacy of cranberry PACs against biofilms. These findings indicate that cranberry PACs have excellent in vitro activity against C. albicans biofilm formation in artificial urine. We present preliminary evidence that cranberry PAC activity against C. albicans biofilm formation is due to anti-adherence properties and/or iron chelation.
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.
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.
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
Product Related Advantages of a Structured PACS Architecture
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.
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.
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.
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.
A Multimodal Search Engine for Medical Imaging Studies.
Pinho, Eduardo; Godinho, Tiago; Valente, Frederico; Costa, Carlos
2017-02-01
The use of digital medical imaging systems in healthcare institutions has increased significantly, and the large amounts of data in these systems have led to the conception of powerful support tools: recent studies on content-based image retrieval (CBIR) and multimodal information retrieval in the field hold great potential in decision support, as well as for addressing multiple challenges in healthcare systems, such as computer-aided diagnosis (CAD). However, the subject is still under heavy research, and very few solutions have become part of Picture Archiving and Communication Systems (PACS) in hospitals and clinics. This paper proposes an extensible platform for multimodal medical image retrieval, integrated in an open-source PACS software with profile-based CBIR capabilities. In this article, we detail a technical approach to the problem by describing its main architecture and each sub-component, as well as the available web interfaces and the multimodal query techniques applied. Finally, we assess our implementation of the engine with computational performance benchmarks.
Picture archiving and communication system--Part one: Filmless radiology and distance radiology.
De Backer, A I; Mortelé, K J; De Keulenaer, B L
2004-01-01
Picture archiving and communication system (PACS) is a collection of technologies used to carry out digital medical imaging. PACS is used to digitally acquire medical images from the various modalities, such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and digital projection radiography. The image data and pertinent information are transmitted to other and possibly remote locations over networks, where they may be displayed on computer workstations for soft copy viewing in multiple locations, thus permitting simultaneous consultations and almost instant reporting from radiologists at a distance. Data are secured and archived on digital media such as optical disks or tape, and may be automatically retrieved as necessary. Close integration with the hospital information system (HIS)--radiology information system (RIS) is critical for system functionality. Medical image management systems are maturing, providing access outside of the radiology department to images throughout the hospital via the Ethernet, at different hospitals, or from a home workstation if teleradiology has been implemented.
The biometric study in different stages of primary angle-closure glaucoma
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
NASA Astrophysics Data System (ADS)
Liang, Cunren; Zeng, Qiming; Jia, Jianying; Jiao, Jian; Cui, Xi'ai
2013-02-01
Scanning synthetic aperture radar (ScanSAR) mode is an efficient way to map large scale geophysical phenomena at low cost. The work presented in this paper is dedicated to ScanSAR interferometric processing and its implementation by making full use of existing standard interferometric synthetic aperture radar (InSAR) software. We first discuss the properties of the ScanSAR signal and its phase-preserved focusing using the full aperture algorithm in terms of interferometry. Then a complete interferometric processing flow is proposed. The standard ScanSAR product is decoded subswath by subswath with burst gaps padded with zero-pulses, followed by a Doppler centroid frequency estimation for each subswath and a polynomial fit of all of the subswaths for the whole scene. The burst synchronization of the interferometric pair is then calculated, and only the synchronized pulses are kept for further interferometric processing. After the complex conjugate multiplication of the interferometric pair, the residual non-integer pulse repetition interval (PRI) part between adjacent bursts caused by zero padding is compensated by resampling using a sinc kernel. The subswath interferograms are then mosaicked, in which a method is proposed to remove the subswath discontinuities in the overlap area. Then the following interferometric processing goes back to the traditional stripmap processing flow. A processor written with C and Fortran languages and controlled by Perl scripts is developed to implement these algorithms and processing flow based on the JPL/Caltech Repeat Orbit Interferometry PACkage (ROI_PAC). Finally, we use the processor to process ScanSAR data from the Envisat and ALOS satellites and obtain large scale deformation maps in the radar line-of-sight (LOS) direction.
Ramos-Álvarez, Irene; Mantey, Samuel A.; Nakamura, Taichi; Nuche-Berenguer, Bernardo; Moreno, Paola; Moody, Terry W.; Maderdrut, Jerome L.; Coy, David H.; Jensen, Robert T.
2015-01-01
Pituitary adenylate-cyclase-activating polypeptide (PACAP) has widespread physiological/pathophysiological actions and there is increased interest for its use therapeutically, especially in the CNS (neuroprotection). Unfortunately, no selective PACAP-analogs exist for PACAP-preferring PAC1-receptors, primarily because of its high sequence identity to VIP and particularly, because of the inability of structure-function studies to separate the pharmacophore of PAC1-R from VPAC1-R, which has high affinity for PACAP and VIP. The present study attempted to develop PAC1-R-selective agonists primarily by making conformationally-restricted PACAP -analogs in positions important for receptor-selectivity/affinity. Forty-six PACAP-related-analogs were synthesized with substitutions in positions 1–4, 14–17, 20–22 ,28,34,38 and receptor-selectivity determined in PAC1-R,VPAC1-R,VPAC2-R-transfected or native cells from binding or cAMP-generation experiments. Fifteen PACAP-analogs had 6–78-fold higher affinities for PAC1-R than VPAC1-R and 13 were agonists. Although binding-affinities correlated significantly with agonist potency, the degree of receptor-spareness varied markedly for the different PACAP-analogs, resulting in selective potencies for activating the PAC1 receptor over the VPAC1 receptor from 0- to-103-fold. In addition, a number of PACAP-analogs were identified that had high selectivity for PAC1-R over VPAC2-R as well as PACAP-analogs that could prove more useful therapeutically because of substitutions known to extend their half-lives (substitutions at potential sites of proteolysis and attachment of long-chain fatty acids). This study provides for the first time a separation of the pharmacophores for PAC1-R and VPAC1-R, resulting in PACAP-related analogs that are PAC1-R-preferring. Some of these analogs, or their modifications, could prove useful as therapeutic agents for various diseases. PMID:25698233
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.
