Comorbidity in Emergency Room: the Psychiatrist’s Perspective

OpenAIRE

Alice Luís

2013-01-01

The author puts forward some considerations about the psychiatric practice in the emergency room of a general hospital. Clinical practice in the emergency room should be highlighted by collaborative work between several medical subspecialities, in- cluding internal medicine and neurology. This is particularly true for patients with comorbidity in order to provide quality of care. Finally, the author reviews several clinical cases and suggests guidelines for their management.

Intrahospital teleradiology from the emergency room

Science.gov (United States)

Fuhrman, Carl R.; Slasky, B. S.; Gur, David; Lattner, Stefanie; Herron, John M.; Plunkett, Michael B.; Towers, Jeffrey D.; Thaete, F. Leland

1993-09-01

Off-hour operations of the modern emergency room presents a challenge to conventional image management systems. To assess the utility of intrahospital teleradiology systems from the emergency room (ER), we installed a high-resolution film digitizer which was interfaced to a central archive and to a workstation at the main reading room. The system was designed to allow for digitization of images as soon as the films were processed. Digitized images were autorouted to both destinations, and digitized images could be laser printed (if desired). Almost real time interpretations of nonselected cases were performed at both locations (conventional film in the ER and a workstation in the main reading room), and an analysis of disagreements was performed. Our results demonstrate that in spite of a `significant' difference in reporting, `clinically significant differences' were found in less than 5% of cases. Folder management issues, preprocessing, image orientation, and setting reasonable lookup tables for display were identified as the main limitations to the systems' routine use in a busy environment. The main limitation of the conventional film was the identification of subtle abnormalities in the bright regions of the film. Once identified on either system (conventional film or soft display), all abnormalities were visible and detectable on both display modalities.

Association between air pollution and ischemic cardiovascular emergency room visits

International Nuclear Information System (INIS)

Lin, C.A.; Amador Pereira, L.A.; Souza onceicao, G.M. de; Kishi, H.S.; Milani, Rodolfo; Ferreira Braga, A.L.; Ascimento Saldiva, P.H.

2003-01-01

This study observed the relationship between air pollutants and ischemic cardiac diseases such as angina and acute myocardial infarction in a representative cardiovascular center emergency room in Sao Paulo, Brazil. Daily emergency room admissions to the Institute of the Heart of the university of Sao Paulo, as well as data concerning daily air pollutant levels and meteorological variables, were collected from January 1994 to august 1995. Generalized additive Poisson regressions were fitted to the logarithm of the expected values of total emergency room visits due to angina or acute myocardial infarction, controlling for smooth functions of season and weather and indicators for days of the week. All investigated pollutants were positively associated with ischemic cardiovascular disease emergency room visits, and the time lags were relatively short, but only CO presented in effect that was statistically significant. An interquartile range increase n CO was associated with an increase of 6.4% (95% CI: 0.7-12.1) in daily angina or acute myocardial infarction emergency room visits. This result did not change when estimates were done using linear models and natural cubic plines. This study showed that air pollution has a role in cardiovascular morbidity in Sao Paulo, reinforcing the necessity for air pollutant mission-controlling polices in urban areas

Modernisation of Radiation Monitoring Room as a Part of Slovenian Emergency Response Centre

International Nuclear Information System (INIS)

Sarvari, A.; Mitic, D.

2003-01-01

In the year 2002 the Slovenian Nuclear Safety Administration (SNSA) moved to the new premises therefore it had to rearrange some of its rooms for the emergency situation. SNSA does not operate with a dedicated Emergency Response Centre (ERC), instead of it the SNSA has to rearrange the existing rooms in case of an emergency. Modernisation of the equipment, with the help of government of the United Kingdom of Great Britain and Northern Ireland, for the emergency situation was carried out, especially in the monitoring room. The radiation monitoring system, which is placed in the monitoring room, continuously collects, processes and archives the incoming data of exposure to radiation and meteorological parameters on the Slovenian territory (A model national emergency response plan for radiological accidents, IAEA, Vienna, 1993. IAEA-TECDOC-718). In the emergency situation the monitoring room transforms into the room for the Dose Assessment Group (DAG), which is part of ERC (IAEA emergency response network, IAEA, Vienna, 2000, EPR-ERNET (2000)). The modernisation of monitoring room and within the DAG room with new equipment and its purpose is described in this article. Modernisation of the monitoring room and the room for DAG showed to be inevitably needed. Modernisation of the monitoring room has brought the SNSA a sophisticated and reliable system of controlling the external exposure to radiation on the Slovenian territory. The equipment, especially the equipment for the use in the emergency situation, brought novelties for the Dose Assessment Group. The group has now better and easier control of radiation situation in case of an accident. In overall this modernisation has put the Slovenian Nuclear Safety Administration a step forward in having a dedicated Emergency Response Centre, since it does not need to rearrange the room for the Dose Assessment Group. (author)

Development, validation and testing of a nursing home to emergency room transfer checklist.

Science.gov (United States)

Tsai, Hsiu-Hsin; Tsai, Yun-Fang

2018-01-01

To develop and test the feasibility of an instrument to support patients' nursing home to emergency room transfer. Transfers from a nursing home care facility to an acute care facility such as a hospital emergency room are common. However, the prevalence of an information gap for transferring residents' health data to acute care facility is high. An evidence-based transfer instrument, which could fill this gap, is lacking. Development of a nursing home to emergency room transfer checklist, validation of items using the Delphi method and testing the feasibility and benefits of using the nursing home to emergency room transfer checklist. Items were developed based on qualitative data from previous research. Delphi validation, retrospective chart review (baseline data) and a 6-month prospective study design were applied to test the feasibility of using the checklist. Variables for testing the feasibility of the checklist included residents' 30-day readmission rate and length of hospital stay. Development of the nursing home to emergency room transfer checklist resulted in four main parts: (i) demographic data of the nursing home resident; (ii) critical data for nursing home to emergency room transfer; (iii) contact information and (iv) critical data for emergency room to nursing home transfer. Two rounds of Delphi validation resulted in a mean score (standard deviation) ranging from 4.39 (1.13)-4.98 (.15). Time required to complete the checklist was 3-5 min. Use of the nursing home to emergency room transfer checklist resulted in a 30-day readmission rate of 13.4%, which was lower than the baseline rate of 15.9%. The nursing home to emergency room transfer checklist was developed for transferring nursing home residents to an emergency room. The instrument was found to be an effective tool for this process. Use of the nursing home to emergency room transfer checklist for nursing home transfers could fill the information gap that exists when transferring older adults

Emergency control room design of a nuclear reactor used to produce radioisotope

Energy Technology Data Exchange (ETDEWEB)

Santos, Isaac J.A.L. dos; Farias, Larissa P. de; Ponte, Luana T.L.; Goncalves, Gabriel L.; Castro, Heraclito M.; Farias, Marcos S.; Carvalho, Paulo V.R. de; Vianna Filho, Alfredo M.V., E-mail: luquetti@ien.gov.br [Instituto Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Departamento Engenharia Nuclear

2015-07-01

A control room is defined as a functional entity with an associated physical structure, where the operators carry out the centralized control, monitoring and administrative responsibilities. Emergency control room acts as an alternative control room for the purpose of shutting down or maintaining the facility in a safe shutdown state when the main control room is uninhabitable. The mission of emergency control room is to provide the resources to bring the plant to a safe shutdown condition after an evacuation of the main control room. An evacuation of the main control room is assumed when there is no possibility to accomplish tasks involved in the shutdown except reactor trip. The purpose of this paper is to present a specific approach for the design of the emergency control room of a nuclear reactor used to produce radioisotope. The approach is based on human factors standards and the participation of a multidisciplinary team in the development phase of the design. Using the information gathered from standards and from the multidisciplinary team a 3D Sketch and a 3D printing of the emergency control room were created. (author)

Emergency control room design of a nuclear reactor used to produce radioisotope

International Nuclear Information System (INIS)

Santos, Isaac J.A.L. dos; Farias, Larissa P. de; Ponte, Luana T.L.; Goncalves, Gabriel L.; Castro, Heraclito M.; Farias, Marcos S.; Carvalho, Paulo V.R. de; Vianna Filho, Alfredo M.V.

2015-01-01

A control room is defined as a functional entity with an associated physical structure, where the operators carry out the centralized control, monitoring and administrative responsibilities. Emergency control room acts as an alternative control room for the purpose of shutting down or maintaining the facility in a safe shutdown state when the main control room is uninhabitable. The mission of emergency control room is to provide the resources to bring the plant to a safe shutdown condition after an evacuation of the main control room. An evacuation of the main control room is assumed when there is no possibility to accomplish tasks involved in the shutdown except reactor trip. The purpose of this paper is to present a specific approach for the design of the emergency control room of a nuclear reactor used to produce radioisotope. The approach is based on human factors standards and the participation of a multidisciplinary team in the development phase of the design. Using the information gathered from standards and from the multidisciplinary team a 3D Sketch and a 3D printing of the emergency control room were created. (author)

A PACS archive architecture supported on cloud services.

Science.gov (United States)

Silva, Luís A Bastião; Costa, Carlos; Oliveira, José Luis

2012-05-01

Diagnostic imaging procedures have continuously increased over the last decade and this trend may continue in coming years, creating a great impact on storage and retrieval capabilities of current PACS. Moreover, many smaller centers do not have financial resources or requirements that justify the acquisition of a traditional infrastructure. Alternative solutions, such as cloud computing, may help address this emerging need. A tremendous amount of ubiquitous computational power, such as that provided by Google and Amazon, are used every day as a normal commodity. Taking advantage of this new paradigm, an architecture for a Cloud-based PACS archive that provides data privacy, integrity, and availability is proposed. The solution is independent from the cloud provider and the core modules were successfully instantiated in examples of two cloud computing providers. Operational metrics for several medical imaging modalities were tabulated and compared for Google Storage, Amazon S3, and LAN PACS. A PACS-as-a-Service archive that provides storage of medical studies using the Cloud was developed. The results show that the solution is robust and that it is possible to store, query, and retrieve all desired studies in a similar way as in a local PACS approach. Cloud computing is an emerging solution that promises high scalability of infrastructures, software, and applications, according to a "pay-as-you-go" business model. The presented architecture uses the cloud to setup medical data repositories and can have a significant impact on healthcare institutions by reducing IT infrastructures.

PACS industry in Korea

Science.gov (United States)

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.

Design and Implementation of PACS at Georgetown University Hospital

Science.gov (United States)

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.

Child abuse inventory at emergency rooms: CHAIN-ER rationale and design

Directory of Open Access Journals (Sweden)

Nieuwenhuis Edward ES

2011-10-01

Full Text Available Abstract Background Child abuse and neglect is an important international health problem with unacceptable levels of morbidity and mortality. Although maltreatment as a cause of injury is estimated to be only 1% or less of the injured children attending the emergency room, the consequences of both missed child abuse cases and wrong suspicions are substantial. Therefore, the accuracy of ongoing detection at emergency rooms by health care professionals is highly important. Internationally, several diagnostic instruments or strategies for child abuse detection are used at emergency rooms, but their diagnostic value is still unknown. The aim of the study 'Child Abuse Inventory at Emergency Rooms' (CHAIN-ER is to assess if active structured inquiry by emergency room staff can accurately detect physical maltreatment in children presenting at emergency rooms with physical injury. Methods/design CHAIN-ER is a multi-centre, cross-sectional study with 6 months diagnostic follow-up. Five thousand children aged 0-7 presenting with injury at an emergency room will be included. The index test - the SPUTOVAMO-R questionnaire- is to be tested for its diagnostic value against the decision of an expert panel. All SPUTOVAMO-R positives and a 15% random sample of the SPUTOVAMO-R negatives will undergo the same systematic diagnostic work up, which consists of an adequate history being taken by a pediatrician, inquiry with other health care providers by structured questionnaires in order to obtain child abuse predictors, and by additional follow-up information. Eventually, an expert panel (reference test determines the true presence or absence of child abuse. Discussion CHAIN-ER will determine both positive and negative predictive value of a child abuse detection instrument used in the emergency room. We mention a benefit of the use of an expert panel and of the use of complete data. Conducting a diagnostic accuracy study on a child abuse detection instrument is also

Assessment of Suicidal Behavior in a Psychiatric Emergency Room in Lisbon.

Science.gov (United States)

Marques, João Gama; Guerreiro, Diogo Frasquilho; Sampaio, Daniel

2015-01-01

Some studies alerted for the burden of suicidal attempters at emergency rooms. In this study we characterized the suicidal patients admitted to a Portuguese emergency room. For three years, all patients assessed by the first author after suicidal behaviour were included. Suicidal intentionality was evaluated with the Pierce Suicide Intent Scale. Clinical records were searched for follow-up status and satisfaction level was assessed through telephone call. From 120 included patients 70.8% were female, with mean age of 42.35 years. Pierce Suicide Intent Scale suicidal intentionality was low in 30.1%, medium in 59.3%, and high in 10.6% of the sample. The most important predictors of Pierce Suicide Intent Scale intentionality were male gender (p suicide (p Suicide Intent Scale is useful on suicidal behavior assessment at emergency rooms. Highly intentional suicidal behaviour is related to male sex, social problems and personal and familial psychiatric history. The quality of administrative records on this psychiatric emergency room setting are still unacceptable. The most important variables correlated with higher suicidal intentionality are the same described in other countries. Of the reachable patients, one fifth was satisfied with provided follow-up. We still need studies for better understanding of suicidal behaviour observed on this Portuguese emergency room.

Why PACS is no longer a four-letter word.

Science.gov (United States)

Chopra, R M

2000-01-01

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

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

Science.gov (United States)

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

Science.gov (United States)

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.

From shared data to sharing workflow: Merging PACS and teleradiology

International Nuclear Information System (INIS)

Benjamin, Menashe; Aradi, Yinon; Shreiber, Reuven

2010-01-01

Due to a host of technological, interface, operational and workflow limitations, teleradiology and PACS/RIS were historically developed as separate systems serving different purposes. PACS/RIS handled local radiology storage and workflow management while teleradiology addressed remote access to images. Today advanced PACS/RIS support complete site radiology workflow for attending physicians, whether on-site or remote. In parallel, teleradiology has emerged into a service of providing remote, off-hours, coverage for emergency radiology and to a lesser extent subspecialty reading to subscribing sites and radiology groups. When attending radiologists use teleradiology for remote access to a site, they may share all relevant patient data and participate in the site's workflow like their on-site peers. The operation gets cumbersome and time consuming when these radiologists serve multi-sites, each requiring a different remote access, or when the sites do not employ the same PACS/RIS/Reporting Systems and do not share the same ownership. The least efficient operation is of teleradiology companies engaged in reading for multiple facilities. As these services typically employ non-local radiologists, they are allowed to share some of the available patient data necessary to provide an emergency report but, by enlarge, they do not share the workflow of the sites they serve. Radiology stakeholders usually prefer to have their own radiologists perform all radiology tasks including interpretation of off-hour examinations. It is possible with current technology to create a system that combines the benefits of local radiology services to multiple sites with the advantages offered by adding subspecialty and off-hours emergency services through teleradiology. Such a system increases efficiency for the radiology groups by enabling all users, regardless of location, to work 'local' and fully participate in the workflow of every site. We refer to such a system as SuperPACS.

Effect of National Football League games on small animal emergency room caseload.

Science.gov (United States)

Rozanski, Elizabeth A; Rondeau, Mark P; Shaw, Scott P; Rush, John E

2009-07-01

To evaluate whether games of popular professional football teams have an effect on small animal emergency room caseload and percentage of dogs and cats that subsequently are hospitalized, are euthanatized, or die following admission to veterinary emergency rooms located within a dedicated fan base. Prospective study. 818 dogs and cats admitted to the emergency room. During the 2007 New England Patriots (NEP) football season, small animal emergency room caseload was recorded for Sunday (4-hour blocks, 8:00 AM until 12:00 midnight) and Monday night (7:00 PM to 11:00 PM). Number of dogs and cats that subsequently were hospitalized, died, or were euthanatized was recorded. Mean game importance rating (GIR) was determined for NEP games (scale, 1 [mild] to 3 [great]). Percentage of dogs and cats admitted from 12:00 noon to 4:00 PM on Sundays during NEP games (mean GIR, 1.7) versus non-NEP games was not different. Mean +/- SD percentage of dogs and cats admitted from 4:00 PM to 8:00 PM on Sundays during NEP games (mean GIR, 2.4) versus non-NEP games was significantly different (18 +/- 5% and 25 +/- 7% of daily caseload, respectively). Percentage of dogs and cats admitted from 8:00 PM to 12:00 midnight on Sundays during NEP games (mean GIR, 2.1) versus non-NEP games was not different. Game type (NEP vs non-NEP) during emergency room admission did not influence whether dogs and cats subsequently were hospitalized, died, or were euthanatized. Professional sporting events may influence veterinary emergency room caseloads.

PACS in nuclear medicine

International Nuclear Information System (INIS)

Kang, Keon Wook

2000-01-01

PACS (Picture Archiving and Communication System) is being rapidly spread and installed in many hospitals, but most of the system do not include nuclear medicine field. Although additional costs of hardware for nuclear medicine PACS is low, the complexity in developing viewing software and little market have made the nuclear medicine PACS not popular. Most PACS utilize DICOM 3.0 as standard format, but standard format in nuclear medicine has been Interfile. Interfile should be converted into DICOM format if nuclear images are to be stored and visualized in most PACS. Nowadays, many vendors supply the DICOM option in gamma camera and PET. Several hospitals in Korea have already installed nucler PACS with DICOM, but only the screen captured images are supplied. Software for visualizing pseudo-color with color lookup tables and expressing with volume view should be developed to fulfill the demand of referring physicians and nuclear medicine physicians. PACS is going to integrate not only radiologic images but also endoscopic and pathologic images. Web and PC based PACS is now a trend and is much compatible with nuclear medicine PACS. Most important barrier for nuclear medicine PACS that we encounter is not a technical problem, but indifference of investor such as administrator of hospital or PACS. Now it is time to support and invest for the development of nuclear medicine PACS

dicomPACS: PACS Leader in Germany - Kodak Partner

OpenAIRE

Maziyar Shakeri

2007-01-01

History of Distributor: We are PDP Co. (Pardazesh Danesh Pezeshki) founded in 1998 with more than 8 years Experiments in Diagnostic Medical Imaging Market .we launched our New Division in 2002 for Digital Imaging and Softcopy under name of PDP View . We studied our market demands and PACS Provider Companies for 2 years and finally we signed the Contract with the first leader German PACS Provider named dicomPACS ® ."nWe are the only company who their 3 engineers well trained in th...

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

Science.gov (United States)

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.

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

NARCIS (Netherlands)

Wetering, R. van de; Batenburg, R.

2014-01-01

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

The treatment of acute soft tissue trauma in Danish emergency rooms

DEFF Research Database (Denmark)

Johannsen, F; Langberg, Henning

1997-01-01

Rest, ice, compression, elevation (RICE) is the most recommended treatment for acute traumatic soft tissue injuries. A questionnaire was given to all Danish emergency rooms (n = 5) regarding their routines for acute treatment of ankle sprains and muscle contusions. Complete answers were received...... from 37 emergency rooms (73%), covering the treatment of 111 ankle sprains and 101 muscle contusions. Treatment with RICE was given in a minority of injuries, ice (21%), compression (32%) and elevation (58%) similarly between injury types. A complete RICE treatment was rarely applied (3%). Verbal...... information on RICE and rehabilitation was given in less than half of the cases. We conclude that the acute treatment of ankle sprains and muscle contusions in the Danish emergency rooms is not applied in accordance with consensus from international literature, and that the instruction in rehabilitation...

Emergency room management of radiation accidents

International Nuclear Information System (INIS)

Rosenberg, R.; Mettler, F.A. Jr.

1990-01-01

Emergency room management of radioactively contaminated patients who have an associated medical injury requiring immediate attention must be handled with care. Radioactive contamination of the skin of a worker is not a medical emergency and is usually dealt with at the plant. Effective preplanning and on-the-scene triage will allow the seriously injured and contaminated patients to get the medical care they need with a minimum of confusion and interference. Immediate medical and surgical priorities always take precedence over radiation injuries and radioactive contamination. Probably the most difficult aspect of emergency management is the rarity of such accidents and hence the unfamiliarity of the medical staff with the appropriate procedures. The authors discuss how the answer to these problems is preplanning, having a simple and workable procedure and finally having 24-h access to experts

Weather conditions influence the number of psychiatric emergency room patients

Science.gov (United States)

Brandl, Eva Janina; Lett, Tristram A.; Bakanidze, George; Heinz, Andreas; Bermpohl, Felix; Schouler-Ocak, Meryam

2017-12-01

The specific impact of weather factors on psychiatric disorders has been investigated only in few studies with inconsistent results. We hypothesized that meteorological conditions influence the number of cases presenting in a psychiatric emergency room as a measure of mental health conditions. We analyzed the number of patients consulting the emergency room (ER) of a psychiatric hospital in Berlin, Germany, between January 1, 2008, and December 31, 2014. A total of N = 22,672 cases were treated in the ER over the study period. Meteorological data were obtained from a publicly available data base. Due to collinearity among the meteorological variables, we performed a principal component (PC) analysis. Association of PCs with the daily number of patients was analyzed with autoregressive integrated moving average model. Delayed effects were investigated using Granger causal modeling. Daily number of patients in the ER was significantly higher in spring and summer compared to fall and winter (p psychiatric patients consulting the emergency room. In particular, our data indicate lower patient numbers during very cold temperatures.

Dental PACS development in Korea

International Nuclear Information System (INIS)

Kim, Eun Kyung

2008-01-01

Picture archiving and communication system (PACS) is an image information technology system for the transmission and storage of medical images. In Korea the first full PACS was installed at Samsung Medical Center in 1994, but, the rate of distribution was very slow. The government's approval for the medical insurance reimbursement for full PACS examinations in November 1999 became the turning point. Thereafter the number of hospitals with full PACS has steeply increased. In September of this year, PACS was installed at 906 medical institutes, including most of university hospitals and general hospitals. The first full dental PACS was installed at Wonkwang University Dental Hospital in 2002. Now ten out of eleven university dental hospitals implemented full dental PACS. The current status and technological factors of dental PACS in Korean university dental hospitals and the future perspectives of dental PACS are described.

Measures of Rehospitalization, Emergency Room Visit, and Community Discharge

Data.gov (United States)

U.S. Department of Health & Human Services — Measures of the Rate of Rehospitalization, Emergency Room Visit, and Community Discharge for Medicare Beneficiaries. These rates are based on Medicare claims data.

Shimadzu AI-PACS 'SAIPACS'

International Nuclear Information System (INIS)

Andoh, Minoru; Asai, Shigeya; Matsui, Norihisa; Nishida, Shinichiro; Horino, Masato

1990-01-01

The PACS-WS named SAIPACS-WS(workstation) has been developed as the first step of complete PACS. This SAIPACS-WS is different from other PACS-WS's, because this is including computer aided diagnostic reporting and computer aided diagnosis by using artificial intelligence technique. In this paper we will report detail of the SAIPACS-WS and discuss the future development of the total PACS setting the SAIPACS-WS in its center. (author)

Evaluation of the preparedness of the children's emergency rooms ...

African Journals Online (AJOL)

PROMOTING ACCESS TO AFRICAN RESEARCH ... Background: The Children Emergency Room (CHER) is the first point of call for many sick children. ... limitation abounds with regards to personnel, high technology infrastructure, personnel ...

Using an open-source PACS virtual machine for a digital angiography unit: methods and initial impressions.

Science.gov (United States)

Kagadis, George C; Alexakos, Christos; Langer, Steve G; French, Todd

2012-02-01

The productivity gains, diagnostic benefit, and enhanced data availability to clinicians enabled by picture archiving and communication systems (PACS) are no longer in doubt. However, commercial PACS offerings are often extremely expensive initially and require ongoing support contracts with vendors to maintain them. Recently, several open-source offerings have become available that put PACS within reach of more users. However, they can be resource-intensive to install and assure that they have room for future growth--both for computational and storage capacity. An alternate approach, which we describe herein, is to use PACS built on virtual machines which can be moved from smaller to larger hardware as needed in a just-in-time manner. This leverages the cost benefits of Moore's Law for both storage and compute costs. We describe the approach and current results in this paper.

Multiple Trauma and Emergency Room Management.

Science.gov (United States)

Frink, Michael; Lechler, Philipp; Debus, Florian; Ruchholtz, Steffen

2017-07-24

The care of severely injured patients remains a challenge. Their initial treatment in the emergency room is the essential link between first aid in the field and definitive in-hospital treatment. We present important elements of the initial in-hospital care of severely injured patients on the basis of pertinent publications retrieved by a selective search in PubMed and the current German S3 guideline on the care of severely and multiply traumatized patients, which was last updated in 2016. The goal of initial emergency room care is the rapid recognition and prompt treatment of acutely life-threatening injuries in the order of their priority. The initial assessment includes physical examination and ultrasonography according to the FAST concept (Focused Assessment with Sonography in Trauma) for the recognition of intraperitoneal hemorrhage. Patients with penetrating chest injuries, massive hematothorax, and/or severe injuries of the heart and lungs undergo emergency thoracotomy; those with signs of hollow viscus perforation undergo emergency laparotomy. If the patient is hemo - dynamically stable, the most important diagnostic procedure that must be performed is computerized tomography with contrast medium. Therapeutic decision-making takes the patient's physiological parameters into account, along with the overall severity of trauma and the complexity of the individual injuries. Depending on the severity of trauma, the immediate goal can be either the prompt restoration of organ structure and function or so-called damage control surgery. The latter focuses, in the acute phase, on hemostasis and on the avoidance of secondary damage such as intra-abdominal contamination or compartment syndrome. It also involves the temporary treatment of fractures with external fixation and the planning of definitive care once the patient's organ functions have been securely stabilized. The care of the severely injured patient should be performed in structured fashion according to the

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

Science.gov (United States)

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.

Medical imaging, PACS, and imaging informatics: retrospective.

Science.gov (United States)

Huang, H K

2014-01-01

. (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.

PAC research in biology

Energy Technology Data Exchange (ETDEWEB)

Chain, C. Y., E-mail: yamil@fisica.unlp.edu.ar [Universidad Nacional de La Plata, IFLP (Argentina); Ceolin, M. [Instituto de Investigaciones Fisicoquimicas Teoricas y Aplicadas, Dto de Quimica, Fac. Cs. Exactas, UNLP (Argentina); Pasquevich, A. F. [Universidad Nacional de La Plata, IFLP (Argentina)

2008-01-15

In this paper possible applications of the Perturbed Angular Correlations (PAC) technique in Biology are considered. Previous PAC experiments in biology are globally analyzed. All the work that appears in the literature has been grouped in a few research lines, just to make the analysis and discussion easy. The commonly used radioactive probes are listed and the experimental difficulties are analyzed. We also report applications of {sup 181}Hf and {sup 111}In isotopes in life sciences other than their use in PAC. The possibility of extending these studies using the PAC technique is discussed.

Therapeutic approach to patients complaining of high blood pressure in a cardiological emergency room

Directory of Open Access Journals (Sweden)

Miguel Gus

1999-03-01

Full Text Available OBJECTIVE: To evaluate the management of patients complaining of high blood pressure (BP in a cardiological emergency room. METHODS: Patients referred to the cardiological emergency room with the main complaint of high blood pressure were consecutively selected. The prescriptions and the choice of antihypertensive drugs were assessed. The classification of these patients as hypertensive emergencies or pseudoemergencies, according to the physician who provided initial care, was recorded. RESULTS: From a total of 858 patients presenting to the emergency room, 80 (9.3% complained of high BP, and 61 (76.3% received antihypertensive drugs. Sublingual nifedipine was the most commonly used drug (59%. One patient received intravenous medication, one patient was hospitalized and 6 patients (7.5% were classified as hypertensive emergencies or pseudoemergencies. CONCLUSION: High BP could seldom be classified as a hypertensive emergency or pseudoemergency, even though it was a frequent complaint (9.3% of visits. Currently, the therapeutic approach is not recommended, even in specialized clinics.

Facets of operational performance in an emergency room (ER)

NARCIS (Netherlands)

van der Vaart, Taco; Vastag, Gyula; Wijngaard, Jacob

This paper, using detailed time measurements of patients complemented by interviews with hospital management and staff, examines three facets of an emergency room's (ER) operational performance: (1) effectiveness of the triage system in rationing patient treatment; (2) factors influencing ER's

The future of PACS

International Nuclear Information System (INIS)

Nagy, Paul G.

2007-01-01

How will the future of picture archiving and communication systems (PACS) look, and how will this future affect the practice of radiology? We are currently experiencing disruptive innovations that will force an architectural redesign, making the majority of today’s commercial PACS obsolete as the field matures and expands to include imaging throughout the medical enterprise. The common architecture used for PACS cannot handle the massive amounts of data being generated by even current versions of computed tomography and magnetic resonance scanners. If a PACS cannot handle today’s technology, what will happen as the field expands to encompass pathology imaging, cone-beam reconstruction, and multispectral imaging? The ability of these new technologies to enhance research and clinical care will be impaired if PACS architectures are not prepared to support them. In attempting a structured approach to predictions about the future of PACS, we offer projections about the technologies underlying PACS as well as the evolution of standards development and the changing needs of a broad range of medical imaging. Simplified models of the history of the PACS industry are mined for the assumptions they provide about future innovations and trends. The physicist frequently participates in or directs technical assessments for medical equipment, and many physicists have extended these activities to include imaging informatics. It is hoped that by applying these speculative but experienced-based predictions, the interested medical physicist will be better able to take the lead in setting information technology strategies that will help facilities not only prepare for the future but continue to enjoy the benefits of technological innovations without disruptive, expensive, and unexpected changes in architecture. A good PACS strategy can help accelerate the time required for innovations to go from the drawing board to clinical implementation.

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

Science.gov (United States)

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.

PACS for Bhutan: a cost effective open source architecture for emerging countries.

Science.gov (United States)

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.

CFD analysis of the temperature field in emergency pump room in Loviisa NPP

Energy Technology Data Exchange (ETDEWEB)

Rämä, Tommi, E-mail: tommi.rama@fortum.com [Fortum Power and Heat, P.O.B. 100, FI-00048 Fortum (Finland); Toppila, Timo, E-mail: timo.toppila@fortum.com [Fortum Power and Heat, P.O.B. 100, FI-00048 Fortum (Finland); Kelavirta, Teemu, E-mail: teemu.kelavirta@fortum.com [Fortum Power and Heat, Loviisa Power Plant, P.O.B. 23, FI-07901 Loviisa (Finland); Martin, Pasi, E-mail: pasi.martin@fortum.com [Fortum Power and Heat, Loviisa Power Plant, P.O.B. 23, FI-07901 Loviisa (Finland)

2014-11-15

Highlights: • Laser scanned room geometry from Loviisa NPP was utilized for CFD simulation. • Uncertainty of CFD simulation was estimated using the Grid Convergence Index. • Measured temperature field of pump room was reproduced with CFD simulation. - Abstract: In the Loviisa Nuclear Power Plant (NPP) six emergency pumps belonging to the same redundancy are located in the same room. During a postulated accident the cooling of the room is needed as the engines of the emergency pumps generate heat. Cooling is performed with fans blowing air to the upper part of the room. Temperature limits have been given to the operating conditions of the main components in order to ensure their reliable operation. Therefore the temperature field of the room is important to know. Temperature measurements were made close to the most important components of the pump room to get a better understanding of the temperature field. For these measurements emergency pumps and cooling fan units were activated. To simulate conditions during a postulated accident additional warm-air heaters were used. Computational fluid dynamic (CFD) simulations were made to support plant measurements. For the CFD study one of the pump rooms of Loviisa NPP was scanned with a laser and this data converted to detailed 3-D geometry. Tetrahedral computation grid was created inside the geometry. Grid sensitivity studies were made, and the model was then validated against the power plant tests. With CFD the detailed temperature and flow fields of the whole room were produced. The used CFD model was able to reproduce the temperature field of the measurements. Two postulated accident cases were simulated. In the cases the operating cooling units were varied. The temperature profile of the room changes significantly depending on which units are cooling and which only circulating the air. The room average temperature stays approximately the same. The simulation results were used to ensure the acceptable operating

Fitting PAC spectra with stochastic models: PolyPacFit

Energy Technology Data Exchange (ETDEWEB)

Zacate, M. O., E-mail: zacatem1@nku.edu [Northern Kentucky University, Department of Physics and Geology (United States); Evenson, W. E. [Utah Valley University, College of Science and Health (United States); Newhouse, R.; Collins, G. S. [Washington State University, Department of Physics and Astronomy (United States)

2010-04-15

PolyPacFit is an advanced fitting program for time-differential perturbed angular correlation (PAC) spectroscopy. It incorporates stochastic models and provides robust options for customization of fits. Notable features of the program include platform independence and support for (1) fits to stochastic models of hyperfine interactions, (2) user-defined constraints among model parameters, (3) fits to multiple spectra simultaneously, and (4) any spin nuclear probe.

PACS for imaging centers.

Science.gov (United States)

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

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

Science.gov (United States)

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.

A strategic PACS maturity approach

NARCIS (Netherlands)

van de Wetering, R.

2011-01-01

Finding the key determinants of Picture Archivingand Communication Systems (PACS)performance in hospitals has been a conundrumfor decades. This research provides a method toassess the strategic alignment of PACS in hospitalsin order to find these key determinants. PACS touches upon every single part

PACS for Bhutan: a cost effective open source architecture for emerging countries

Directory of Open Access Journals (Sweden)

Osman Ratib

2016-07-01

Full Text Available Abstract 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. Messages/teaching points • 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

Categorizing "frequent visitors" in the psychiatric emergency room: a semistructured interview study

DEFF Research Database (Denmark)

Buus, Niels

2011-01-01

Nurses can become demoralized and hostile toward frequent visitors in psychiatric emergency rooms because of the number of visits. The aim of this study was to develop more knowledge about the ways in which nurses categorize frequent visitors. Eleven nurses were interviewed, and their categorizing...... practices were examined from a social constructionist perspective. The results showed that the nurses did not categorize frequent visitors as particularly unlikeable or difficult to treat. Like other visitors, they could be categorized as difficult if they obstructed a smooth flow of successful referrals...... through the emergency room and/or there was poor rapport with the nurses....

"Boarding" Psychiatric Patients in Emergency Rooms: One Court Says "No More".

Science.gov (United States)

Appelbaum, Paul S

2015-07-01

"Boarding" involuntary psychiatric patients in medical emergency rooms is common in many parts of the United States. The practice, driven by a shortage of alternative resources, including limited inpatient capacity, can result in patients' being held for days without treatment or a hospital room, often in busy corridors or treatment rooms. A recent challenge to this practice led the Washington Supreme Court to declare it illegal and resulted in the appropriation of substantial funding to create new psychiatric beds. Centralized psychiatric crisis services, with appropriate payment models, may offer another approach to reducing the need for holding patients awaiting inpatient admission.

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

Science.gov (United States)

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.

History of PACS in Asia

International Nuclear Information System (INIS)

Inamura, Kiyonari; Kim, Jong Hyo

2011-01-01

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.

MedPAC Data Book

Data.gov (United States)

U.S. Department of Health & Human Services — MedPACs Data Book is the result of discussions with congressional staff members regarding ways that MedPAC can better support them. Some of the information it...