Interrelated aldosterone and parathyroid hormone mutually modify cardiovascular mortality risk.
Tomaschitz, Andreas; Pilz, Stefan; Rus-Machan, Jutta; Meinitzer, Andreas; Brandenburg, Vincent M; Scharnagl, Hubert; Kapl, Martin; Grammer, Tanja; Ritz, Eberhard; Horina, Jörg H; Kleber, Marcus E; Pieske, Burkert; Kraigher-Krainer, Elisabeth; Hartaigh, Bríain Ó; Toplak, Hermann; van Ballegooijen, Adriana J; Amrein, Karin; Fahrleitner-Pammer, Astrid; März, Winfried
2015-04-01
Inappropriate aldosterone and parathyroid hormone (PTH) secretion is associated with increased cardiovascular risk. Accumulating evidence suggests bidirectional interplay between aldosterone and PTH. We evaluated the cross-sectional relationship between plasma aldosterone concentration (PAC), aldosterone to renin ratio (ARR) and PTH and subsequently tested whether the interaction between PAC and PTH modified the risk of cardiovascular death. PAC [78.0 (48.0-123.0) pg/mL], ARR [6.4 (2.9-12.9) pg/mL/pg/mL] and PTH concentration [median: 29.0 (22.0-40.0) pg/mL] were measured in 3074 patients (mean age: 62.5 ± 10.6 years; 30.3% women) referred to coronary angiography in a tertiary care center in Southwest Germany. Using multiple linear regression analysis, PAC and ARR emerged as an independent predictor of higher PTH concentrations (β=0.12 and 0.21, P<0.001 for both) irrespective of intake of antihypertensive treatment, 25(OH)D, kidney function, serum calcium, phosphate, magnesium, cortisol, NT-pro-BNP, soluble α-klotho and FGF-23 concentration. After a median follow-up of 9.9 years, 512 (16.7%) participants had died due to fatal cardiovascular events. Multivariate Cox proportional hazard analysis revealed that both PAC and PTH were independently associated with cardiovascular mortality, with a potential synergistic interaction (P=0.028). PAC and PTH are exclusively associated with cardiovascular death in subjects with PTH and PAC concentrations above the median, respectively (PAC: HR per log SD: 1.14; 95% CI 1.02-1.29; P=0.026; PTH: HR per log SD: 1.18; 95% CI 1.02-1.37; P=0.031). Higher PAC and ARR were independently associated with PTH. PAC was independently related to incident cardiovascular mortality exclusively in patients with elevated PTH and vice versa. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
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.
Reduction of Enteric Viruses by Blueberry Juice and Blueberry Proanthocyanidins.
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.
Ben Lagha, Amel; LeBel, Geneviève; Grenier, Daniel
2018-01-10
The highbush blueberry (Vaccinium corymbosum) has a beneficial effect on several aspects of human health. The present study investigated the effects of highbush blueberry proanthocyanidins (PACs) on the virulence properties of Aggregatibacter actinomycetemcomitans and macrophage-associated inflammatory responses. PACs were isolated from frozen highbush blueberries using solid-phase chromatography. A microplate dilution assay was performed to determine the effect of highbush blueberry PACs on A. actinomycetemcomitans growth as well as biofilm formation stained with crystal violet. Tight junction integrity of oral keratinocytes was assessed by measuring the transepithelial electrical resistance (TER), while macrophage viability was determined with a colorimetric MTT assay. Pro-inflammatory cytokine and MMP secretion by A. actinomycetemcomitans-stimulated macrophages was quantified by ELISA. The U937-3xκB-LUC monocyte cell line transfected with a luciferase reporter gene was used to monitor NF-κB activation. Highbush blueberry PACs reduced the growth of A. actinomycetemcomitans and prevented biofilm formation at sub-inhibitory concentrations. The treatment of pre-formed biofilms with the PACs resulted in a loss of bacterial viability. The antibacterial activity of the PACs appeared to involve damage to the bacterial cell membrane. The PACs protected the oral keratinocytes barrier integrity from damage caused by A. actinomycetemcomitans. The PACs also protected macrophages from the deleterious effect of leukotoxin Ltx-A and dose-dependently inhibited the secretion of pro-inflammatory cytokines (IL-1β, IL-6, CXCL8, TNF-α), matrix metalloproteinases (MMP-3, MMP-9), and sTREM-1 by A. actinomycetemcomitans-treated macrophages. The PACs also inhibited the activation of the NF-κB signaling pathway. The antibacterial and anti-inflammatory properties of highbush blueberry PACs as well as their ability to protect the oral keratinocyte barrier and neutralize leukotoxin activity suggest that they may be promising candidates as novel therapeutic agents.
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.
Dentin biomodification potential depends on polyphenol source.