Evaluation of care for traffic accidents victims made by on duty emergency physicians and surgeons in the emergency room

Directory of Open Access Journals (Sweden)

VLAUDIMIR DIAS MARQUES

Full Text Available ABSTRACT Objective: to evaluate the care for victims of traffic accidents by on call emergency physicians and/or surgeons in the emergency room. Methods: we conducted a retrospective, descriptive and exploratory study on the care for traffic accidents victims in the urban area of Maringá-PR, between July 2013 and July 2014 in reference hospitals. We assessed demographics and vocational training through a questionnaire sent to the attending physicians. Results: of the 688 records evaluated, 99% of patients had a prehospital Revised Trauma Score of 12. Statistical analysis showed that in the cases conducted by the emergency physicians (n=187, the recording of the Glasgow Coma Scale and the performance of surgical procedures were less common, whereas the recording of blood pressure values was performed in greater numbers when compared with cases led by surgeons (n=501. There was a statistically significant relationship (p<0.01 between the length of hospital stay and surgical specialty, with a greater chance (crude OR=28 in the period from one to six hours for the group treated by emergency doctors. Most physicians participating in the study were young, with emergency room time of up to one to two years, and with ATLS training. Among those who had attended the ATLS course, 60% did so in the last four years. Surgeons performed 73% of hospital treatments. Conclusion: in the care of traffic victims with minor injuries, the Glasgow Coma Scale, the blood pressure levels, the type of treatment in the emergency room and hospital stay had different approaches between emergency physicians and surgeons.

Evaluation of the preparedness of the children's emergency rooms ...

African Journals Online (AJOL)

2017-02-09

Feb 9, 2017 ... beds per nurse ranges from 3-15, giving a nurse: patient ratio of 1:3-15. (Table 1) .... Emergency Rooms (CHER) in the tertiary health institu- .... vices offered in our tertiary centres must go beyond the mundane ... medical tourism abroad as most often any care beyond the basic ... of general practitioner care.

Suspected leaking abdominal aortic aneurysm: use of sonography in the emergency room.

Science.gov (United States)

Shuman, W P; Hastrup, W; Kohler, T R; Nyberg, D A; Wang, K Y; Vincent, L M; Mack, L A

1988-07-01

To determine the value of sonography in the emergent evaluation of suspected leaking abdominal aortic aneurysms, the authors examined 60 patients in the emergency department using sonography and a protocol involving advance radio notification from the ambulance; arrival of sonographic personnel and equipment in the triage room before patient arrival; and, during other triage activities, rapid sonographic evaluation of the aorta for aneurysm and of the paraaortic region for extraluminal blood. Sonographic findings were correlated with surgical results and clinical outcome. When performed under these circumstances, sonography was accurate in demonstrating presence or absence of aneurysm (98%), but its sensitivity for extraluminal blood was poor (4%). A combination of sonographic confirmation of aneurysm, abdominal pain, and unstable hemodynamic condition resulted in the correct decision to perform emergent surgery in 21 of 22 patients (95%). An abbreviated sonographic examination done in the emergency room can provide accurate, useful information about the presence of aneurysm; this procedure does not significantly delay triage of these patients.

Current status and installation of dental PACS

International Nuclear Information System (INIS)

Park, Chang Seo; Kim, Kee Deog; Park, Hyok; Jeong, Ho Gul

2004-01-01

Picture Archiving and Communication System (PACS) is difficult to implement in the best of situations, but evidence is growing that the benefits are significant. The aims of this study are to analyze the current status of full PACS and establish successful installation standard of dental PACS. Materials and Methods were based on the investigation of current working status and installation standard of PACS, and observation of variable issues to installation of dental PACS. By September 30, 2004, full PACS implementations in their facilities were 88.1% in specialized general hospitals (37 installations out of total 42 hospitals), 59.8% in general hospitals (144 installations out of total 241 hospitals), 12.3% in medical hospitals (116 installations out of total 941 hospitals) and 3.6% in dental hospitals (4 installations out of total 110 hospitals). Only 4 university dental hospitals currently have installed and are operating full PACS. Major obstacle to wide spread of dental PACS is initial high investments. Clinical environments of dental PACS differed from medical situation. Because of characteristic dental practice, the initial investments for dental PACS are generally much greater than those of medical PACS. Also new economic crisis makes users scruple. The best way to overcome these limitations is to establish an economic installation standard for dental PACS. Also the clear technical communication between the customer and the supplier before both sides are committed to the obstacles are critical to its success.

History of PACS in Asia.

Science.gov (United States)

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.

Preparing for Sudden Death: Social Work in the Emergency Room.

Science.gov (United States)

Wells, Paula J.

1993-01-01

Provides guidelines from social work perspective on how social workers and health care professionals can provide bereavement counseling for families whose relatives have died in emergency room. Discusses providing family with privacy and accessibility; keeping family informed; using understandable terminology; speaking directly about death;…

Child Abuse: The Value of Systematic Screening at Emergency Rooms

NARCIS (Netherlands)

Sittig, J.S.

2015-01-01

There is no conclusive evidence that diagnostic tools detect physical child abuse among children coming to emergency rooms (ERs), but his evidence is urgently needed because both false-positive and false-negative diagnoses have serious adverse effects. This thesis describes several aspects of the

Reliability issues in PACS

Science.gov (United States)

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.

Short history of PACS. Part I: USA

Energy Technology Data Exchange (ETDEWEB)

Huang, H.K., E-mail: hkhuang@aol.com [Departments of Radiology and Biomedical Engineering, University of Southern California (United States); Hong Kong Polytechnic University (Hong Kong); Shanghai Institute of Technical Physics, Chinese Academy of Sciences (China)

2011-05-15

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.

Short history of PACS. Part I: USA

International Nuclear Information System (INIS)

Huang, H.K.

2011-01-01

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.

Digital image display system for emergency room

International Nuclear Information System (INIS)

Murry, R.C.; Lane, T.J.; Miax, L.S.

1989-01-01

This paper reports on a digital image display system for the emergency room (ER) in a major trauma hospital. Its objective is to reduce radiographic image delivery time to a busy ER while simultaneously providing a multimodality capability. Image storage, retrieval, and display will also be facilitated with this system. The system's backbone is a token-ring network of RISC and personal computers. The display terminals are higher- function RISC computers with 1,024 2 color or gray-scale monitors. The PCs serve as administrative terminals. Nuclear medicine, CT, MR, and digitized film images are transferred to the image display system

Short history of PACS. Part I: USA.

Science.gov (United States)

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.

Cervical Spine Collar Removal by Emergency Room Nurses: A Quality Improvement Project.

Science.gov (United States)

Fontaine, Guillaume; Forgione, Massimo; Lusignan, Francis; Lanoue, Marc-André; Drouin, Simon

2018-05-01

The Canadian C-Spine Rule (CCR) is a clinical decision aid to facilitate the safe removal of cervical collars in the alert, orientated, low-risk adult trauma patient. Few health care settings have assessed initiatives to train charge nurses to use the CCR. This practice improvement project conducted in a secondary trauma center in Canada aimed to (1) train charge nurses of the emergency room to use the CCR, (2) monitor its use throughout the project period, and (3) compare the assessments of the charge nurses with those of emergency physicians. The project began with the creation of an interdisciplinary team. Clinical guidelines were established by the interdisciplinary project team. Nine charge nurses of the emergency room were then trained to use the CCR (3 on each 8-hour shift). The use of the CCR was monitored throughout the project period, from June 1 to October 5, 2016. The 3 aims of this practice improvement project were attained successfully. Over a 5-month period, 114 patients were assessed with the CCR. Charge nurses removed the cervical collars for 54 of 114 patients (47%). A perfect agreement rate (114 of 114 patients, 100%) was attained between the assessments of the nurses and those of physicians. This project shows that the charge nurses of a secondary trauma center can use the CCR safely on alert, orientated, and low-risk adult trauma patients as demonstrated by the agreement in the assessments of emergency room nurses and physicians. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

PM2.5 constituents and hospital emergency-room visits in Shanghai, China.

Science.gov (United States)

Qiao, Liping; Cai, Jing; Wang, Hongli; Wang, Weibing; Zhou, Min; Lou, Shengrong; Chen, Renjie; Dai, Haixia; Chen, Changhong; Kan, Haidong

2014-09-02

Although ambient PM2.5 has been linked to adverse health effects, the chemical constituents that cause harm are largely unclear. Few prior studies in a developing country have reported the health impacts of PM2.5 constituents. In this study, we examined the short-term association between PM2.5 constituents and emergency room visits in Shanghai, China. We measured daily concentrations of PM2.5, organic carbon (OC), elemental carbon (EC), and eight water-soluble ions between January 1, 2011 and December 31, 2012. We analyzed the data using overdispersed generalized linear Poisson models. During our study period, the mean daily average concentration of PM2.5 in Shanghai was 55 μg/m(3). Major contributors to PM2.5 mass included OC, EC, sulfate, nitrate, and ammonium. For a 1-day lag, an interquartile range increment in PM2.5 mass (36.47 μg/m(3)) corresponded to 0.57% [95% confidence interval (CI): 0.13%, 1.01%] increase of emergency room visits. In all the three models used, we found significant positive associations of emergency room visits with OC and EC. Our findings suggest that PM2.5 constituents from the combustion of fossil fuel (e.g., OC and EC) may have an appreciable influence on the health impact attributable to PM2.5.

Picture archiving and communications systems (PACS)

International Nuclear Information System (INIS)

Huang, H.K.; Dwyer, S.J. III; Angus, W.M.; Capp, M.P.; Arenson, R.L.; Kangarloo, H.

1987-01-01

This special focus session discusses the current status of picture archiving and communication systems (PACS). The first presentation focuses on the technological advances in various PACS components. The second presentation concentrates on image archiving - what is required, what is available. The third talk is on the concept of a total digital radiology department in the past, the present, and the future. The fourth panelist discusses evaluating various imaging systems as PACS components for the intensive care unit. Finally, one hears about clinical experience with two operating PACS modules, one in pediatric radiology and the second in a coronary care unit

PACS on mobile devices

Science.gov (United States)

Parikh, Ashesh; Mehta, Nihal

2015-03-01

Recent advances in internet browser technologies makes it possible to incorporate advanced functionality of a traditional PACS for viewing DICOM medical images on standard web browsers without the need to pre-install any plug-ins, apps or software. We demonstrate some of the capabilities of standard web browsers setting the stage for a cloud-based PACS.

Suicide Mortality of Suicide Attempt Patients Discharged from Emergency Room, Nonsuicidal Psychiatric Patients Discharged from Emergency Room, Admitted Suicide Attempt Patients, and Admitted Nonsuicidal Psychiatric Patients

Science.gov (United States)

Choi, Jae W.; Park, Subin; Yi, Ki K.; Hong, Jin P.

2012-01-01

The suicide mortality rate and risk factors for suicide completion of patients who presented to an emergency room (ER) for suicide attempt and were discharged without psychiatric admission, patients who presented to an ER for psychiatric problems other than suicide attempt and were discharged without psychiatric admission, psychiatric inpatients…

Neuroimaging of Patients with Headache in the Emergency Room: A Retrospective Analysis

Directory of Open Access Journals (Sweden)

ibrahim Burak Atci

2015-03-01

Conclusion: In the emergency department during evaluation of headache, that should be done first is the exclusion of headaches which is caused by non beningn intracranial patologies. Therefore, from the entrance of the patients evaluated in the emergency room, it is important that they must be directed to rapid diagnosis and treatment with considering the red alert findings. [Cukurova Med J 2015; 40(1.000: 86-90

The Detector Physics and Applications Center - DePAC

CERN Document Server

Plothow-Besch, H; Fiorini, C; Grupen, C; Hassard, J; Longoni, A; Walenta, Albert H

2001-01-01

A new project, the 'Detector Physics and Applications Center (DePAC)', is presented. DePAC is a general detector and sensor database, which is not application specific, on the Internet. DePAC collects and explains the physics, the technology and the application of a wide range of radiation detectors. DePAC also collects and describes information about noise problems, front-end electronics, data transfer, processing and storage. DePAC provides short write-ups and source code of all sorts of detector related software depending on availability. DePAC collects useful constants and properties of materials in an exhaustive series of tables and graphs. DePAC also acts as a point of contact for researchers and industry in an interdisciplinary way, e.g. in biology, in medicine, in materials research and in high energy or nuclear physics. Last but not least, DePAC aims to develop also into a virtual lecturing school and serves as a tutorial for students and all interested scientists.

The Detector Physics and Applications Center—DePAC

Science.gov (United States)

Plothow-Besch, H.; Besch, H.-J.; Fiorini, C.; Grupen, C.; Hassard, J.; Longoni, A.; Walenta, A. H.

2001-09-01

A new project, the "Detector Physics and Applications Center (DePAC)", is presented. DePAC is a general detector and sensor database, which is not application specific, on the Internet. DePAC collects and explains the physics, the technology and the application of a wide range of radiation detectors. DePAC also collects and describes information about noise problems, front-end electronics, data transfer, processing and storage. DePAC provides short write-ups and source code of all sorts of detector related software depending on availability. DePAC collects useful constants and properties of materials in an exhaustive series of tables and graphs. DePAC also acts as a point of contact for researchers and industry in an interdisciplinary way, e.g. in biology, in medicine, in materials research and in high energy or nuclear physics. Last but not least, DePAC aims to develop also into a virtual lecturing school and serves as a tutorial for students and all interested scientists.

The Detector Physics and Applications Center - DePAC

International Nuclear Information System (INIS)

Plothow-Besch, H.; Besch, H.-J.; Fiorini, C.; Grupen, C.; Hassard, J.; Longoni, A.; Walenta, A.H.

2001-01-01

A new project, the 'Detector Physics and Applications Center (DePAC)', is presented. DePAC is a general detector and sensor database, which is not application specific, on the Internet. DePAC collects and explains the physics, the technology and the application of a wide range of radiation detectors. DePAC also collects and describes information about noise problems, front-end electronics, data transfer, processing and storage. DePAC provides short write-ups and source code of all sorts of detector related software depending on availability. DePAC collects useful constants and properties of materials in an exhaustive series of tables and graphs. DePAC also acts as a point of contact for researchers and industry in an interdisciplinary way, e.g. in biology, in medicine, in materials research and in high energy or nuclear physics. Last but not least, DePAC aims to develop also into a virtual lecturing school and serves as a tutorial for students and all interested scientists

Enterprise imaging and multi-departmental PACS

International Nuclear Information System (INIS)

Bergh, Bjoern

2006-01-01

The aim of this review is to present the status of digital image acquisition and archiving outside of radiology and to describe the technical concepts and possibilities of how a ''radiology'' Picture Archiving and Communication System (PACS) can become a multi-departmental (MD-)PACS. First the principles of system integration technology are explained and illustrated by the description of a typical radiology system integration. Then four types of modality integration approaches are defined: the direct modality integration (Type-I), the integration via DICOM acquisition software (Type-II) the integration via specialised systems either with (Type-III) or without PACS connection (Type-IV). The last section is dedicated to the presentation of the PACS requirements of selected interdisciplinary modality types [Endoscopy, Ultrasound and Electrocardiography (ECG)] and clinical disciplines (Pathology, Dermatology, Ophthalmology and Cardiology), which are then compared with the technical possibilities of a MD-PACS. (orig.)

Errors in radiographic recognition in the emergency room

International Nuclear Information System (INIS)

Britton, C.A.; Cooperstein, L.A.

1986-01-01

For 6 months we monitored the frequency and type of errors in radiographic recognition made by radiology residents on call in our emergency room. A relatively low error rate was observed, probably because the authors evaluated cognitive errors only, rather than include those of interpretation. The most common missed finding was a small fracture, particularly on the hands or feet. First-year residents were most likely to make an error, but, interestingly, our survey revealed a small subset of upper-level residents who made a disproportionate number of errors

Trends in PACS architecture

International Nuclear Information System (INIS)

Bellon, Erwin; Feron, Michel; Deprez, Tom; Reynders, Reinoud; Van den Bosch, Bart

2011-01-01

Radiological Picture Archiving and Communication Systems (PACS) have only relatively recently become abundant. Many hospitals have made the transition to PACS about a decade ago. During that decade requirements and available technology have changed considerably. In this paper we look at factors that influence the design of tomorrow's systems, especially those in larger multidisciplinary hospitals. We discuss their impact on PACS architecture (a technological perspective) as well as their impact on radiology (a management perspective). We emphasize that many of these influencing factors originate outside radiology and that radiology has little impact on these factors. That makes it the more important for managers in radiology to be aware of architectural aspects and it may change cooperation of radiology with, among others, the hospital's central IT department.

A PACS maturity model: a systematic meta-analytic review on maturation and evolvability of PACS in the hospital enterprise.

NARCIS (Netherlands)

Wetering, R. van de; Batenburg, R.

2009-01-01

INTRODUCTION: With PACS and medical imaging technology maturing, the importance of organizational maturity and effective deployment of PACS in the hospital enterprise are becoming significant. OBJECTIVE: The objective of this paper is twofold. Firstly, PACS literature on maturity and evolvability in

Internationalization of healthcare applications: a generic approach for PACS workstations.

Science.gov (United States)

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.

PACS module image communication at UCLA

International Nuclear Information System (INIS)

Stewart, B.K.; Taira, R.K.; Cho, P.S.; Mankovich, N.J.

1987-01-01

The advent of the ACR-NEMA digital and communication standard for PACS implementation between imaging, storage and display devices may simplify the networking problems inherent to PACS in the future. However, since the ACR-NEMA interface has not been implemented in manufactured products, the components of a PACS at the present time use various network interface designs, requiring substantial effort in the area of hardware and software integration. Many communication systems are used for the PACS implementation in Pediatric Radiology at UCLA, including baseband, broadband, as well as various parallel-line interface protocols, e.g. GP-IB. A VAX 11/750 minicomputer serves as the host computer for the UCLA Pediatric Radiology PACS system. Communication between the many peripherals take place through the host computer, which acts as the central node. Several communication links have been established, primarily: host computer to other local computers, image processors, various peripherals (digitizers, storage media, etc.) and, of course, to the 512, 1024 and 2048 viewing stations

Current developments in departmental PACS for ultrasound.

Science.gov (United States)

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

[Advanced Trauma Life Support (ATLS) in the emergency room. Is it suitable as an SOP?].

Science.gov (United States)

Shafizadeh, S; Tjardes, T; Steinhausen, E; Balke, M; Paffrath, T; Bouillon, B; Bäthis, H

2010-08-01

There is clinical evidence that a standardized management of trauma patients in the emergency room improves outcome. ATLS is a training course that teaches a systematic approach to the trauma patient in the emergency room. The aims are a rapid and accurate assessment of the patient's physiologic status, treatment according to priorities, and making decisions on whether the local resources are sufficient for adequate definitive treatment of the patient or if transfer to a trauma center is necessary. Above all it is important to prevent secondary injury, to realize timing as a relevant factor in the initial treatment, and to assure a high standard of care. A standard operating procedure (SOP) exactly regulates the approach to trauma patients and determines the responsibilities of the involved faculties. An SOP moreover incorporates the organizational structure in the treatment of trauma patients as well as the necessary technical equipment and staff requirements. To optimize process and result quality, priorities are in the fields of medical fundamentals of trauma care, education, and fault management. SOPs and training courses increase the process and result quality in the treatment of the trauma patient in the emergency room. These programs should be based on the special demands of the physiology of the trauma as well as the structural specifics of the hospital. ATLS does not equal an SOP but it qualifies as a standardized concept for management of trauma patients in the emergency room.

76 FR 76937 - Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting-Room Change

Science.gov (United States)

2011-12-09

... DEPARTMENT OF COMMERCE Bureau of Industry and Security Emerging Technology and Research Advisory Committee; Notice of Partially Closed Meeting--Room Change The Emerging Technology and Research Advisory... emerging technology and research activities, including those related to deemed exports. Agenda Wednesday...

Coronary Computed Tomography Angiography in the Assessment of Acute Chest Pain in the Emergency Room

Energy Technology Data Exchange (ETDEWEB)

Prazeres, Carlos Eduardo Elias dos; Cury, Roberto Caldeira; Carneiro, Adriano Camargo de Castro [Hospital do Coração - HCor, Associação do Sanatório Sírio, São Paulo, SP (Brazil); Rochitte, Carlos Eduardo, E-mail: rochitte@cardiol.br [Hospital do Coração - HCor, Associação do Sanatório Sírio, São Paulo, SP (Brazil); Instituto do Coração - InCor - HCFMUSP, São Paulo, SP (Brazil)

2013-12-15

The coronary computed tomography angiography has recently emerged as an accurate diagnostic tool in the evaluation of coronary artery disease, providing diagnostic and prognostic data that correlate directly with the data provided by invasive coronary angiography. The association of recent technological developments has allowed improved temporal resolution and better spatial coverage of the cardiac volume with significant reduction in radiation dose, and with the crucial need for more effective protocols of risk stratification of patients with chest pain in the emergency room, recent evaluation of the computed tomography coronary angiography has been performed in the setting of acute chest pain, as about two thirds of invasive coronary angiographies show no significantly obstructive coronary artery disease. In daily practice, without the use of more efficient technologies, such as coronary angiography by computed tomography, safe and efficient stratification of patients with acute chest pain remains a challenge to the medical team in the emergency room. Recently, several studies, including three randomized trials, showed favorable results with the use of this technology in the emergency department for patients with low to intermediate likelihood of coronary artery disease. In this review, we show data resulting from coronary angiography by computed tomography in risk stratification of patients with chest pain in the emergency room, its diagnostic value, prognosis and cost-effectiveness and a critical analysis of recently published multicenter studies.

Coronary Computed Tomography Angiography in the Assessment of Acute Chest Pain in the Emergency Room

International Nuclear Information System (INIS)

Prazeres, Carlos Eduardo Elias dos; Cury, Roberto Caldeira; Carneiro, Adriano Camargo de Castro; Rochitte, Carlos Eduardo

2013-01-01

The coronary computed tomography angiography has recently emerged as an accurate diagnostic tool in the evaluation of coronary artery disease, providing diagnostic and prognostic data that correlate directly with the data provided by invasive coronary angiography. The association of recent technological developments has allowed improved temporal resolution and better spatial coverage of the cardiac volume with significant reduction in radiation dose, and with the crucial need for more effective protocols of risk stratification of patients with chest pain in the emergency room, recent evaluation of the computed tomography coronary angiography has been performed in the setting of acute chest pain, as about two thirds of invasive coronary angiographies show no significantly obstructive coronary artery disease. In daily practice, without the use of more efficient technologies, such as coronary angiography by computed tomography, safe and efficient stratification of patients with acute chest pain remains a challenge to the medical team in the emergency room. Recently, several studies, including three randomized trials, showed favorable results with the use of this technology in the emergency department for patients with low to intermediate likelihood of coronary artery disease. In this review, we show data resulting from coronary angiography by computed tomography in risk stratification of patients with chest pain in the emergency room, its diagnostic value, prognosis and cost-effectiveness and a critical analysis of recently published multicenter studies

Current status of the UCSF second-generation PACS

Science.gov (United States)

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.

A DICOM based PACS for nuclear medicine; Ein DICOM-basiertes PACS fuer die Nuklearmedizin

Energy Technology Data Exchange (ETDEWEB)

Lassmann, M.; Reiners, C. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

2002-02-01

The installation of a radiology information system (RIS) connected to a hospital information system (HIS) and a picture archiving and communications system (PACS) seems mandatory for a nuclear medicine department in order to guarantee a high patient throughput. With these systems a fast transmission of reports, images to the in- and out-patients' wards and private practitioners is realized. Therefore, since April 2000, at the department of nuclear medicine of the university of Wuerzburg a completely DICOM based PACS has been implemented in addition to the RIS. With this system a DICOM based workflow is realized throughout the department of nuclear medicine for reporting and archiving. The PACS is connected to six gamma-cameras, a PET scanner, a bone densitometry system and an ultrasound device. The volume of image data archived per month is 4 GByte. Patient demographics are provided to the modalities via DICOM-Worklist. With these PACS components a department specific archive purely based on DICOM can be realized. During the installation process problems occurred mainly because of the complex DICOM standard for nuclear medicine. Related to that is the problem that most of the software implementations still contain bugs or are not adapted to the needs of a nuclear medicine department (particularly for PET). A communication software for the distribution of nuclear medicine reports and images based on techniques used for the worldwide web is currently tested. (orig.) [German] Fuer eine nuklearmedizinische Klinik ist ein Klinikinformationssystem (KIS) gekoppelt mit einem Radiologieinformationssystem (RIS) sowie einem Bildarchivierungs- und Verteilungssystem (PACS) unabdingbar, um einen schnellen Patientendurchsatz sowie die zeitnahe Uebermittlung von Befunden inklusive nuklearmedizinischen Bildern an zuweisende Stationen, Ambulanzen und externe Zuweiser zu gewaehrleisten. Daher wurde im April 2000 an der Klinik und Poliklinik fuer Nuklearmedizin der Universitaet

Effect of powdered activated carbon (PAC) on MBR performance and effluent trihalomethane formation: At the initial stage of PAC addition.

Science.gov (United States)

Gao, Yue; Ma, Defang; Yue, Qinyan; Gao, Baoyu; Huang, Xia

2016-09-01

In this study, the MBR was used to treat municipal wastewater for reuse. Effects of powdered activated carbon (PAC) addition on MBR system in terms of effluent water quality, trihalomethane (THM) formation and membrane organic fouling tendency of MBR sludge supernatant at the initial stage of PAC addition were investigated. Effects of chlorine dose and contact time on THM formation and speciation were also studied. PAC addition enhanced the removal of organic matters, especially aromatic components, which improved the UV254 removal rate from 34% to 83%. PAC addition greatly reduced the membrane organic fouling tendency of MBR sludge supernatant. PAC addition reduced the MBR effluent trihalomethane formation potential (THMFP) from 351.29 to 241.95μg/L, while increased THM formation reactivity by 42%. PAC addition enhanced the formation of higher toxic bromine-containing THMs. High chlorine dose and contact time resulted in higher THM formation but lower proportion of bromine-containing THMs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Actual concepts of digital PAC-spectroscopy

Energy Technology Data Exchange (ETDEWEB)

Roeder, J., E-mail: j.roeder@tu-bs.de; Herden, C., E-mail: cherden@viewplus.de [Braunschweig University of Technology, Institute of Physical and Theoretical Chemistry (Germany); Gardner, J. A., E-mail: john.gardner@viewplus.com [Oregon State University (United States); Becker, K. D., E-mail: k-d.becker@tu-bs.de [Braunschweig University of Technology, Institute of Physical and Theoretical Chemistry (Germany); Uhrmacher, M., E-mail: muhrmac@gwdg.de; Hofsaess, H., E-mail: hhofsae@uni-goettingen.de [University of Goettingen, II. Institute of Physics (Germany)

2008-01-15

In conventional perturbed angular correlation (PAC)-spectroscopy huge amounts of events are processed by fast electronics. Modern digital signal processing devices and the improvement in the computer technology in recent years allow today digital PAC-spectrometer setups capable to perform software-based data processing with all the benefits of storage, repeatable data analysis under different limits, and easy switching between different isotopes. In this paper we discuss experiences and concepts of a first realized digital PAC-spectrometer, which will be rebuild at ISOLDE/CERN/Geneva.

Picture archiving and communications systems (PACS): an introduction

International Nuclear Information System (INIS)

Schwartz, L.H.

2001-01-01

Picture Archiving and Communications Systems (PACS) has revolutionized the practice of radiology. PACS consist of a variety of electronic/computer components, and the connectivity between these components. PACS is an efficient means to transmit, store, retrieve and digitally display medical images

PCaPAC 2006 Proceedings

Energy Technology Data Exchange (ETDEWEB)

Pavel Chevtsov; Matthew Bickley (Eds.)

2007-03-30

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

Integration of computer-aided diagnosis/detection (CAD) results in a PACS environment using CAD-PACS toolkit and DICOM SR

International Nuclear Information System (INIS)

Le, Anh H.T.; Liu, Brent; Huang, H.K.

2009-01-01

Picture Archiving and Communication System (PACS) is a mature technology in health care delivery for daily clinical imaging service and data management. Computer-aided detection and diagnosis (CAD) utilizes computer methods to obtain quantitative measurements from medical images and clinical information to assist clinicians to assess a patient's clinical state more objectively. CAD needs image input and related information from PACS to improve its accuracy; and PACS benefits from CAD results online and available at the PACS workstation as a second reader to assist physicians in the decision making process. Currently, these two technologies remain as two separate independent systems with only minimal system integration. This paper describes a universal method to integrate CAD results with PACS in its daily clinical environment. The method is based on Health Level 7 (HL7) and Digital imaging and communications in medicine (DICOM) standards, and Integrating the Healthcare Enterprise (IHE) workflow profiles. In addition, the integration method is Health Insurance Portability and Accountability Act (HIPAA) compliant. The paper presents (1) the clinical value and advantages of integrating CAD results in a PACS environment, (2) DICOM Structured Reporting formats and some important IHE workflow profiles utilized in the system integration, (3) the methodology using the CAD-PACS integration toolkit, and (4) clinical examples with step-by-step workflows of this integration. (orig.)

Role of pacs in an integrated communication system

International Nuclear Information System (INIS)

Thompson, B.G.; Creasy, J.L.; Johnston, R.E.; Parrish, D.; Scatliff, J.H.

1986-01-01

An integrated computer-based communications system uses multiple computers for the high speed transmission, storage, enhancement and display for medical information. Interconnected by a network such as coaxial and fiberoptic cables or microwave stations, the system would provide integrated communications throughout a satellite medical environment. As the availability of proven PACS components becomes a commercial reality, migratory expansion of PACS within the radiology clinical, educational and research areas will be possible. When the PACS is integrated with hospital, radiology and medical school information systems it provides the image component of a total medical information system. Current PACS efforts are on a research basis including the development of prototype systems. This paper provides an overview of implementation strategies. Issues to be discussed include PACS research objectives, typical implementation methods, and a review of interactions between PACS and radiology information systems (RIS) and hospital information systems

Tracking PACS usage with open source tools.

Science.gov (United States)

French, Todd L; Langer, Steve G

2011-08-01

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

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

Science.gov (United States)

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.

PACS in the nuclear medicine service

International Nuclear Information System (INIS)

Bitter, F.; Hellwig, D.; Weller, R.; Almasi, L.; Adam, W.E.

1988-01-01

A Picture Archiving and Communication System (PACS) is to be understood as a central system in a hospital spanning all services, interconnecting all imaging stations and allowing digital picture archivation. All data of a patient are prepared for direct access. A PAC system is made up of the following components: imaging equipment and data systems, viewing stations (image display), picture communication, storage, archive, connection to hospital information system. The authors explain the requirements to be met by a PACS, its set-up and mode of function, and they system the use. (orig./MG) [de

Youth Versus Adult “Weightlifting” Injuries Presenting to United States Emergency Rooms: Accidental Versus Nonaccidental Injury Mechanisms

OpenAIRE

Myer, Gregory D.; Quatman, Carmen E.; Khoury, Jane; Wall, Eric J.; Hewett, Timothy E.

2009-01-01

Myer, GD, Quatman, CE, Khoury, J, Wall, EJ, and Hewett, TE. Youth versus adult “weightlifting” injuries presenting to united states emergency rooms: accidental versus nonaccidental injury mechanisms. J Strength Cond Res 23(7): 2054–2060, 2009—Resistance training has previously been purported to be unsafe and ineffective in children. The purpose of this investigation was to evaluate resistance training-related injuries presenting to U.S. emergency rooms by age, type, and mechanism of injury. W...

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

OpenAIRE

Horton, Maria C.; Lewis, Thomas E.; Kinsey, Thomas V.

1999-01-01

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 ...

Can PACS make a radiology department more competitive?

International Nuclear Information System (INIS)

Strickland, Nicola H.

1999-01-01

One of the motives for putting in a picture archiving and communication system (PACS) is to improve efficiency and hence enhance the competitive strength of the radiology department. Many would argue that it is now negligent to consider installing an old fashioned conventional radiology department rather than a PACS. In considering the issue it is important to be clear about the nature of the competition facing radiologists. This varies depending on the country and upon whether the institution is public or private. PACS can potentially help to overcome this competition in two ways: by providing real-time radiology, and by enabling teleradiology. Success in these areas requires state-of-the-art implementations of PACS, particularly clinically relevant PACS software, and adequate staffing levels

Educational paper Detection of child abuse and neglect at the emergency room

NARCIS (Netherlands)

Teeuw, Arianne Hélène; Derkx, Bert H. F.; Koster, Willeke A.; van Rijn, Rick R.

2012-01-01

The emergency room (ER) represents the main system entry for crises-based health care visits. It is estimated that 2% to 10% of children visiting the ER are victims of child abuse and neglect (CAN). Therefore, ER personnel may be the first hospital contact and opportunity for CAN victims to be

The application of a "6S Lean" initiative to improve workflow for emergency eye examination rooms.

Science.gov (United States)

Nazarali, Samir; Rayat, Jaspreet; Salmonson, Hilary; Moss, Theodora; Mathura, Pamela; Damji, Karim F

2017-10-01

Ophthalmology residents on call at the Royal Alexandra Hospital identified workplace disorganization and lack of standardization in emergency eye examination rooms as an impediment to efficient patient treatment. The aim of the study was to use the "6S Lean" model to improve workflow in eye examination rooms at the Royal Alexandra Hospital. With the assistance of quality improvement consultants, the "6S Lean" model was applied to the current operation of the emergency eye clinic examination rooms. This model, considering 8 waste categories, was then used to recommend and implement changes to the examination rooms and to workplace protocols to enhance efficiency and safety. Eye examination rooms were improved with regards to setup, organization of supplies, inventory control, and maintenance. All targets were achieved, and the 5S audit checklist score increased by 33 points from 44 to 77. Implementation of the 6S methodology is a simple approach that removes inefficiencies from the workplace. The ophthalmology clinic removed waste from all 8 waste categories, increased audit results, mitigated patient and resident safety risks, and ultimately redirected resident time back to patient care delivery. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

IHE profiles applied to regional PACS

International Nuclear Information System (INIS)

Fernandez-Bayo, Josep

2011-01-01

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

The HERSCHEL/PACS early Data Products

Science.gov (United States)

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.

Waiting room crowding and agitation in a dedicated psychiatric emergency service.

Science.gov (United States)

El-Mallakh, Rif S; Whiteley, Amanda; Wozniak, Tanya; Ashby, McCray; Brown, Shawn; Colbert-Trowel, Danya; Pennington, Tammy; Thompson, Michael; Tasnin, Rokeya; Terrell, Christina L

2012-05-01

Emergency department crowding is a growing problem that impacts patient care and safety. The effect of crowding has not been examined in emergency psychiatric services. The association between patient census and use of restraints, seclusion, and anti-agitation medications as needed was examined for 1 month. A total of 689 patients were seen in 31 days. The average hourly census was 6.8 ± 2.8 (range 0 to 18). There were 33 incidences of seclusion or restraint and an additional 15 instances of medications administered for agitation. The use of seclusion, restraint, or medication for agitation was significantly associated with census (r2 = 0.3, F = 5.47, P = .036). Crowding in emergency psychiatric waiting rooms may increase the need for seclusion, restraint, or medications for agitation.

PACS strategy for imaging centers.

Science.gov (United States)

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

PACS influence the radiographer's work

International Nuclear Information System (INIS)

Fridell, Kent; Aspelin, Peter; Edgren, Lars; Lindskoeld, Lars; Lundberg, Nina

2009-01-01

Radiological departments are changing rapidly due to the implementation of digital images and PACS (Picture Archiving and Communication Systems). The introduction of new technology seems to dissolve boundaries between the professions in the work environment where the technology is introduced. This process tends to change the organization and its routines. The aim of this qualitative study is to explore changes in radiographers' work with regard to skills, work practice and technology. The study used open-ended interviews to explore the radiographers' perceptions of such changes, and to identify problems and solutions pertaining to work practice. Inspiration is taken from grounded theory to explain the changes in work that were found. Respondents were selected from a total of 133 potential participants as a theoretical or purposive sample. The changing trends within the professional role indicated that radiographers, as image producers, shifted their focus from the ability to set the optimal exposure parameters in order to obtain the optimal image for diagnosis to become expert in exposure parameters, projection techniques and diagnostic practice, having multifaceted skills, as being the jack of all trades. When implementing PACS there was an obvious change in image production. At the start there were visions of new routines, and therefore the radiographers became early adopters to the new technology; in practice the organization was stacked in old routines, as the routines were inflexible and PACS work was pushed into old work routines. Although inflexible, this does not mean that they cannot change, and obviously in 2006 new routines had been implemented making it possible for the radiographers in finding new ways for collaborating with colleagues. The new technology immediately created a vision of improved service to the clinicians. In order to optimize the service the radiographers developed an insight into the need for a more comprehensive change in work using

Making PACS the present, not the future.