Aguiar, T R; Vidal, C M P; Phansalkar, R S; Todorova, I; Napolitano, J G; McAlpine, J B; Chen, S N; Pauli, G F; Bedran-Russo, A K
2014-04-01
Although proanthocyanidins (PACs) modify dentin, the effectiveness of different PAC sources and the correlation with their specific chemical composition are still unknown. This study describes the chemical profiling of natural PAC-rich extracts from 7 plants using ultra high pressure/performance liquid chromatography (UHPLC) to determine the overall composition of these extracts and, in parallel, comprehensively evaluate their effect on dentin properties. The total polyphenol content of the extracts was determined (as gallic acid equivalents) using Folin-Ciocalteau assays. Dentin biomodification was assessed by the modulus of elasticity, mass change, and resistance to enzymatic biodegradation. Extracts with a high polyphenol and PAC content from Vitis vinifera, Theobroma cacao, Camellia sinensis, and Pinus massoniana induced a significant increase in modulus of elasticity and mass. The UHPLC analysis showed the presence of multiple types of polyphenols, ranging from simple phenolic acids to oligomeric PACs and highly condensed tannins. Protective effect against enzymatic degradation was observed for all experimental groups; however, statistically significant differences were observed between plant extracts. The findings provide clear evidence that the dentin bioactivities of PACs are source dependent, resulting from a combination of concentration and specific chemical constitution of the complex PAC mixtures.
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
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.
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
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.
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.
Guo, Junyuan; Chen, Cheng
2017-10-01
This study investigated the production of a bioflocculant by using rice stover and its potential in sludge dewatering. Production of the bioflocculant was positively associated with cell growth and highest value of 2.37 g L -1 was obtained with main backbone of polysaccharides. The bioflocculant showed good performances in sludge dewatering, after conditioned by this bioflocculant, dry solids (DS) and specific resistance to filtration (SRF) of typical wastewater activated sludge reached 19.3% and 4.8 × 10 12 m kg -1 , respectively, which were much better than the ones obtained with chemical flocculants. Sludge dewatering was further improved when the bioflocculant and polyaluminum chloride (PAC) were used simultaneously, and the optimized conditioning process by the composite was bioflocculant of 10.5 g kg -1 , PAC of 19.4 g kg -1 , and pH of 8.1. Under this optimal condition, DS and SRF of the sludge appeared as 24.1% and 3.0 × 10 12 m kg -1 , respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.
Cdc42 regulates junctional actin but not cell polarization in the Caenorhabditis elegans epidermis
Zilberman, Yuliya; Abrams, Joshua; Anderson, Dorian C.
2017-01-01
During morphogenesis, adherens junctions (AJs) remodel to allow changes in cell shape and position while preserving adhesion. Here, we examine the function of Rho guanosine triphosphatase CDC-42 in AJ formation and regulation during Caenorhabditis elegans embryo elongation, a process driven by asymmetric epidermal cell shape changes. cdc-42 mutant embryos arrest during elongation with epidermal ruptures. Unexpectedly, we find using time-lapse fluorescence imaging that cdc-42 is not required for epidermal cell polarization or junction assembly, but rather is needed for proper junctional actin regulation during elongation. We show that the RhoGAP PAC-1/ARHGAP21 inhibits CDC-42 activity at AJs, and loss of PAC-1 or the interacting linker protein PICC-1/CCDC85A-C blocks elongation in embryos with compromised AJ function. pac-1 embryos exhibit dynamic accumulations of junctional F-actin and an increase in AJ protein levels. Our findings identify a previously unrecognized molecular mechanism for inhibiting junctional CDC-42 to control actin organization and AJ protein levels during epithelial morphogenesis. PMID:28903999
Conley, Dalton; McCabe, Brian J
2012-01-01
Evidence on the relationship between political contributions and legislators' voting behavior is marred by concerns about endogeneity in the estimation process. Using a legislator's offspring sex mix as a truly exogenous variable, we employ an instrumental variable estimation procedure to predict the effect of voting behavior on political contributions. Following previous research, we find that a legislator's proportion daughters has a significant effect on voting behavior for women's issues, as measured by score in the "Congressional Record on Choice" issued by NARAL Pro-Choice America. In the second stage, we make a unique contribution by demonstrating a significant impact of exogenous voting behavior on PAC contributions, lending further credibility to the hypothesis that Political Action Committees respond to legislators' voting patterns by "rewarding" political candidates that vote in line with the positions of the PAC, rather than affecting those same votes - at least in this high-profile policy domain. Copyright © 2011 Elsevier Inc. All rights reserved.
The Fundamental Re-Thinking and Redesign of the Military Pay Document Processing System.
1999-03-01
the Army and Coast Guard’s MPDP can be dramatically improved by eliminating middlemen functions (PAC and finance office) and shortening the value chain using IT along with other transformation enablers.
Granular activated carbon for removal of organic matter and turbidity from secondary wastewater.
Hatt, J W; Germain, E; Judd, S J
2013-01-01
A range of commercial granular activated carbon (GAC) media have been assessed as pretreatment technologies for a downstream microfiltration (MF) process. Media were assessed on the basis of reduction in both organic matter and turbidity, since these are known to cause fouling in MF membranes. Isotherm adsorption analysis through jar testing with supplementary column trials revealed a wide variation between the different adsorbent materials with regard to organics removal and adsorption kinetics. Comparison with previous work using powdered activated carbon (PAC) revealed that for organic removal above 60% the use of GAC media incurs a significantly lower carbon usage rate than PAC. All GACs tested achieved a minimum of 80% turbidity removal. This combination of turbidity and organic removal suggests that GAC would be expected to provide a significant reduction in fouling of a downstream MF process with improved product water quality.
A Herschel resolved debris disc around HD 105211
NASA Astrophysics Data System (ADS)
Hengst, S.; Marshall, J. P.; Horner, J.; Marsden, S. C.
2017-07-01
Debris discs are the dusty aftermath of planet formation processes around main-sequence stars. Analysis of these discs is often hampered by the absence of any meaningful constraint on the location and spatial extent of the disc around its host star. Multi-wavelength, resolved imaging ameliorates the degeneracies inherent in the modelling process, making such data indispensable in the interpretation of these systems. The Herschel Space Observatory observed HD 105211 (η Cru, HIP 59072) with its Photodetector Array Camera and Spectrometer (PACS) instrument in three far-infrared wavebands (70, 100 and 160 μm). Here we combine these data with ancillary photometry spanning optical to far-infrared wavelengths in order to determine the extent of the circumstellar disc. The spectral energy distribution and multi-wavelength resolved emission of the disc are simultaneously modelled using a radiative transfer and imaging codes. Analysis of the Herschel/PACS images reveals the presence of extended structure in all three PACS images. From a radiative transfer model we derive a disc extent of 87.0 ± 2.5 au, with an inclination of 70.7 ± 2.2° to the line of sight and a position angle of 30.1 ± 0.5°. Deconvolution of the Herschel images reveals a potential asymmetry but this remains uncertain as a combined radiative transfer and image analysis replicates both the structure and the emission of the disc using a single axisymmetric annulus.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Daniel J. Stepan; Thomas A. Moe; Melanie D. Hetland
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 further affect public water suppliers with respect to DBPs. Powdered activated carbon (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) frommore » 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. This project, a cooperative effort between the Energy & Environmental Research Center (EERC), the Grand Forks Water Treatment Plant, and the University of North Dakota Department of Civil Engineering, consists of several interrelated tasks. The objective of the research was to evaluate a cost-effective PAC produced from North Dakota lignite for removing NOM from water and reducing trihalomethane formation potential. The research approach was to develop a statistically valid testing protocol that can be used to compare dose-response relationships between North Dakota lignite-derived PAC and commercially available PAC products. A statistical analysis was performed to determine whether significant correlations exist between operating conditions, water properties, PAC properties, and dose-response behavior. Pertinent physical and chemical properties were also measured for each of the waters and each of the PACs.« less
Suh, Siri
2015-06-01
The "rightness" of a technology for completing a particular task is negotiated by medical professionals, patients, state institutions, manufacturing companies, and non-governmental organizations. This paper shows how certain technologies may challenge the meaning of the "job" they are designed to accomplish. Manual vacuum aspiration (MVA) is a syringe device for uterine evacuation that can be used to treat complications of incomplete abortion, known as post-abortion care (PAC), or to terminate pregnancy. I explore how negotiations over the rightness of MVA as well as PAC unfold at the intersection of national and global reproductive politics during the daily treatment of abortion complications at three hospitals in Senegal, where PAC is permitted but induced abortion is legally prohibited. Although state health authorities have championed MVA as the "preferred" PAC technology, the primary donor for PAC, the United States Agency for International Development, does not support the purchase of abortifacient technologies. I conducted an ethnography of Senegal's PAC program between 2010 and 2011. Data collection methods included interviews with 49 health professionals, observation of PAC treatment and review of abortion records at three hospitals, and a review of transnational literature on MVA and PAC. While MVA was the most frequently employed form of uterine evacuation in hospitals, concerns about off-label MVA practices contributed to the persistence of less effective methods such as dilation and curettage (D&C) and digital curettage. Anxieties about MVA's capacity to induce abortion have constrained its integration into routine obstetric care. This capacity also raises questions about what the "job," PAC, represents in Senegalese hospitals. The prioritization of MVA's security over women's access to the preferred technology reinforces gendered inequalities in health care. Copyright © 2015 Elsevier Ltd. All rights reserved.
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.