Science.gov (United States)

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.

Cloning and expression profiling of the PacSnRK2 and PacPP2C gene families during fruit development, ABA treatment, and dehydration stress in sweet cherry.

Science.gov (United States)

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.

[Management of an elderly patient in the emergency room at the end of life : A medical ethics challenge].

Science.gov (United States)

Michels, G; Nies, R; Ortmann, S; Pfister, R; Salomon, F

2018-04-01

A 94-year-old patient with cardiogenic shock due to myocardial infarction was admitted via the emergency room. A coronary angiography and intensive care were requested. The need for care due to dementia was known. After case discussion in the interdisciplinary and multiprofessional treatment team, the decision for a palliative care concept in the form of symptom control was made in the emergency room, taking into account the patient's medical history, the current situation, and the presumed patient consent. The integration of medical ethics aspects and palliative medicine into "geriatric emergency medicine" will present a challenge in the future.

Benchmark test of CP-PACS for lattice QCD

International Nuclear Information System (INIS)

Yoshie, Tomoteru

1996-01-01

The CP-PACS is a massively parallel computer dedicated for calculations in computational physics and will be in operation in the spring of 1996 at Center for Computational Physics, University of Tsukuba. In this paper, we describe the architecture of the CP-PACS and report the results of the estimate of the performance of the CP-PACS for typical lattice QCD calculations. (author)

Parents as Agents of Change (PAC in pediatric weight management: The protocol for the PAC randomized clinical trial

Directory of Open Access Journals (Sweden)

Ball Geoff D C

2012-08-01

Full Text Available Abstract Background There is an urgent need to develop and evaluate weight management interventions to address childhood obesity. Recent research suggests that interventions designed for parents exclusively, which have been named parents as agents of change (PAC approaches, have yielded positive outcomes for managing pediatric obesity. To date, no research has combined a PAC intervention approach with cognitive behavioural therapy (CBT to examine whether these combined elements enhance intervention effectiveness. This paper describes the protocol our team is using to examine two PAC-based interventions for pediatric weight management. We hypothesize that children with obesity whose parents complete a CBT-based PAC intervention will achieve greater reductions in adiposity and improvements in cardiometabolic risk factors, lifestyle behaviours, and psychosocial outcomes than children whose parents complete a psycho-education-based PAC intervention (PEP. Methods/Design This study is a pragmatic, two-armed, parallel, single-blinded, superiority, randomized clinical trial. The primary objective is to examine the differential effects of a CBT-based PAC vs PEP-based PAC intervention on children’s BMI z-score (primary outcome. Secondary objectives are to assess intervention-mediated changes in cardiometabolic, lifestyle, and psychosocial variables in children and parents. Both interventions are similar in frequency of contact, session duration, group facilitation, lifestyle behaviour goals, and educational content. However, the interventions differ insofar as the CBT-based intervention incorporates theory-based concepts to help parents link their thoughts, feelings, and behaviours; these cognitive activities are enabled by group leaders who possess formal training in CBT. Mothers and fathers of children (8–12 years of age; BMI ≥85th percentile are eligible to participate if they are proficient in English (written and spoken and agree for at least

Effects of a training workshop on suicide prevention among emergency room nurses.

Science.gov (United States)

Kishi, Yasuhiro; Otsuka, Kotaro; Akiyama, Keiko; Yamada, Tomoki; Sakamoto, Yumiko; Yanagisawa, Yaeko; Morimura, Hiroshi; Kawanishi, Chiaki; Higashioka, Hiroaki; Miyake, Yasushi; Thurber, Steven

2014-01-01

Suicide attempts are frequently encountered by emergency department nurses. Such encounters can potentially provide a foundation for secondary suicide prevention. The aim of the present investigation was to evaluate the effect of a 7-hr training program for emergency room nursing personnel in Japan. In all, 52 nurses completed the questionnaires before the workshop and 1 month after the workshop. The nurses' understanding of and willingness to care for suicidal patients positively changed. It is feasible to provide a 7-hr, relatively short, workshop on suicidal prevention aimed at emergency medical staff and to improve attitudes during a follow-up of 1 month. It is uncertain whether the positive attitudes of emergency nurses toward suicide and/or educational interventions could impact the outcomes of these interventions. Further studies are needed to address these important questions in this field.

PACS: Concepts and Trends

Science.gov (United States)

Bandon, David; Ratib, Osman; Lovis, Christian; Geissbuhler, Antoine

Picture Archiving and Communication Systems (PACS) are becoming part of the core components of today's infrastructure for digital radiology. In modern setting they also extend to the whole medical enterprise and integrate into the patient medical record. While local architectures may vary significantly, the major features such as image archiving and retrieval, workflow management, workstations and image acquisition and quality control systems constitute the key elements of such systems. PACS has also vocation to extend beyond the radiological images to become the common platform for hospital wide management of all images. The wireless access can contribute to expand the scope of image distribution.

Integrated RIS-PACS system

International Nuclear Information System (INIS)

Nishihara, Eitaro; Kura, Hiroyuki; Fukushima, Yuki

1994-01-01

We have developed an integrated RIS-PACS (radiology information system-picture archiving and communication system) system which supports examination, interpretation, and management in the diagnostic imaging department. The system was introduced in the Toshiba Hospital in May 1993, concurrently with the renewal of the hospital facilities. The integrated RIS-PACS system consists of a radiology information management system, and an image management system. The system supports wet (immediate) reading and chronological comparative reading using viewing workstation, enables routine operations to be performed in the diagnostic imaging department without film transportation, and contributes to the improvement of management efficiency in the department. (author)

PACS project management utilizing web-based tools

Science.gov (United States)

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.

Picture archiving and communication systems (PACS) for hospitals, a survey

International Nuclear Information System (INIS)

Haar Romeny, B.M. ter; Graaf, C.N. de; Waes, P.F.G.M. van; Rijk, P.P. van; Helder, J.C.; Valk, J.P.J. de

1985-01-01

In this article a survey is given for Picture Archiving and Communication Systems (PACS). Several aspects of PACS are treated, as image management, the introduction of the system, expenses etc. Special reference is made to the component parts of PACS: image stations, memory, network, software and coupling to the hospital information system. The introduction of PACS in Dutch hospitals is described. (Auth.)

Evaluation of a PACS workstation for interpreting body CT studies

International Nuclear Information System (INIS)

Franken, E.A.; Berbaum, K.S.; Honda, H.; McGuire, C.; Weis, R.R.; Barloon, T.

1989-01-01

This paper reports conventional hard-copy images from 266 body CT studies compared with those provided by a picture archiving and communication system (PACS) workstation. PACS images were evaluated before and after use of various image processing features. Most cases were depicted equally well, but in about one-fourth of the cases, diagnostic features were shown more clearly on PACS images. When PACS images were viewed first, a change in diagnosis after subsequent hardcopy inspection was infrequent, but when hard-copy images were viewed first, the results were converse. The image processing features of PACS were critical for its superior performance. The ability of a PACS to provide both image display and manipulation results in the superiority of that system

Clinical experience with PACS at Northwestern: year two

Science.gov (United States)

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.

The PAC-men revival : increasing need of PAC qualified colleagues

NARCIS (Netherlands)

Morren, J.; van der Heijden, S.

2012-01-01

More and more Protection, Automation, and Control (PAC) equipment is installed in the electricity (distribution) grid. For many employees of the network operators, the introduction of this equipment requires a change of mind, as this so-called secondary equipment is fundamentally different from the

Stroke Education in an Emergency Department Waiting Room: a Comparison of Methods

Directory of Open Access Journals (Sweden)

Yu-Feng Yvonne Chan1

2015-03-01

Full Text Available Background: Since the emergency department (ED waiting room hosts a large, captive audience of patients and visitors, it may be an ideal location for conduct-ing focused stroke education. The aim of this study was to assess the effective-ness of various stroke education methods.Methods: Patients and visitors of an urban ED waiting room were randomized into one of the following groups: video, brochure, one-to-one teaching, combi-nation of these three methods, or control group. We administered a 13-question multiple-choice test to assess stroke knowledge prior to, immediately after, and at 1 month post-education to patients and visitors in the ED waiting room.Results: Of 4 groups receiving education, all significantly improved their test scores immediately post intervention (test scores 9.4±2.5-10.3±2.0, P<0.01. At 1 month, the combination group retained the most knowledge (9.4±2.4 exceed-ing pre-intervention and control scores (both 6.7±2.6, P<0.01.Conclusion: Among the various stroke education methods delivered in the ED waiting room, the combination method resulted in the highest knowledge reten-tion at 1-month post intervention.

Geometrical Acceptance Analysis for RPC PAC Trigger

CERN Document Server

Seo, Eunsung

2010-01-01

The CMS(Compact Muon Solenoid) is one of the four experiments that will analyze the collision results of the protons accelerated by the Large Hardron Collider(LHC) at CERN(Conseil Europen pour la Recherche Nuclaire). In case of the CMS experiment, the trigger system is divided into two stages : The Level-1 Trigger and High Level Trigger. The RPC(Resistive Plate Chamber) PAC(PAttern Comparator) Trigger system, which is a subject of this thesis, is a part of the Level-1 Muon Trigger System. Main task of the PAC Trigger is to identify muons, measures transverse momenta and select the best muon candidates for each proton bunch collision occurring every 25 ns. To calculate the value of PAC Trigger efficiency for triggerable muon, two terms of different efficiencies are needed ; acceptance efficiency and chamber efficiency. Main goal of the works described in this thesis is obtaining the acceptance efficiency of the PAC Trigger in each logical cone. Acceptance efficiency is a convolution of the chambers geometry an...

PACS quality control and automatic problem notifier

Science.gov (United States)

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

Alcohol and Violence in the Emergency Room: A Review and Perspectives from Psychological and Social Sciences

Directory of Open Access Journals (Sweden)

Cheryl Cherpitel

2013-09-01

Full Text Available Our objective is to present a focused review of the scientific literature on the effect of alcohol consumption on violence related-injuries assessed in the emergency room (ER and to show how psychological and behavioral sciences could lead to a better understanding of the factors contributing to alcohol-related injuries in the ER. We retrieved published literature through a detailed search in Academic Search Premier, MEDLINE with Full Text PsycARTICLES, Psychology and Behavioral Sciences Collection, PsycINFO, PUBMed and SocINDEX with Full Text for articles related to emergency rooms, medical problems and sociocognitive models addressing alcohol intoxication articles. The first search was conducted in June 2011 and updated until August 2013. Literature shows that compared to uninjured patients; injured ones have a higher probability of: (i having an elevated blood-alcohol concentration upon arrival at the ER; (ii reporting having drunk alcohol during the six hours preceding the event; and (iii suffering from drinking-related consequences that adversely affect their social life. The main neurocognitive and sociocognitive models on alcohol and aggression are also discussed in order to understand the aetiology of violence-related injuries in emergency rooms. Suggestions are made for future research and prevention.

Process development and fabrication for sphere-pac fuel rods

International Nuclear Information System (INIS)

Welty, R.K.; Campbell, M.H.

1981-06-01

Uranium fuel rods containing sphere-pac fuel have been fabricated for in-reactor tests and demonstrations. A process for the development, qualification, and fabrication of acceptable sphere-pac fuel rods is described. Special equipment to control fuel contamination with moisture or air and the equipment layout needed for rod fabrication is described and tests for assuring the uniformity of the fuel column are discussed. Fuel retainers required for sphere-pac fuel column stability and instrumentation to measure fuel column smear density are described. Results of sphere-pac fuel rod fabrication campaigns are reviewed and recommended improvements for high throughput production are noted

Prevalence of substance use among trauma patients treated in a Brazilian emergency room

Directory of Open Access Journals (Sweden)

Reis Alessandra Diehl

2006-01-01

Full Text Available OBJECTIVE: Although there is a considerable amount of data in the literature regarding the association between alcohol consumption and injuries treated in emergency rooms, little is known about the relationship between such injury and the use of other substances. The objective of this study was to estimate the prevalence of substance use in patients admitted to the emergency room for non-fatal injuries. METHOD: A prospective cross-sectional study assessing all patients admitted to the emergency room within 6 hours after a non-fatal injury was conducted over a three-month period. The following were used as measures of alcohol and drug use: a standardized World Health Organization questionnaire; a self-administered questionnaire related to drug consumption within the 24 hours preceding contact; the Drug Abuse Screening Test; urine screens for cannabis, cocaine and benzodiazepines; and determination of blood alcohol concentration. Descriptive analyses were performed and the confidence interval used was 95%. RESULTS: A total of 353 patients were included. Cannabis and cocaine screens were conducted for 242 patients and benzodiazepine screens were conducted for 166. Blood alcohol concentrations reached the level of positivity in 11% (n = 39, and 10% (n = 33 presented some degree of intoxication. Among the 242 patients screened, 13.6% (n = 33 tested positive for cannabis, and 3.3% (n = 8 tested positive for cocaine, whereas 4.2% (n = 7 of the 166 patients screened tested positive for benzodiazepines. CONCLUSIONS: Substance use was highly prevalent among these individuals. In this sample, the frequency for the use of cannabis (an illicit drug was comparable to that of alcohol. More studies are needed in order to characterize such use among Brazilians and to develop proper approaches to such cases, with the aim of reducing substance use and its consequences.

[Índice de Saturación Modificado y Ambulancias (ISMA): Ambulance assignment and remote Emergency Room Bed Reservation].

Science.gov (United States)

Polanco-González, Carlos; Castañón-González, Jorge Alberto; Villanueva-Martínez, Sebastián; Samaniego-Mendoza, José Lino; Buhse, Thomas

2015-01-01

In most places all over the world–including our country–services in emergency rooms are oversaturated. This situation frequently forces the continuously arriving ambulances to be redirected to other medical units, delaying the admission of patients moved and thus adversely affecting their physical condition. To introduce an improvement to the Índicede Saturación Modificado computational system, which monitors the degree of saturation of a network of emergency medical services, to include a network of ambulances, enabling in the system: (i) the effective allocation of ambulances to the site of the accident, or severe clinical event, and (ii) the remote booking of beds in the nearest and least saturated emergency room available. The evaluation and connectivity of the computational improvement to the Índicede Saturación Modificado system was carried out with a computational test verifying these two aspects, using only differences in postal codes, for time measuring. The verification of its sustainability online showed the new Índice de Saturación Modificado y Ambulancias system (ISMA) has a robust structure capable of being adapted to mobile phones, laptops or tablets, and can efficiently administrate: (i) the quantification of excessive demand in the emergency room services of a hospital network, (ii) the allocation of ambulances attending the site of the event or contingency, and (iii) the allocation of ambulances and patients, in the best distance-time conditions, from the site of the accident or clinical event to the nearest and least saturated emergency room service. This administrative management tool is efficient and simple to use, and it optimally relates independent service networks.

[Economic and organizational evaluation of an imaging network (PACS)].

Science.gov (United States)

Charvet-Protat, S; Thoral, F

1998-12-01

Over the last twenty years, imaging modalities featuring new image production methods (ultrasound, nuclear magnetic resonance, etc.) have appeared on the market. Nevertheless, conventional radiology still accounts for 70% of the image examinations carried out in most western countries, including France. The conventional radiological image is in the process of evolving from analog to digital form. Digitalization of radiology means that image acquisition, archiving and distribution functions that were previously carried out by hand can now be automated using a Picture Archiving and Communication System. Decision-makers are having to decide whether or not to promote the development of PACS which, while they considerably modernize the way in which images are managed, also require heavy capital outlays. A critical appraisal of the literature allowed us to evaluate the relative cost and the efficiency of these image networks in comparison with film-based archiving and communication systems. It is clear from the economic evaluation that a PACS strategy involves greater costs than a film system. While PACS systems do generate savings on film and on storage space and obviate the need for certain staff, these savings do not offset the extra equipment and maintenance costs. This situation is likely to persist for some years yet, even when future price reductions are taken into account. The objective of this new radiological information management method is to improve organizational efficiency and hospital productivity. However, the economic evaluations that have been published to date are cost studies which do not take the efficiency criterion into account. A number of potential organizational benefits such as the fact that medical decisions can be made more quickly or that the average length of hospital stays can be reduced, are often claimed for PACS. However, for methodological reasons, these results cannot be generalised to cover all PACS. It is difficult to compare PACS

Status of the CP-PACS Project

International Nuclear Information System (INIS)

Ukawa, A.

1995-01-01

The CP-PACS Project, which started in April 1992, is a five-year plan to develop a massively parallel computer for carrying out research in computational physics with primary emphasis on lattice QCD. This article describes the architectural design of the CP-PACS computer, the entire computing system including the front end and mass storage, and results of benchmarks for the expected performance for lattice QCD applications. ((orig.))

IHE, Solution for integration of information systems and PACS

Directory of Open Access Journals (Sweden)

Milad Janghorban Lariche

2014-10-01

Full Text Available PACS is used as a way to store images and matches well with the workflow in the radiology department and can spread to other parts of hospital. Integration with other PACS and other hospital systems like radiology information system (RIS, hospital information system (HIS, and electronic patient records has been completely done, but there are still problems. PACS also provide good conditions for setting up Tele-radiology. The next step for PACS is where hospitals and health care organizations share photos in integrated electronic patient record. Among the different ways for sharing photos between different hospitals, IHE (integrating the health care enterprise standard indexes the cross-enterprise document sharing profile (XDS and allows sharing photos from various hospitals even if their PACS has different brands and different vendors. Application of XDS is useful for sharing images between health care organizations without duplicating them in a central archive. Images need to be indexed in a central registry. In the XDS profile, IHE defines an indexing mechanism for printing and indexing images in the central document registry. IHE also defines mechanisms to be used by each hospital to retrieve images, regardless of storing them in hospital PACS.