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
Suh, Siri
2015-01-01
The “rightness” of a technology for completing a particular task is negotiated by medical professionals, patients, state institutions, manufacturing companies, and non-governmental organizations. This paper shows how certain technologies may challenge the meaning of the “job” they are designed to accomplish. Manual vacuum aspiration (MVA) is a syringe device for uterine evacuation that can be used to treat complications of incomplete abortion, known as post-abortion care (PAC), or to terminate pregnancy. I explore how negotiations over the rightness of MVA as well as PAC unfold at the intersection of national and global reproductive politics during the daily treatment of abortion complications at three hospitals in Senegal, where PAC is permitted but induced abortion is legally prohibited. Although state health authorities have championed MVA as the “preferred” PAC technology, the primary donor for PAC, the United States Agency for International Development, does not support the purchase of abortifacient technologies. I conducted an ethnography of Senegal's PAC program between 2010 and 2011. Data collection methods included interviews with 49 health professionals, observation of PAC treatment and review of abortion records at three hospitals, and a review of transnational literature on MVA and PAC. While MVA was the most frequently employed form of uterine evacuation in hospitals, concerns about off-label MVA practices contributed to the persistence of less effective methods such as dilation and curettage (D&C) and digital curettage. Anxieties about MVA's capacity to induce abortion have constrained its integration into routine obstetric care. This capacity also raises questions about what the “job,” PAC, represents in Senegalese hospitals. The prioritization of MVA's security over women's access to the preferred technology reinforces gendered inequalities in health care. PMID:25948127
Déziel, Bob A; Patel, Kunal; Neto, Catherine; Gottschall-Pass, Katherine; Hurta, Robert A R
2010-10-15
Prostate cancer is one of the most common cancers in the Western world, and it is believed that an individual's diet affects his risk of developing cancer. There has been an interest in examining phytochemicals, the secondary metabolites of plants, in order to determine their potential anti-cancer activities in vitro and in vivo. In this study we document the effects of proanthocyanidins (PACs) from the American Cranberry (Vaccinium macrocarpon) on matrix metalloproteinase (MMP) activity in DU145 human prostate cancer cells. Cranberry PACs decreased cellular viability of DU145 cells at a concentration of 25 µg/ml by 30% after 6 h of treatment. Treatment of DU145 cells with PACs resulted in an inhibition of both MMPs 2 and 9 activity. PACs increased the expression of TIMP-2, a known inhibitor of MMP activity, and decreased the expression of EMMPRIN, an inducer of MMP expression. PACs decreased the expression of PI-3 kinase and AKT proteins, and increased the phosphorylation of both p38 and ERK1/2. Cranberry PACs also decreased the translocation of the NF-κB p65 protein to the nucleus. Cranberry PACs increased c-jun and decreased c-fos protein levels. These results suggest that cranberry PACs decreases MMP activity through the induction and/or inhibition of specific temporal MMP regulators, and by affecting either the phosphorylation status and/or expression of MAP kinase, PI-3 kinase, NF-κB and AP-1 pathway proteins. This study further demonstrates that cranberry PACs are a strong candidate for further research as novel anti-cancer agents. © 2010 Wiley-Liss, Inc.
The cost of post-abortion care in developing countries: a comparative analysis of four studies
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
Drescher, M J; Drescher, D G; Khan, K M; Hatfield, J S; Ramakrishnan, N A; Abu-Hamdan, M D; Lemonnier, L A
2006-09-29
Pituitary adenylyl cyclase-activating polypeptide (PACAP), via its specific receptor pituitary adenylyl cyclase-activating polypeptide receptor 1 (PAC1-R), is known to have roles in neuromodulation and neuroprotection associated with glutamatergic and cholinergic neurotransmission, which, respectively, are believed to form the primary basis for afferent and efferent signaling in the organ of Corti. Previously, we identified transcripts for PACAP preprotein and multiple splice variants of its receptor, PAC1-R, in microdissected cochlear subfractions. In the present work, neural localizations of PACAP and PAC1-R within the organ of Corti and spiral ganglion were examined, defining sites of PACAP action. Immunolocalization of PACAP and PAC1-R in the organ of Corti and spiral ganglion was compared with immunolocalization of choline acetyltransferase (ChAT) and synaptophysin as efferent neuronal markers, and glutamate receptor 2/3 (GluR2/3) and neurofilament 200 as afferent neuronal markers, for each of the three cochlear turns. Brightfield microscopy giving morphological detail for individual immunolocalizations was followed by immunofluorescence detection of co-localizations. PACAP was found to be co-localized with ChAT in nerve fibers of the intraganglionic spiral bundle and beneath the inner and outer hair cells within the organ of Corti. Further, evidence was obtained that PACAP is expressed in type I afferent axons leaving the spiral ganglion en route to the auditory nerve, potentially serving as a neuromodulator in axonal terminals. In contrast to the efferent localization of PACAP within the organ of Corti, PAC1-R immunoreactivity was co-localized with afferent dendritic neuronal marker GluR2/3 in nerve fibers passing beneath and lateral to the inner hair cell and in fibers at supranuclear and basal sites on outer hair cells. Given the known association of PACAP with catecholaminergic neurotransmission in sympathoadrenal function, we also re-examined the issue of whether the organ of Corti receives adrenergic innervation. We now demonstrate the existence of nerve fibers within the organ of Corti which are immunoreactive for the adrenergic marker dopamine beta-hydroxylase (DBH). DBH immunoreactivity was particularly prominent in nerve fibers both at the base and near the cuticular plate of outer hair cells of the apical turn, extending to the non-sensory Hensen's cell region. Evidence was obtained for limited co-localization of DBH with PAC1-R and PACAP. In the process of this investigation, we obtained evidence that efferent and afferent nerve fibers, in addition to adrenergic nerve fibers, are present at supranuclear sites on outer hair cells and distributed within the non-sensory epithelium of the apical cochlear turn for rat, based upon immunoreactivity for the corresponding neuronal markers. Overall, PACAP is hypothesized to act within the organ of Corti as an efferent neuromodulator of afferent signaling via PAC1-R that is present on type I afferent dendrites, in position to afford protection from excitotoxicity. Additionally, PACAP/PAC1-R may modulate secretion of catecholamines from adrenergic terminals within the organ of Corti.
Neilson, Andrew P; O'Keefe, Sean F; Bolling, Bradley W
2016-01-01
Proanthocyanidins (PACs) are an abundant but complex class of polyphenols found in foods and botanicals. PACs are polymeric flavanols with a variety of linkages and subunits. Connectivity and degree of polymerization (DP) determine PAC bioavailability and bioactivity. Current quantitative and qualitative methods may ignore a large percentage of dietary PACs. Subsequent correlations between intake and activity are hindered by a lack of understanding of the true PAC complexity in many foods. Additionally, estimates of dietary intakes are likely inaccurate, as nutrient databank values are largely based on standards from cocoa (monomers to decamers) and blueberries (mean DP of 36). Improved analytical methodologies are needed to increase our understanding of the biological roles of these complex compounds.