[Temperature that modifies the effect of air pollution on emergency room visits for circulatory and respiratory diseases in Beijing, China].

Science.gov (United States)

Wang, L L; Zhang, Q; Bai, R H; Mi, B B; Yan, H

2017-08-10

Objective: To analyze the temperature modification effect on emergency room visits for circulatory and respiratory diseases caused by air pollution, in Beijing. Methods: Data on both circulatory and respiratory diseases in 2010 and 2011 were collected, Both meteorological and air pollutants related data were obtained from the National Scientific Data Sharing Platform for Population and Health. By using the stratified time-series models, we analyzed the effects of air pollution on emergency room visits for circulatory and respiratory diseases under different temperature zones, from 2010 to 2011, in Beijing. Results: Low temperature (daily average temperatureeffect of air pollution index (API) on emergency room visits for circulatory diseases, Under 10 units of API, the relative risks and confidence interval appeared as 1.067 (1.054-1.080). However, high (daily average temperature between 24.4 ℃ and 28.5 ℃) and extra-high temperature (daily average temperature >28.5 ℃) could enhance the effect of API on emergency room visits for respiratory diseases, Under 10 units of API, the relative risks and confidence interval were 1.021 (1.015-1.028) and 1.006 (1.003-1.008), respectively. Conclusion: Temperature seemed to have modified the association between air pollution and both circulatory and respiratory diseases.

[Breaking bad news in the emergency room: Suggestions and future challenges].

Science.gov (United States)

Landa-Ramírez, Edgar; López-Gómez, Antonio; Jiménez-Escobar, Irma; Sánchez-Sosa, Juan José

2017-01-01

The aim of this paper is to describe educational programs that reportedly teach how to break bad news in the emergency department. We also suggest some recommendations on how to communicate bad news based on the research of evidence available in the field. The examined evidence points toward six major components with which physicians should familiarize when communicating bad news: 1) doctor-patient empathic communication, 2) establishing a proper space to give the news, 3) identifying characteristics of the person who receives the news, 4) essential aspects for communicating the news; 5) emotional support, and 6) medical and administrative aspects of the encounter. Finally, we point out several limitations in the studies in the field and future challenges identified in the communication of bad news in emergency room facilities.

Fusion breeder sphere - PAC blanket design

International Nuclear Information System (INIS)

Sullivan, J.D.; Palmer, B.J.F.

1987-11-01

There is a considerable world-wide effort directed toward the production of materials for fusion reactors. Many ceramic fabrication groups are working on making lithium ceramics in a variety of forms, to be incorporated into the tritium breeding blanket which will surround the fusion reactor. Current blanket designs include ceramic in either monolithic or packed sphere bed (sphere-pac) forms. The major thrust at AECL is the production of lithium aluminate spheres to be incorporated in a sphere-pac bed. Contemporary studies on breeder blanket design offer little insight into the requirements on the sizes of the spheres. This study examined the parameters which determine the properties of pressure drop and coolant requirements. It was determined that an optimised sphere-pac bed would be composed of two diameters of spheres: 75 weight % at 3 mm and 25 weight % at 0.3 mm

A spatial analysis of heat stress related emergency room visits in rural Southern Ontario during heat waves.

Science.gov (United States)

Bishop-Williams, Katherine E; Berke, Olaf; Pearl, David L; Kelton, David F

2015-08-06

In Southern Ontario, climate change may have given rise to an increasing occurrence of heat waves since the year 2000, which can cause heat stress to the general public, and potentially have detrimental health consequences. Heat waves are defined as three consecutive days with temperatures of 32 °C and above. Heat stress is the level of discomfort. A variety of heat stress indices have been proposed to measure heat stress (e.g., the heat stress index (HSI)), and has been shown to predict increases in morbidity and/or mortality rates in humans and other species. Maps visualizing the distribution of heat stress can provide information about related health risks and insight for control strategies. Information to inform heat wave preparedness models in Ontario was previously only available for major metropolitan areas. Hospitals in communities of fewer than 100,000 individuals were recruited for a pilot study by telephone. The number of people visiting the emergency room or 24-hour urgent care service was collected for a total of 27 days, covering three heat waves and six 3-day control periods from 2010-2012. The heat stress index was spatially predicted using data from 37 weather stations across Southern Ontario by geostatistical kriging. Poisson regression modeling was applied to determine the rate of increased number of emergency room visits in rural hospitals with respect to the HSI. During a heat wave, the average rate of emergency room visits was 1.11 times higher than during a control period (IRR = 1.11, CI95% (IRR) = (1.07,1.15), p ≤ 0.001). In a univariable model, HSI was not a significant predictor of emergency room visits, but when accounting for the confounding effect of a spatial trend polynomial in the hospital location coordinates, a one unit increase in HSI predicted an increase in daily emergency rooms visits by 0.4% (IRR = 1.004, CI95%(IRR) = (1.0005,1.007), p = 0.024) across the region. One high-risk cluster and no low risk

The future of PACS in healthcare enterprises

International Nuclear Information System (INIS)

Faggioni, Lorenzo; Neri, Emanuele; Castellana, Carlo; Caramella, Davide; Bartolozzi, Carlo

2011-01-01

Picture Archiving and Communication System (PACS), which was originally designed as a tool for facilitating radiologists in interpreting images more efficiently, is evolving into a hospital-integrated system storing diagnostic imaging information that often reaches far beyond Radiology. The continuous evolution of PACS technology has led to a gradual broadening of its applications, ranging from teleradiology to CAD (Computer-Assisted Diagnosis) and multidimensional imaging, and is moving into the direction of providing access to image data outside the Radiology department, so to reach all the branches of the healthcare enterprise. New perspectives have been created thanks to new technologies (such as holographic media and GRID computing) that are likely due to expand PACS-based applications even further, improving patient care and enhancing overall productivity.

Integration Of An MR Image Network Into A Clinical PACS

Science.gov (United States)

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.

Project plan for PACS networking construction and cabling

International Nuclear Information System (INIS)

Luo Min; Wang Xiaolin; Luo Song; Lei Wenyong; Wang Xuejian; Wen Hongyue; Wu Hongxing

2002-01-01

Objective: To meet the networking requirement of the heave data flow, load balance, and potential networking storm during expanding the application of PACS. Methods: Intel Net Structure 480T Giga Switch was used as main switch and connected to each building by optical channel at 1 Giga speed to archive 100 MB/s to each port. At the same time, the in dependence of the original networking construction was physically kept. The layer 3 and 4 switchers was used as load balance to reduce the heavy load of the networking, and all the cabling for PACS used the super CAT5 along with the Intel Net Structure 1520 to prepare for the potential networking storm. Results: An advanced intranet was set up to fully meet the high standard requirement of PACS. The good foundation for upgrading the whole networking system to 1 Giga application was built for realized share and transmission of image, information, and patient data within the hospital. The base was established for the standardized management of the hospital. Conclusion: Good planning is the 1 st step in setting up PACS and the equipment are the platform to run PACS and all kinds of HIS. The networking construction is the foundation of e-hospitals

Improving Patients Experience in Peadiatric Emergency Waiting Room.

Science.gov (United States)

Ehrler, Frederic; Siebert, Johan; Wipfli, Rolf; Duret, Cyrille; Gervaix, Alain; Lovis, Christian

2016-01-01

When visiting the emergency department, the perception of the time spent in the waiting room before the beginning of the care, may influence patients' experience. Based on models of service evaluation, highlighting the importance of informing people about their waiting process and their place in the queue, we have developed an innovative information screen aiming at improving perception of time by patients. Following an iterative process, a group of experts including computer scientists, ergonomists and caregivers designed a solution adapted to the pediatric context. The solution includes a screen displaying five lanes representing triage levels. Patients are represented by individual avatars, drawn sequentially in the appropriate line. The interface has been designed using gamification principle, aiming at increasing acceptance, lowering learning curve and improving satisfaction. Questionnaire based evaluation results revealed high satisfaction from the 278 respondents even if the informative content was not always completely clear.

bond activation and catalysis by Ru -pac complexes

Indian Academy of Sciences (India)

and their reactivity towards oxidation of a few organic compounds. Keywords. Kinetics; catalysis; -O–O- bond activation; Ru-pac complex; oxidation. 1. Introduction. Ru-pac complexes exhibit catalytic properties,1 in homogeneous conditions in the presence of oxygen atom donors, that mimic the biological enzymatic oxi-.

PACS in Töölö hospital.

Science.gov (United States)

Kinnunen, J; Pohjonen, H

2001-07-01

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

Design and optimizing factors of PACS network architecture

International Nuclear Information System (INIS)

Tao Yonghao; Miao Jingtao

2001-01-01

Objective: Exploring the design and optimizing factors of picture archiving and communication system (PACS) network architecture. Methods: Based on the PACS of shanghai first hospital to performed the measurements and tests on the requirements of network bandwidth and transmitting rate for different PACS functions and procedures respectively in static and dynamic network traffic situation, utilizing the network monitoring tools which built-in workstations and provided by Windows NT. Results: No obvious difference between switch equipment and HUB when measurements and tests implemented in static situation except route which slow down the rate markedly. In dynamic environment Switch is able to provide higher bandwidth utilizing than HUB and local system scope communication achieved faster transmitting rate than global system. Conclusion: The primary optimizing factors of PACS network architecture design include concise network topology and disassemble tremendous global traffic to multiple distributed local scope network communication to reduce the traffic of network backbone. The most important issue is guarantee essential bandwidth for diagnosis procedure of medical imaging

The sphere-PAC fuel code 'SPHERE-3'

International Nuclear Information System (INIS)

Wallin, H.

2000-01-01

Sphere-PAC fuel is an advanced nuclear fuel, in which the cladding tube is filled with small fuel spheres instead of the more usual fuel pellets. At PSI, the irradiation behaviour of sphere-PAC fuel is calculated using the computer code SPHERE-3. The paper describes the present status of the SPHERE-3 code, and some results of the qualification process against experimental data. (author)

The sphere-pac fuel code 'SPHERE-3'

International Nuclear Information System (INIS)

Wallin, H.; Nordstroem, L.A.; Hellwig, C.

2001-01-01

Sphere-pac fuel is an advanced nuclear fuel, in which the cladding tube is filled with small fuel spheres instead of the more usual fuel pellets. At PSI, the irradiation behaviour of sphere-pac fuel is calculated using the computer code SPHERE-3. The paper describes the present status of the SPHERE-3 code, and some results of the qualification process against experimental data. (author)

[PACS-based endoscope image acquisition workstation].

Science.gov (United States)

Liu, J B; Zhuang, T G

2001-01-01

A practical PACS-based Endoscope Image Acquisition Workstation is here introduced. By a Multimedia Video Card, the endoscope video is digitized and captured dynamically or statically into computer. This workstation realizes a variety of functions such as the endoscope video's acquisition and display, as well as the editing, processing, managing, storage, printing, communication of related information. Together with other medical image workstation, it can make up the image sources of PACS for hospitals. In addition, it can also act as an independent endoscopy diagnostic system.

Prevalence of thyroid dysfunction in patients with acute atrial fibrillation attended at a cardiology emergency room

Directory of Open Access Journals (Sweden)

Juarez Neuhaus Barbisan

Full Text Available CONTEXT: Atrial fibrillation occurs frequently in patients with thyrotoxicosis, while it has low prevalence in adults of the general population. The prevalence of thyroid dysfunction in subjects with atrial fibrillation is 0 to 24%, a wide variation that is attributed to the different methodologies applied. However, continuous use of amiodarone in patients with previous atrial fibrillation may interfere with these prevalence rates. OBJECTIVE: In this study, we present the prevalence of thyroid dysfunction in adult patients who presented at a cardiac emergency room with acute atrial fibrillation, using a sensitive thyroid-stimulating hormone (TSH assay and triiodothyronine (T3 and thyroxine (T4 determination. TYPE OF STUDY: Cross-sectional study SETTING: Emergency room of a tertiary care facility. PARTICIPANTS: A total of 72 patients with atrial fibrillation who presented at the emergency room not more than 48 hours after its onset. PROCEDURES: A standardized questionnaire and 12-lead electrocardiogram were applied, and T3, T4 and TSH were determined. MAIN MEASUREMENTS: TSH, T3 and T4 determination. RESULTS: Among these patients, 16.6% had altered thyroid function tests: 6.9% had hyperthyroidism, 5.6% hypothyroidism and 4.2% had increased T4 levels, by means of amiodarone use. CONCLUSION: The high prevalence of thyroid dysfunction in our study, especially hyperthyroidism, suggests that routine thyroid testing with sensitivethyroid-stimulating hormone assay is required in patients with acute atrial fibrillation.

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

Science.gov (United States)

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.

Outcome of burr hole surgery in the emergency room for severe acute subdural hematoma

International Nuclear Information System (INIS)

Park, Young-Soo; Hironaka, Yasuhiro; Motoyama, Yasushi; Asai, Hideki; Watanabe, Tomoo; Nishio, Kenji; Nakase, Hiroyuki; Okuchi, Kazuo

2010-01-01

We have performed burr hole surgery in the emergency room for severe acute subdural hematoma from April 2007 in twenty five patients. All patients were deep comatose and showed cerebral herniation sign with bilateral pupillary abnormalities. Burr hole surgeries were performed as soon as possible after CT evaluation. Continually decomporresive craiectomies were followed if clinical improvements were achieved and mild baribiturate-moderate hypothermia combined (MB-MH) therapy was induced postoperatively in some cases. The mean average was 65.6 years (range 16-93). The causes of head injuries were traffic accident in 9, fall down in 13 and unknown in 3. The mean Glasgow coma scale (GCS) on admission was 4.4 (range 3-9). The mean time interval from arrival to burr hole surgery was 33.5 minutes (range 21-50 minutes). Decompressive craniectomy was indicated in 14 cases and MB-MH therapy was induced in 13 cases. The overall clinical outcome consisted of good recovery in 3, moderate disability in 2, severe disability in 3, persistent vegetative state in 3 and death in 14. Favorable results can be expected even in patients with serious acute subdural hematoma. Emergent burr hole surgery was effective to decrease intracranial pressure rapidly and to save time. So active burr hole surgery in the emergency room is strongly recommended to all cases of severe acute subdural hematoma. (author)

Perceptions on the Impact of a Just-in-Time Room on Trainees and Supervising Physicians in a Pediatric Emergency Department.

Science.gov (United States)

Thomas, Anita A; Uspal, Neil G; Oron, Assaf P; Klein, Eileen J

2016-12-01

Just-in-time (JIT) training refers to education occurring immediately prior to clinical encounters. An in situ JIT room in a pediatric emergency department (ED) was created for procedural education. We examined trainee self-reported JIT room use, its impact on trainee self-perception of procedural competence/confidence, and the effect its usage has on the need for intervention by supervising physicians during procedures. Cross-sectional survey study of a convenience sample of residents rotating through the ED and supervising pediatric emergency medicine physicians. Outcomes included JIT room use, trainee procedural confidence, and frequency of supervisor intervention during procedures. Thirty-one of 32 supervising physicians (97%) and 122 of 186 residents (66%) completed the survey, with 71% of trainees reporting improved confidence, and 68% reporting improved procedural skills ( P  < .05, +1.4-point average skills improvement on a 5-point Likert scale). Trainees perceived no difference among supervising physicians intervening in procedures with or without JIT room use ( P  = .30, paired difference -0.0 points). Nearly all supervisors reported improved trainee procedural confidence, and 77% reported improved trainee procedural skills after JIT room use ( P  < .05, paired difference +1.8 points); 58% of supervisors stated they intervene in procedures without trainee JIT room use, compared with 42% with JIT room use ( P  < .05, paired difference -0.4 points). Use of the JIT room led to improved trainee confidence and supervisor reports of less procedural intervention. Although it carries financial and time costs, an in situ JIT room may be important for convenient JIT training.

HyPac french platform on the hydrogen and fuel cells; HyPac plateforme francaise sur l'hydrogene et les piles a combustible

Energy Technology Data Exchange (ETDEWEB)

Lucchese, P. [N ' ERGY, 85 - Antigny (France)

2008-07-01

HyPac is a french platform on the hydrogen and fuel cells applications, created in 2008. the authors presents the opportunities of the french platform HyPac, the objectives, the participants and the budget. (A.L.B.)

[Conflictive patients in the emergency room: Definition, classification and ethical aspects].

Science.gov (United States)

Herreros, B; García Casasola, G; Pintor, E; Sánchez, M A

2010-09-01

A conflictive patient is one who provokes a problem (a conflict) by their attitude or behavior for the physician. Ethical conflicts in emergency care are common and many of them occur with these patients. Among the most common types of patients who generate personal conflicts with health professionals are overly demanding patients, those who refuse medical interventions, those who are aggressive, litigators, excessively-recurrent users of the heath system and those who go to the emergency room without an urgent condition. A patient may include several of these profiles ("mixed" patient). When they appear, the approach should be, if possible, by a team, establishing a deliberative process. If there is doubt and when possible, the ethics committee of the institution should be consulted, seeking the protocols, this best being institutional, on the subject. After that, if the decision is difficult, support must be sought from the emergency staff and even management. The whole process should be reflected in the clinical history. Specific education in bioethics and communication skills can be of great help to minimize and cope better with long-term conflicts. Copyright 2009 Elsevier España, S.L. All rights reserved.

Removal of a synthetic organic chemical by PAC-UF systems. II: Model application.

Science.gov (United States)

Matsui, Y; Colas, F; Yuasa, A

2001-02-01

This paper describes several application potentials with a recently developed model for predicting the synthetic organic chemical (SOC) removal by powdered activated carbon (PAC) adsorption during ultrafiltration (UF) and discusses the removal mechanism. The model was successfully applied, without any modification, to dead-end mode operation as well as to cross-flow mode operation, validating the assumption of the internal diffusion control mechanism and the continuously-stirred-tank-reactor (CSTR) concept. Even when UF was operated in a cross-flow mode, PAC added was re-circulating in suspension for only a short time. Then, solute uptake took place mostly by PAC immobilized in membrane tubes not only for dead-end operation but also for cross-flow operation. Therefore, cross-flow operation did not have any advantage regarding the SOC mass transfer on PAC in UF loop over dead-end operation. The model simulation implied that pulse PAC addition at the beginning of filtration cycle resulted better SOC removal than continuous PAC addition. However, for the pulse PAC addition mode, the model predicted somewhat lower effluent SOC concentration than the observed values, and the benefit of pulse PAC application in terms of reducing SOC over its continuous dosage was not confirmed. Longer detention time of PAC dosed in a pulse than continuously dosed PAC could possibly further decrease internal diffusivity.

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

Science.gov (United States)

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.

LANSCE personnel access control system (PACS)

International Nuclear Information System (INIS)

Sturrock, J.C.; Gallegos, F.R.; Hall, M.J.

1997-01-01

The Radiation Security System (RSS) at the Los Alamos Neutron Science Center (LANSCE) provides personnel protection from prompt radiation due to accelerated beam. The Personnel Access Control System (PACS) is a component of the RSS that is designed to prevent personnel access to areas where prompt radiation is a hazard. PACS was designed to replace several older personnel safety systems (PSS) with a single modem unified design. Lessons learned from the operation over the last 20 years were incorporated into a redundant sensor, single-point failure safe, fault tolerant, and tamper-resistant system that prevents access to the beam areas by controlling the access keys and beam stoppers. PACS uses a layered philosophy to the physical and electronic design. The most critical assemblies are battery backed up, relay logic circuits; less critical devices use Programmable Logic Controllers (PLCs) for timing functions and communications. Outside reviewers have reviewed the operational safety of the design. The design philosophy, lessons learned, hardware design, software design, operation, and limitations of the device are described

Incremental cost of PACS in a medical intensive care unit

Science.gov (United States)

Langlotz, Curtis P.; Cleff, Bridget; Even-Shoshan, Orit; Bozzo, Mary T.; Redfern, Regina O.; Brikman, Inna; Seshadri, Sridhar B.; Horii, Steven C.; Kundel, Harold L.

1995-05-01

Our purpose is to determine the incremental costs (or savings) due to the introduction of picture archiving and communication systems (PACS) and computed radiology (CR) in a medical intensive care unit (MICU). Our economic analysis consists of three measurement methods. The first method is an assessment of the direct costs to the radiology department, implemented in a spreadsheet model. The second method consists of a series of brief observational studies to measure potential changes in personnel costs that might not be reflected in administrative claims. The third method (results not reported here) is a multivariate modeling technique which estimates the independent effect of PACS/CR on the cost of care (estimated from administrative claims data), while controlling for clinical case- mix variables. Our direct cost model shows no cost savings to the radiology department after the introduction of PACS in the medical intensive care unit. Savings in film supplies and film library personnel are offset by increases in capital equipment costs and PACS operation personnel. The results of observational studies to date demonstrate significant savings in clinician film-search time, but no significant change in technologist time or lost films. Our model suggests that direct radiology costs will increase after the limited introduction of PACS/CR in the MICU. Our observational studies show a small but significant effect on clinician film search time by the introduction of PACS/CR in the MICU, but no significant effect on other variables. The projected costs of a hospital-wide PACS are currently under study.

[Sewage sludge conditioning by bioleaching-dual PAC and PAM addition].

Science.gov (United States)

Liu, Chang-Geng; Zhang, Pan-Yue; Zeng, Guang-Ming; Liu, Yong-Gang

2010-09-01

Bioleaching-dual polyaluminum chloride (PAC) and polyacrylamide (PAM) addition was used to condition sewage sludge. The results showed that FeSO4 x 7H2O addition improved the bioleaching rate obviously with a fixed sulfur power dosage of 3 g x L(-1); when the FeSO4 x 7H2O dosage was 8 g x L(-1), the bioleaching lasted 1.5 d to decrease the sludge pH below 2. Bioleaching improved the sludge dewaterability significantly with a specific resistance to filtration (SRF) reduction of 77.52% from 6.45 x 10(10)s2 x g(-10 to 1.45 x 10(10)s2 x g(-1), but the bioleached sludge was still difficult to be dewatered. After adjusting the bioleached sludge pH to 6, PAC and PAM were used to enhance conditioning of the bioleached sludge. The results indicated that the optimal dosage was 200 mg x L(-1) for PAC or 50 mg x L(-1) for PAM when single chemical was used. When PAC and PAM were dually used, the optimal dosages of PAC and PAM were 100 mg x L(-1) and 25 mg x L(-1), respectively; SRF and moisture of sludge cake reduced to 2.02 x 10(8) s2 x g(-1) and 74.81%, respectively, showing good dewaterability of the treated sludge. Compared with the single use of PAC and PAM, the dual use of PAC and PAM showed the advantages of lower cost and better conditioning effect.

La inserción al Asia-Pacífico, oportunidades y desafíos para el Valle del Cauca y la región pacífica colombiana

Directory of Open Access Journals (Sweden)

Ricardo Coutin

2014-12-01

Full Text Available Resumen: El objetivo general del texto es brindar una aproximación a los retos y las oportunidades que representa, para el Valle del Cauca y la Región Pacífica colombiana, la inserción al Asia-Pacífico. Para lo cual se plantean tres objetivos específicos: primero, analizar someramente el contexto económico comercial del Asia-Pacífico y América Latina, con especial énfasis en Colombia y los demás países de la Alianza del Pacífico (AP; segundo, estudiar las oportunidades y los retos para el Valle del Cauca y la Región Pacífica colombiana que plantea la puesta en escena del bloque comercial denominado Alianza del Pacífico; y tercero, indagar sobre los retos de competitividad y productividad que enfrenta el Valle del Cauca y que afectan el ambiente de negocios. El documento concluye que Colombia se encuentra rezagada en su inserción con la cuenca del Asia-Pacífico; también se plantea la necesidad de abordar el tema de estudio desde un enfoque subnacional.

THE APPLICATION OF EVIDENCE BASED DESIGN IN EMERGENCY ROOM OF PUBLIC HOSPITAL OF DR. R. SOSODORO DJATIKOESOEMO BOJONEGORO

Directory of Open Access Journals (Sweden)

Noerkayatin ,

2015-07-01

Full Text Available The Hospital facilities built under Evidence Based Design (EBD will create a safe and comfortable environment, lower the nosocomial infection, quicken the patient recovery, lower the treatment cost, and improve staffs’ performance. The emergency room of public hospital of Dr.R.Sosodoro Djatikoesoemo Bojonegoro needs to be redesigned because the existing design does not meet physical safety. The reparation should refer to Facilities and Safety Management (FMS, Indonesian regulation, EBD concept and benchmarking to RSCM Jakarta considered as an application sample. This research applies case study with descriptive single case study design. The result of the research shows that reparation should be done that includes site and location, building components, and rooms lay out. The width of the rooms should meet minimal standard. The placing of triage room and resuscitation should be in the front area. Sinks should be located near the entrance of every room. The isolation and decontamination rooms should be provided.

Java-based cryptosystem for PACS and tele-imaging

Science.gov (United States)

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

1998-07-01

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

REVIEW ARTICLE REVI REVI Talking PACS: Part 1 – What is PACS?

African Journals Online (AJOL)

Image management is the administration of imaging examination requests, the performance of ... responsibility dependent on a long chain of human interaction that often fails. Within both ... This is an information system responsible for the storage, distribution .... This refers to a computer interface to gain access to the PACS.

Partners Against Crime (PAC) Districts

Data.gov (United States)

City and County of Durham, North Carolina — The Partners Against Crime (PAC) program promotes collaboration among police officers, Durham residents, and city and county government officials to find...

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

Science.gov (United States)

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

Performance characteristics of the Mayo/IBM PACS

Science.gov (United States)

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

1991-07-01

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

Occurrence rate and clinical predictors of hypertensive pseudocrisis in emergency room care.

Science.gov (United States)

Sobrinho, Silvestre; Correia, Luís C L; Cruz, Constança; Santiago, Mila; Paim, Ana Catarina; Meireles, Bruno; Andrade, Mariana; Kerner, Mariana; Amoedo, Paula; de Souza, Carlos Marcílio

2007-05-01

To describe the prevalence of hypertensive pseudocrisis in patients treated in emergency rooms with substantially elevated blood pressure levels. To compare this prevalence in private and public hospitals. To describe the frequency of wrong treatment for this condition. To identify, during triage, independent predictors of pseudocrisis. To evaluate the prognosis of patients with pseudocrisis. Patients above the age of 18, admitted to the Emergency Rooms of two hospitals (private and public) during a 6 month timeframe, with diastolic blood pressure > or = 120 mmHg were included in the study. Hypertensive pseudocrisis was determined when none of the criteria for hypertensive crisis were present (Guidelines of the Brazilian Society of Cardiology(1)). In the 110 patients studied, the prevalence of hypertensive pseudocrisis was 48% (95% CI = 39%-58%) and prevailed in the private hospital (59% vs 37%, p=0.02). The frequency of wrong treatment was similar between the two hospitals (94% vs 95%, p=0.87). After multivariate analysis, the presence of headache upon admission (Odds Ratio=5.4; 95% CI = 5.1-13; pcrisis group (0% vs 21%, p=0.0004). There is a high prevalence of hypertensive pseudocrisis in patients when hypertensive crisis is suspected, particularly in the private hospital. The frequency of wrong treatment was similar for both the private and public hospitals. Headaches and diastolic BP levels are independent predictors for this clinical condition. Hypertensive pseudocrisis has a low rate of lethality.

Sizing a PACS

Science.gov (United States)

Wilson, Dennis L.; Glicksman, Robert A.

1994-05-01

A Picture Archiving and Communications System (PACS) must be able to support the image rate of the medical treatment facility. In addition the PACS must have adequate working storage and archive storage capacity required. The calculation of the number of images per minute and the capacity of working storage and of archiving storage is discussed. The calculation takes into account the distribution of images over the different size of radiological images, the distribution between inpatient and outpatient, and the distribution over plain film CR images and other modality images. The support of the indirect clinical image load is difficult to estimate and is considered in some detail. The result of the exercise for a particular hospital is an estimate of the average size of the images and exams on the system, of the number of gigabytes of working storage, of the number of images moved per minute, of the size of the archive in gigabytes, and of the number of images that are to be moved by the archive per minute. The types of storage required to support the image rates and the capacity required are discussed.

Altered Circadian Food Anticipatory Activity Rhythms in PACAP Receptor 1 (PAC1 Deficient Mice.

Directory of Open Access Journals (Sweden)

Jens Hannibal

Full Text Available 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.

PAC Experiments at ISOLDE

CERN Multimedia

2002-01-01

The study of hyperfine interactions offers the possibility to use radioactive nuclei as probes in matter. The @g-@g perturbated angular correlation (PAC) technique following implantation has found widespread application in this field. At ISOLDE we have been investigating electric field gradients at impurities in non-cubic metals in an ongoing series of experiments. \\\\ \\\\ The small number of probe atoms necessary for these measurements make them also ideally suited for studies of surface problems like diffusion, structure and dynamics. Cd on a molybdenum O110? surface will be studied as first system. For this purpose 10|1|0~atoms of |1|1|1|mCd will be evaporated onto the clean surface and the electric field gradient for isolated adatoms on terrace sites will be determined by PAC. The UHV system constructed for such experiments at ISOLDE is shown in the schematic drawing. It is coupled to the beam line through differential pumping stations and contains standard surface treatment and analysis equipment.

PACS-Based Computer-Aided Detection and Diagnosis

Science.gov (United States)

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.

Sulfonylurea monotherapy and emergency room utilization among elderly patients with type 2 diabetes.

Science.gov (United States)

Rajpathak, Swapnil N; Fu, Chunmay; Brodovicz, Kimberley; Engel, Samuel S; Heaton, Pamela C

2015-09-01

In elderly Americans with type 2 diabetes, use of insulin and oral antidiabetic drugs (OADs) accounts for almost one-fourth of drug adverse event-related hospitalizations. It is not clear, however, if sulfonylureas (SUs), frequently prescribed OADs known to cause hypoglycemia, increase the risk of emergency room (ER) visits compared to other OADs. The aim of this study was to compare the emergency room utilization between US elderly patients with diabetes on SU monotherapy vs. other non-SU monotherapies. This retrospective cohort study was conducted using MarketScan(®) database (2009-10) and aimed to evaluate the association between use of SU and ER visits. The analysis included 28,533 patients (aged ≥65 years) receiving SU monotherapy at baseline and 1:1 propensity score (PS)-matched group receiving monotherapy with other OADs. ER utilization was determined during a 1-year follow-up period. The SU and non-SU groups were overall well balanced after PS matching. The mean (SD) number of ER visits during the follow-up was 0.56 among users of SU users compared to 0.49 (Pmetformin users. Elderly patients with type 2 diabetes on SU monotherapy were more likely to use ER than those on other monotherapies. Further studies are needed to confirm our findings and evaluate other factors associated with ER visits. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

HyPac french platform on the hydrogen and fuel cells

International Nuclear Information System (INIS)

Lucchese, P.

2008-01-01

HyPac is a french platform on the hydrogen and fuel cells applications, created in 2008. the authors presents the opportunities of the french platform HyPac, the objectives, the participants and the budget. (A.L.B.)

PACS: Do clinical users benefit from it as a training adjunct?

Directory of Open Access Journals (Sweden)

J van Heerden

2011-05-01

Full Text Available Background. Over the past four years, Steve Biko Academic Hospital has been in the process of implementing and refining the use of a picture archiving and communications system (PACS. As part of a post-implementation refining process, it is necessary to evaluate user-perceptions in order to improve on good system qualities and correct flaws. Aim. The aim of this study was to assess whether medical clinicians perceived PACS as a positive adjunct to training and teaching opportunities – specifically those opportunities related to radiological image viewing and interpretation as part of patient case discussions. Method. Standardised questionnaires with ‘free text’ and ‘option selection’ questions were distributed to clinicians who, as part of their training, rotated at Steve Biko Academic Hospital (where a PACS is in place as well as other teaching hospitals without a PACS. Between February 2009 and May 2009, approximately 400 questionnaires were distributed. As a result of constant academic rotations, leave schedules of medical staff and posts vacated, questionnaires could not be distributed to the entire target population that was estimated to be in the region of 550 medical clinicians (comprising senior medical students, interns, medical officers, registrars and consultants. Of the 400 questionnaires distributed, 189 completed questionnaires were returned. Completion of the questionnaires was voluntary and anonymous. Results and conclusion. Although a PACS relates specifically to the archiving and retrieval of radiological images and reports, it became clear from the feedback received from medical clinicians (who are ward-based, theatre-based or clinic-based users of a digital system that many other factors, such as lack of adequate hardware and sub-optimal personal IT proficiency, contributed to some of the negative PACS-related perceptions and ‘lost teaching opportunities’ reported. Negative comments specifically related to PACS

The management and realizing of image data flow in PACS

International Nuclear Information System (INIS)

Tao Yonghao; Miao Jingtao

2002-01-01

Objective: To explore the management model and realizing of PACS image data-flow. Methods: Based on the implementing environment and management model of PACS image data-flow after full digital reengineering for radiology department in Shanghai First Hospital was completed, analysis on image data flow types, procedure, and achieving pattern were conducted. Results: Two kinds of image data-flow management were set up for the PACS of Shanghai First Hospital, which included image archiving procedure and image forward procedure. The former was implemented with central management model while the latter was achieved with a program that functionally acted as workflow management running on the central server. Conclusion: The image data-flow management pattern, as a key factor for PACS, has to be designed and implemented functionally and effectively depending on the performance environment, the tasks and requirements specified to particular user

A DICOM based PACS for nuclear medicine

International Nuclear Information System (INIS)

Lassmann, M.; Reiners, C.

2002-01-01

The installation of a radiology information system (RIS) connected to a hospital information system (HIS) and a picture archiving and communications system (PACS) seems mandatory for a nuclear medicine department in order to guarantee a high patient throughput. With these systems a fast transmission of reports, images to the in- and out-patients' wards and private practitioners is realized. Therefore, since April 2000, at the department of nuclear medicine of the university of Wuerzburg a completely DICOM based PACS has been implemented in addition to the RIS. With this system a DICOM based workflow is realized throughout the department of nuclear medicine for reporting and archiving. The PACS is connected to six gamma-cameras, a PET scanner, a bone densitometry system and an ultrasound device. The volume of image data archived per month is 4 GByte. Patient demographics are provided to the modalities via DICOM-Worklist. With these PACS components a department specific archive purely based on DICOM can be realized. During the installation process problems occurred mainly because of the complex DICOM standard for nuclear medicine. Related to that is the problem that most of the software implementations still contain bugs or are not adapted to the needs of a nuclear medicine department (particularly for PET). A communication software for the distribution of nuclear medicine reports and images based on techniques used for the worldwide web is currently tested. (orig.) [de

Quality of emergency rooms and urgent care services: user satisfaction.

Science.gov (United States)

Lima, Cássio de Almeida; Santos, Bruna Tatiane Prates dos; Andrade, Dina Luciana Batista; Barbosa, Francielle Alves; Costa, Fernanda Marques da; Carneiro, Jair Almeida

2015-01-01

To evaluate the quality of emergency rooms and urgent care services according to the satisfaction of their users. A cross-sectional descriptive study with a quantitative approach. The sample comprised 136 users and was drawn at random. Data collection took place between October and November 2012 using a structured questionnaire. Participants were mostly male (64.7%) aged less than 30 years (55.8%), and the predominant level of education was high school (54.4%). Among the items evaluated, those that were statistically associated with levels of satisfaction with care were waiting time, confidence in the service, model of care, and the reason for seeking care related to acute complaints, cleanliness, and comfortable environment. Accessibility, hospitality, and infrastructure were considered more relevant factors for patient satisfaction than the cure itself.