Alamri, Sultan H; Kennedy, Courtney C; Marr, Sharon; Lohfeld, Lynne; Skidmore, Carly J; Papaioannou, Alexandra
2015-08-01
Osteoporosis is a major global health problem, especially among long-term care (LTC) facilities. Despite the availability of effective clinical guidelines to prevent osteoporosis and bone fractures, few LTC homes actually adhere to these practical recommendations. The purpose of this study was to identify barriers to the implementation of evidence-based practices for osteoporosis and fracture prevention in LTC facilities and elicit practical strategies to address these barriers. We performed a qualitative analysis of action plans formulated by Professional Advisory Committee (PAC) teams at 12 LTC homes in the intervention arm of the Vitamin D and Osteoporosis Study (ViDOS) in Ontario, Canada. PAC teams were comprised of medical directors, administrators, directors of care, pharmacists, dietitians, and other staff. Thematic content analysis was performed to identify the key themes emerging from the action plans. LTC teams identified several barriers, including lack of educational information and resources prior to the ViDOS intervention, difficulty obtaining required patient information for fracture risk assessment, and inconsistent prescribing of vitamin D and calcium at the time of admission. The most frequently suggested recommendations was to establish and adhere to standard admission orders regarding vitamin D, calcium, and osteoporosis therapies, improve the use of electronic medical records for osteoporosis and fracture risk assessment, and require bone health as a topic at quarterly reviews and multidisciplinary conferences. This qualitative study identified several important barriers and practical recommendations for improving the implementation of osteoporosis and fracture prevention guidelines in LTC settings.
DICOM static and dynamic representation through unified modeling language
NASA Astrophysics Data System (ADS)
Martinez-Martinez, Alfonso; Jimenez-Alaniz, Juan R.; Gonzalez-Marquez, A.; Chavez-Avelar, N.
2004-04-01
The DICOM standard, as all standards, specifies in generic way the management in network and storage media environments of digital medical images and their related information. However, understanding the specifications for particular implementation is not a trivial work. Thus, this work is about understanding and modelling parts of the DICOM standard using Object Oriented methodologies, as part of software development processes. This has offered different static and dynamic views, according with the standard specifications, and the resultant models have been represented through the Unified Modelling Language (UML). The modelled parts are related to network conformance claim: Network Communication Support for Message Exchange, Message Exchange, Information Object Definitions, Service Class Specifications, Data Structures and Encoding, and Data Dictionary. The resultant models have given a better understanding about DICOM parts and have opened the possibility of create a software library to develop DICOM conformable PACS applications.
ASR-9 processor augmentation card (9-PAC) phase II scan-scan correlator algorithms
DOT National Transportation Integrated Search
2001-04-26
The report documents the scan-scan correlator (tracker) algorithm developed for Phase II of the ASR-9 Processor Augmentation Card (9-PAC) project. The improved correlation and tracking algorithms in 9-PAC Phase II decrease the incidence of false-alar...
Jørgensen, L B; Behnke, H D; Mabry, T J
1977-01-01
Three glucosinolate-containing species, Armoracia rusticana Gaertner, Meyer et Scherbius (Brassicaceae), Capparis cynophallophora L. (Capparaceae) and Drypetes roxburghii (Wall.) Hurusawa (Euphorbiaceae), are shown by both light and electron microscopy to contain protein-accumulating cells (PAC). The PAC of Armoracia and Copparis (former "myrosin cells") occur as idioblasts. The PAC of Drypetes are usual members among axial phloem parenchyma cells rather than idioblasts. In Drypetes the vacuoles of the PAC are shown ultrastructurally to contain finely fibrillar material and to originate from local dilatations of the endoplasmic reticulum. The vacuoles in PAC of Armoracia and Capparis seem to originate in the same way; but ultrastructurally, their content is finely granular. In addition, Armoracia and Capparis are shown by both light and electron microscopy to contain dilated cisternae (DC) of the endoplasmic reticulum in normal parenchyma cells, in accord with previous findings for several species within Brassicaceae. The relationship of PAC and DC to glucosinolates and the enzyme myrosinase is discussed.
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.
NASA Astrophysics Data System (ADS)
Dang, Xugang; Chen, Hui; Shan, Zhihua
2017-07-01
One chemical sand-fixing materials based on poly(acrylic acid)-corn starch (PACS) blend was studied in this work. The PACS blend was prepared by solution mixing method between PA and CS. In order to prepare sand-fixing materials for environmental applications using the well-established method of spraying evenly PACS blend solution on the surfaces of fine sand. Fourier transform infrared spectroscopy (FT-IR) revealed the existence of the intermolecular interactions between the blend components. Scanning electron microscope (SEM) analysis showed a continuous phase of blend, and it also showed the good sand-fixing capacity. The test results of hygroscopicity and water retention experiments indicated that the blends had excellent water-absorbing and water-retention capacity. The results of contact angle measurements between the PACS solutions and fine sand showed that the PACS blend has a satisfactory effect on fine sand wetting. And the PACS, as a sand-fixation material, has excellent sand-fixation rate up to 99.5%.
The development and validation of the Physical Appearance Comparison Scale-Revised (PACS-R).
Schaefer, Lauren M; Thompson, J Kevin
2014-04-01
The Physical Appearance Comparison Scale (PACS; Thompson, Heinberg, & Tantleff, 1991) was revised to assess appearance comparisons relevant to women and men in a wide variety of contexts. The revised scale (Physical Appearance Comparison Scale-Revised, PACS-R) was administered to 1176 college females. In Study 1, exploratory factor analysis and parallel analysis using one half of the sample suggested a single factor structure for the PACS-R. Study 2 utilized the remaining half of the sample to conduct confirmatory factor analysis, item analysis, and to examine the convergent validity of the scale. These analyses resulted in an 11-item measure that demonstrated excellent internal consistency and convergent validity with measures of body satisfaction, eating pathology, sociocultural influences on appearance, and self-esteem. Regression analyses demonstrated the utility of the PACS-R in predicting body satisfaction and eating pathology. Overall, results indicate that the PACS-R is a reliable and valid tool for assessing appearance comparison tendencies in women. Copyright © 2014. Published by Elsevier Ltd.
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.
Phansalkar, Rasika S; Nam, Joo-Won; Chen, Shao-Nong; McAlpine, James B; Leme, Ariene A; Aydin, Berdan; Bedran-Russo, Ana-Karina; Pauli, Guido F
2018-02-02
Proanthocyanidins (PACs) find wide applications for human use including food, cosmetics, dietary supplements, and pharmaceuticals. The chemical complexity associated with PACs has triggered the development of various chromatographic techniques, with countercurrent separation (CCS) gaining in popularity. This study applied the recently developed DESIGNER (Depletion and Enrichment of Select Ingredients Generating Normalized Extract Resources) approach for the selective enrichment of trimeric and tetrameric PACs using centrifugal partition chromatography (CPC). This CPC method aims at developing PAC based biomaterials, particularly for their application in restoring and repairing dental hard tissue. A general separation scheme beginning with the depletion of polymeric PACs, followed by the removal of monomeric flavan-3-ols and a final enrichment step produced PAC trimer and tetramer enriched fractions. A successful application of this separation scheme is demonstrated for four polyphenol rich plant sources: grape seeds, pine bark, cinnamon bark, and cocoa seeds. Minor modifications to the generic DESIGNER CCS method were sufficient to accommodate the varying chemical complexities of the individual source materials. The step-wise enrichment of PAC trimers and tetramers was monitored using normal phase TLC and Diol-HPLC-UV analyses. CPC proved to be a reliable tool for the selective enrichment of medium size oligomeric PACs (OPACs). This method plays a key role in the development of dental biomaterials considering its reliability and reproducibility, as well as its scale-up capabilities for possible larger-scale manufacturing. Copyright © 2017 Elsevier B.V. All rights reserved.
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.
O'Neal, Wesley T; Kamel, Hooman; Kleindorfer, Dawn; Judd, Suzanne E; Howard, George; Howard, Virginia J; Soliman, Elsayed Z
2016-01-01
It is currently unknown if premature atrial contractions (PACs) detected on the routine screening electrocardiogram are associated with an increased risk of ischemic stroke. We examined the association between PACs and ischemic stroke in 22,975 (mean age 64 ± 9.2; 56% women; 40% black) participants from the Reasons for Geographic and Racial Differences in Stroke study. Participants who were free of stroke at baseline were included. PACs were detected from centrally read electrocardiograms at baseline. Cox regression was used to examine the association between PACs and ischemic stroke events through March 31, 2014. PACs were present in 1,687 (7.3%) participants at baseline. In a Cox regression model adjusted for stroke risk factors and potential confounders, PACs were associated with an increased risk of ischemic stroke (hazards ratio (HR) 1.34, 95% CI 1.04-1.74). The relationship was limited to non-lacunar infarcts (HR 1.42, 95% CI 1.08-1.87), and not lacunar strokes (HR 1.01, 95% CI 0.51-2.03). An interaction by sex was detected, with the association between PACs and ischemic stroke being stronger among women (HR 1.82, 95% CI 1.29-2.56) than men (HR 1.03, 95% CI 0.69-1.52; p-interaction = 0.0095). PACs detected on the routine electrocardiogram are associated with an increased risk for non-lacunar ischemic strokes, especially in women. © 2016 S. Karger AG, Basel.
NASA Astrophysics Data System (ADS)
Chao, Woodrew; Ho, Bruce K. T.; Chao, John T.; Sadri, Reza M.; Huang, Lu J.; Taira, Ricky K.
1995-05-01
Our tele-medicine/PACS archive system is based on a three-tier distributed hierarchical architecture, including magnetic disk farms, optical jukebox, and tape jukebox sub-systems. The hierarchical storage management (HSM) architecture, built around a low cost high performance platform [personal computers (PC) and Microsoft Windows NT], presents a very scaleable and distributed solution ideal for meeting the needs of client/server environments such as tele-medicine, tele-radiology, and PACS. These image based systems typically require storage capacities mirroring those of film based technology (multi-terabyte with 10+ years storage) and patient data retrieval times at near on-line performance as demanded by radiologists. With the scaleable architecture, storage requirements can be easily configured to meet the needs of the small clinic (multi-gigabyte) to those of a major hospital (multi-terabyte). The patient data retrieval performance requirement was achieved by employing system intelligence to manage migration and caching of archived data. Relevant information from HIS/RIS triggers prefetching of data whenever possible based on simple rules. System intelligence embedded in the migration manger allows the clustering of patient data onto a single tape during data migration from optical to tape medium. Clustering of patient data on the same tape eliminates multiple tape loading and associated seek time during patient data retrieval. Optimal tape performance can then be achieved by utilizing the tape drives high performance data streaming capabilities thereby reducing typical data retrieval delays associated with streaming tape devices.
Effect of adsorbent addition on floc formation and clarification.
Younker, Jessica M; Walsh, Margaret E
2016-07-01
Adding adsorbent into the coagulation process is an emerging treatment solution for targeting hard-to-remove dissolved organic compounds from both drinking water and industrial wastewater. The impact of adding powdered activated carbon (PAC) or organoclay (OC) adsorbents with ferric chloride (FeCl3) coagulant was investigated in terms of potential changes to the coagulated flocs formed with respect to size, structure, and breakage and regrowth properties. The ability of dissolved air flotation (DAF) and sedimentation (SED) clarification processes to remove hybrid adsorbent-coagulant flocs was also evaluated through clarified water quality analysis of samples collected in bench-scale jar test experiments. The jar tests were conducted using both a synthetic fresh water and oily wastewater test water spiked with dissolved aromatic compounds phenol and naphthalene. Results of the study demonstrated that addition of adsorbent reduced the median coagulated floc size by up to 50% but did not affect floc strength or regrowth potential after application of high shear. Experimental results in fresh water demonstrated that sedimentation was more effective than DAF for clarification of both FeCl3-PAC and FeCl3-OC floc aggregates. However, experimental tests performed on the synthetic oily wastewater showed that coagulant-adsorbent floc aggregates were effectively removed with both DAF and sedimentation treatment, with lower residual turbidity achieved in clarified water samples than with coagulation treatment alone. Addition of OC or PAC into the coagulation process resulted in removals of over half, or nearly all of the dissolved aromatics, respectively. Copyright © 2016 Elsevier Ltd. All rights reserved.
Integrating CAD modules in a PACS environment using a wide computing infrastructure.
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.
[Design of the image browser for PACS image workstation].
Li, Feng; Zhou, He-Qin
2006-09-01
The design of PACS image workstation based on DICOM3.0 is introduced in the paper, then the designing method of the PACS image browser based on the control system theory is presented,focusing on two main units:DICOM analyzer and the information mapping transformer.
Hosie, Annmarie; Agar, Meera; Lobb, Elizabeth; Davidson, Patricia M; Phillips, Jane
2017-10-01
Delirium is a serious acute neurocognitive condition frequently occurring for hospitalized patients, including those receiving care in specialist palliative care units. There are many delirium evidence-practice gaps in palliative care, including that the condition is under-recognized and challenging to assess. To report the meta-synthesis of a research project investigating delirium epidemiology, systems and nursing practice in palliative care units. The Delirium in Palliative Care (DePAC) project was a two-phase sequential transformative mixed methods design with knowledge translation as the theoretical framework. The project answered five different research questions about delirium epidemiology, systems of care and nursing practice in palliative care units. Data integration and metasynthesis occurred at project conclusion. There was a moderate to high rate of delirium occurrence in palliative care unit populations; and palliative care nurses had unmet delirium knowledge needs and worked within systems and team processes that were inadequate for delirium recognition and assessment. The meta-inference of the DePAC project was that a widely-held but paradoxical view that palliative care and dying patients are different from the wider hospital population has separated them from the overall generation of delirium evidence, and contributed to the extent of practice deficiencies in palliative care units. Improving palliative care nurses' capabilities to recognize and assess delirium will require action at the patient and family, nurse, team and system levels. A broader, hospital-wide perspective would accelerate implementation of evidence-based delirium care for people receiving palliative care, both in specialist units, and the wider hospital setting. Copyright © 2017 Elsevier Ltd. All rights reserved.
Increasing Youth Physical Activity with Activity Calendars
ERIC Educational Resources Information Center
Eckler, Seth
2016-01-01
Physical educators often struggle with ways to get their students to be active beyond the school day. One strategy to accomplish this is the use of physical activity calendars (PACs). The purpose of this article is to support the use of PACs and give practical advice for creating effective PACs.
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...
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.
A centralized platform for geo-distributed PACS management.
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.
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
Penzkofer, Alfons; Stierl, Manuela; Mathes, Tilo; Hegemann, Peter
2014-11-01
The photoactivated cyclase bPAC of the microbial mats bacterium Beggiatoa sp. consists of a BLUF domain and an adenylyl cyclase domain. It has strong activity of photo-induced cyclic adenylyl monophosphate (cAMP) formation and is therefore an important optogenetic tool in neuroscience applications. The SUMO-bPAC-Y7F mutant where Tyr-7 is replaced by Phe-7 in the BLUF domain has lost the typical BLUF domain photo-cycle dynamics. Instead, the investigated SUMO-bPAC-Y7F mutant consisted of three protein conformations with different triplet based photo-dynamics: (i) reversible flavin quinone (Fl) cofactor reduction to flavin semiquinone (FlH), (ii) reversible violet/near ultraviolet absorbing flavin photoproduct (FlA) formation, and (iii) irreversible red absorbing flavin photoproduct (FlC) formation. Absorption and emission spectroscopic measurements on SUMO-bPAC-Y7F were carried out before, during and after light exposure. Flavin photo-dynamics schemes are developed for the SUMO-bPAC-Y7F fractions performing photo-induced FlH, FlA, and FlC formation. Quantitative parameters of the flavin cofactor excitation, relaxation and recovery dynamics in SUMO-bPAC-Y7F are determined. Copyright © 2014 Elsevier B.V. All rights reserved.
XDS-I Gateway Development for HIE Connectivity with Legacy PACS at Gil Hospital.
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.