La inserción al Asia-Pacífico, oportunidades y desafíos para el Valle del Cauca y la región pacífica colombiana

OpenAIRE

Ricardo Coutin

2014-01-01

Resumen: El objetivo general del texto es brindar una aproximación a los retos y las oportunidades que representa, para el Valle del Cauca y la Región Pacífica colombiana, la inserción al Asia-Pacífico. Para lo cual se plantean tres objetivos específicos: primero, analizar someramente el contexto económico comercial del Asia-Pacífico y América Latina, con especial énfasis en Colombia y los demás países de la Alianza del Pacífico (AP); segundo, estudiar las oportunidades y los retos para el Va...

La inserción al Asia-Pacífico, oportunidades y desafíos para el Valle del Cauca y la región pacífica colombiana

OpenAIRE

Countin, Ricardo

2014-01-01

El objetivo general del texto es brindar una aproximación a los retos y las oportunidades que representa, para el Valle del Cauca y la Región Pacífica colombiana, la inserción al Asia-Pacífico. Para lo cual se plantean tres objetivos específicos: primero, analizar someramente el contexto económico comercial del Asia-Pacífico y América Latina, con especial énfasis en Colombia y los demás países de la Alianza del Pacífico (AP); segundo, estudiar las oportunidades y los retos para el Valle del C...

Emergency room visits due to external causes and alcohol consumption - Capitals and the Federal District, Brazil, 2011

Directory of Open Access Journals (Sweden)

Márcio Dênis Medeiros Mascarenhas

2015-04-01

Full Text Available The study objective was to describe the profile and factors related to alcohol consumption among emergency room visits by external causes. It is a cross-sectional study with data from the Survey of Violence and Injuries in Emergency between September and October 2011, in 24 state capitals and the Federal District. Statistical analysis were performed for all cases treated in selected services, comparing the characteristics of the victims, according to the statement of alcohol consumption. 33,289 visits to emergency rooms by external causes in the population above 18 years of age were included. The prevalence of self-reported statement of alcohol consumption among these services was 14.9% for the 24 capitals and the Federal District, and was significantly higher among visits by violent causes than by accidents. For both accidents and violence the associated causes were victims male, black/brown, less educated, members of specific populations, occurrences on public roads. The results support global discussions on the importance of establishing policies and legal measures to restrict the consumption of alcohol and vehicular direction, control advertising of alcoholic beverages, and laws normalizing the functioning of sales points of alcoholic beverages.

Perceived Parental Care and Control among Israeli Female Adolescents Presenting to Emergency Rooms after Self-Poisoning

Science.gov (United States)

Diamond, Gary M.; Didner, Hila; Waniel, Ariela; Priel, Beatriz; Asherov, Jack; Arbel, Shosh

2005-01-01

Levels of perceived parental care and control among 24 female Israeli adolescents presenting at emergency rooms after a self-poisoning act of low lethality were compared to those found among 23 non-self-harming, community controls. Adolescents' perceived levels of parental care and control were measured via both adolescents' self-report and…

Radiology department design to accommodate the future introduction of global PACS

International Nuclear Information System (INIS)

Naylor, A.F.

1992-01-01

In the light of the continuing development of pictorial archiving and communication systems (PACS) and image management and communications (MACS) systems it is appropriate to consider the provision that should be made in the design of a new or renovated department of radiology to accommodate these new technologies at either an earlier or later date. This paper considers 3 particular aspects of the influence of PACS on future department design: 1) the requirement for either more or less total department gross square feet, 2) the provision for the specific allocation of spaces at certain locations for PACS equipment and functions, and 3) the provision for dedicated pathways for fiber optic communications among the many locations in the department where PACS components would be located. (author). 1 fig

Does PACS improve diagnostic accuracy in chest radiograph interpretations in clinical practice?

International Nuclear Information System (INIS)

Hurlen, Petter; Borthne, Arne; Dahl, Fredrik A.; Østbye, Truls; Gulbrandsen, Pål

2012-01-01

Objectives: To assess the impact of a Picture Archiving and Communication System (PACS) on the diagnostic accuracy of the interpretation of chest radiology examinations in a “real life” radiology setting. Materials and methods: During a period before PACS was introduced to radiologists, when images were still interpreted on film and reported on paper, images and reports were also digitally stored in an image database. The same database was used after the PACS introduction. This provided a unique opportunity to conduct a blinded retrospective study, comparing sensitivity (the main outcome parameter) in the pre and post-PACS periods. We selected 56 digitally stored chest radiograph examinations that were originally read and reported on film, and 66 examinations that were read and reported on screen 2 years after the PACS introduction. Each examination was assigned a random number, and both reports and images were scored independently for pathological findings. The blinded retrospective score for the original reports were then compared with the score for the images (the gold standard). Results: Sensitivity was improved after the PACS introduction. When both certain and uncertain findings were included, this improvement was statistically significant. There were no other statistically significant changes. Conclusion: The result is consistent with prospective studies concluding that diagnostic accuracy is at least not reduced after PACS introduction. The sensitivity may even be improved.

A neurosurgery/stereotactic radiotherapy dedicated PACS for conformal radiotherapy

International Nuclear Information System (INIS)

Lefkopoulos, D.; Bocquiault, P.; Levrier, M.; Merienne, L.; Schlienger, M.

1995-01-01

To realise conformal cerebral stereotactic irradiations we use a Neurosurgery/stereotactic dedicated PACS between two distant hospitals. It connects the stereotactic neurosurgery planification imaging system NEUROAXIS (Sopelem-Sofretec/Ste Anne Hospital) with the dosimetric TPS ARTEMIS-3D/Dosigray (Tenon Hospital). NEUROAXIS is a computer aided stereotactic biopsies and stereo-electroencephalographies, used by surgeons in operating room. The system determines the precise location data for Talairach radiological equipment (X ray source at 5 meters from film) and the geometry of scanner and MRI stereotactical referentials. It provides a full set of features for lesion localization, geometrical computations, surgical planifications, picture archiving, stereotactic angiography, CT and MRI image processing and networking. It sends images through the French public digital network ISDN (NUMERIS/France Telecom : 2x64 Kbits/s) from Ste Anne to Tenon Hospital. Stereotactic angiographic and CT images are reformatted into the DOSIGRAY image processing environment where 3-D dose distributions, displays and DVHs are computed to determine the optimal treatment. ARTEMIS-3D/Dosigray is a TPS for stereotactic radiotherapy devised by the Tenon Hospital for clinical methodology and 3D dose calculations, optimization software development and the Dosigray company for multimodality imaging, (2D(3D)) computer graphics for dose and anatomical representation and data networking. Communication within the radiation oncology department is provided by local area ETHERNET network, linking heterogeneous systems (Vaxstations-3200; Decstation (5000(240))) by means of different protocols. The works in progress are to send back via the same network the 3-D dose matrix to Neurosurgery department NEUROAXIS system. Our PACS is used since six months to treat patients. It has permitted to improve the treatment quality in comparison with our first version TPS ARTEMIS-3D

PAC and μSr investigations of light interstitial diffusion in intermetallic hydrides

International Nuclear Information System (INIS)

Boyer, P.; Baudry, A.

1988-01-01

Specific aspects of the Perturbed Angular Correlation (PAC) of gamma rays concerning its application to the study of atomic diffusion in solids are presented. PAC results recently obtained on the 181 Ta probe in several crystalline and amorphous phases of Zr 2 Ni hydrides are briefly summarized. Preliminary μSR results relative to these intermetallic hydrides are presented and compared to the PAC data

Acquisition and analysis of throughput rates for an operational department-wide PACS

Science.gov (United States)

Stewart, Brent K.; Taira, Ricky K.; Dwyer, Samuel J., III; Huang, H. K.

1992-07-01

The accurate prediction of image throughput is a critical issue in planning for and acquisition of any successful Picture Archiving and Communication System (PACS). Bottlenecks or design flaws can render an expensive PACS implementation useless. This manuscript presents a method for accurately predicting and measuring image throughput of a PACS design. To create the simulation model of the planned or implemented PACS, it must first be decomposed into principal tasks. We have decomposed the entire PACS image management chain into eight subsystems. These subsystems include network transfers over three different networks (Ethernet, FDDI and UltraNet) and five software programs and/or queues: (1) transfer of image data from the imaging modality computer to the image acquisition/reformatting computer; (2) reformatting the image data into a standard image format; (3) transferring the image data from the acquisition/reformatting computer to the image archive computer; (4) updating a relational database management system over the network; (5) image processing-- rotation and optimal gray-scale lookup table calculation; (6) request that the image be archived; (7) image transfer from the image archive computer to a designated image display workstation; and (8) update the local database on the image display station, separate the image header from the image data and store the image data on a parallel disk array. Through development of an event logging facility and implementation of a network management package we have acquired throughput data for each subsystem in the PACS chain. In addition, from our PACS relational database management system, we have distilled the traffic generation patterns (temporal, file size and destination) of our imaging modality devices. This data has been input into a simulation modeling package (Block Oriented Network Simulator-- BONeS) to estimate the characteristics of the modeled PACS, e.g., the throughput rates and delay time. This simulation

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

Science.gov (United States)

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

2013-07-31

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

Scientific programming on massively parallel processor CP-PACS

International Nuclear Information System (INIS)

Boku, Taisuke

1998-01-01

The massively parallel processor CP-PACS takes various problems of calculation physics as the object, and it has been designed so that its architecture has been devised to do various numerical processings. In this report, the outline of the CP-PACS and the example of programming in the Kernel CG benchmark in NAS Parallel Benchmarks, version 1, are shown, and the pseudo vector processing mechanism and the parallel processing tuning of scientific and technical computation utilizing the three-dimensional hyper crossbar net, which are two great features of the architecture of the CP-PACS are described. As for the CP-PACS, the PUs based on RISC processor and added with pseudo vector processor are used. Pseudo vector processing is realized as the loop processing by scalar command. The features of the connection net of PUs are explained. The algorithm of the NPB version 1 Kernel CG is shown. The part that takes the time for processing most in the main loop is the product of matrix and vector (matvec), and the parallel processing of the matvec is explained. The time for the computation by the CPU is determined. As the evaluation of the performance, the evaluation of the time for execution, the short vector processing of pseudo vector processor based on slide window, and the comparison with other parallel computers are reported. (K.I.)

Integration of a clinical trial database with a PACS

International Nuclear Information System (INIS)

Van Herk, M

2014-01-01

Many clinical trials use Electronic Case Report Forms (ECRF), e.g., from OpenClinica. Trial data is augmented if DICOM scans, dose cubes, etc. from the Picture Archiving and Communication System (PACS) are included for data mining. Unfortunately, there is as yet no structured way to collect DICOM objects in trial databases. In this paper, we obtain a tight integration of ECRF and PACS using open source software. Methods: DICOM identifiers for selected images/series/studies are stored in associated ECRF events (e.g., baseline) as follows: 1) JavaScript added to OpenClinica communicates using HTML with a gateway server inside the hospitals firewall; 2) On this gateway, an open source DICOM server runs scripts to query and select the data, returning anonymized identifiers; 3) The scripts then collects, anonymizes, zips and transmits selected data to a central trial server; 4) Here data is stored in a DICOM archive which allows authorized ECRF users to view and download the anonymous images associated with each event. Results: All integration scripts are open source. The PACS administrator configures the anonymization script and decides to use the gateway in passive (receiving) mode or in an active mode going out to the PACS to gather data. Our ECRF centric approach supports automatic data mining by iterating over the cases in the ECRF database, providing the identifiers to load images and the clinical data to correlate with image analysis results. Conclusions: Using open source software and web technology, a tight integration has been achieved between PACS and ECRF.

Introduction to PAC-experiments and hyperfine interaction measurements in solids

International Nuclear Information System (INIS)

Manasijevic, M.; Koicki, S.; Cekic, B.; Ivanovic, N.; Milosevic, Z.; Koteski, V.; Radisavljevic, I.; Cavor, J.; Marjanovic, D.

2001-01-01

Perturbed angular correlation (PAC) has for many years been a productive experimental technique for obtaining information about the static and dynamic behaviour of local and electronic structures of solids on a microscope scale, without changing the main properties of the material. This article contains an outline of the basic principles of PAC. A summary of the technique and experimental requirements is given, followed by a brief discussion of the parameters which can be extracted from the PAC measurements. Some examples then illustrate the recent developments in the applications to problems of interest for solid state physics nad materials science, performed in VINCA Institute. (author)

The sphere-PAC fuel code 'SPHERE-3'

Energy Technology Data Exchange (ETDEWEB)

Wallin, H

2000-07-01

Sphere-PAC fuel is an advanced nuclear fuel, in which the cladding tube is filled with small fuel spheres instead of the more usual fuel pellets. At PSI, the irradiation behaviour of sphere-PAC fuel is calculated using the computer code SPHERE-3. The paper describes the present status of the SPHERE-3 code, and some results of the qualification process against experimental data. (author)

Implementation of MINI-PACS using the DICOM converter on the Web

International Nuclear Information System (INIS)

Ji, Youn Sang

2000-01-01

In recent years, medical procedures have become more complex, while financial pressures for shortened hospital stays and increased efficiency in patient care have increased. As a result, several shortcomings of present film-based systems for managing medical images have become apparent. Maintaining film space is labor intensive and consumes valuable space. Because only single copies of radiological examinations exist, they are prone to being lost or misplaced, thereby consuming additional valuable time and expense. In this paper, MINI-PACS for image archiving, transmission, and viewing offers a solution to these problems. Proposed MINI-PACS consists of mainly four parts such as Web Module, Client-Server Module, Internal Module, Acquisition Module. In addition, MINI-PACS system includes DICOM Converter that Non-DICOM file format converts standard file format. In Client-Server Module case, Proposed system is combined both SCU(Service Class User: Client) part and SCP(Service Class Provider: Server) part therefore this system provides the high resolution image processing techniques based on windows platform. Because general PACS system is too expensive for Medium and Small hospitals to install and operate the full-PACS. Also, we constructed Web Module for database connection through the WWW.=20

Surgery of the elderly in emergency room mode. Is there a place for laparoscopy?

Science.gov (United States)

Michalik, Maciej; Dowgiałło-Wnukiewicz, Natalia; Lech, Paweł; Zacharz, Krzysztof

2017-06-01

An important yet difficult problem is qualification for surgery in elderly patients. With age the risk of comorbidities increases - multi-disease syndrome. Elderly patients suffer from frailty syndrome. Many body functions become impaired. All these factors make the elderly patient a major challenge for surgical treatment. Analysis of the possibility of developing the indications and contraindications and the criteria for surgical treatment of the elderly based on our own cases. Discussion whether there is a place for laparoscopy during surgery of the elderly in emergency room (ER) mode. The analysis was performed based on seven cases involving surgical treatment of elderly patients who were admitted to the hospital in emergency room mode. The patients were hospitalized in the General and Minimally Invasive Surgery Clinic in Olsztyn in 2016. Surgical treatment of elderly patients should be planned with multidisciplinary teams. Geriatric surgery centers should be developed to minimize the risk of overzealous treatment and potential complications. Laparoscopy should always be considered in the case of ER procedures or diagnostics. Elderly patients should not be treated as typical adults, but as a separate group of patients requiring special treatment. Due to the existing additional disease in the elderly, the frailty syndrome, any surgical intervention should be minimally invasive. The discussion about therapy should be conducted by a team of specialists from a variety of medical fields.

75 FR 80082 - State, Local, Tribal, And Private Sector Policy Advisory Committee (SLTPS-PAC)

Science.gov (United States)

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...

Bioavailability of {sup 99m}Tc-paclitaxel-glucuronide ({sup 99m}Tc-PAC-G)

Energy Technology Data Exchange (ETDEWEB)

Biber Muftuler, F.Z.; Demir, I.; Uenack, P.; Ichedef, C.; Yurt Kilcar, A. [Ege Univ., Izmir (Turkey). Dept. of Nuclear Applications

2011-07-01

An antitumor agent paclitaxel (PAC) has been proved to be efficient in the treatment of breast and ovarian cancer. Glucuronic acid-derived paclitaxel compound (paclitaxel-glucuronide (PAC-G)) was enzymatically synthesized using microsome preparate separated from rat livers. The biodistribution mechanism of PAC-G in healthy female Albino Wistar rats has been investigated. The expected structure is confirmed according to LC/MS results, and the possible attachment is to C2-hydroxyl group. PAC-G was labeled with {sup 99m}Tc and the radiochemical yield of radiolabeled compound ({sup 99m}Tc-PAC-G) was 98.0 {+-} 02.74% (n=9). The range of the breast/blood and breast/muscle ratios is approximately between 3 and 35 in 240 min. All these experimental studies indicate that {sup 99m}Tc-PAC-G may potentially be used in breast tissue as an imaging agent. (orig.)

PACS/IMAC technology assessment

OpenAIRE

Schilling, Ronald B.

1997-01-01

According to Peter Ogle of Digital Imaging (San Francisco, CA), “Radiologists should help identify common values for the use of information technology in medicine.” Achieving a set of common values often requires a framework for organizing the thought process involved. That is the focus of this article in addressing the subject of picture archiving and communication system (PACS) technology assessment.

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

Science.gov (United States)

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

1998-02-01

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

Emergency room visits for work-related injuries: characteristics and associated factors - capitals and the Federal District, Brazil, 2011.

Science.gov (United States)

Mascarenhas, Márcio Dênis Medeiros; de Freitas, Mariana Gonçalves; Monteiro, Rosane Aparecida; da Silva, Marta Maria Alves; Malta, Deborah Carvalho; Gómez, Carlos Minayo

2015-03-01

Work-related injuries, often classified as occupational injuries (OI), stand out among visits due to external causes (accidents and violence) in health services. To describe the characteristics and factors associated with emergency room visits for OI, a cross-sectional study was conducted using data from the Survey of Violence and Injuries in Emergency Services (VIVA Inquérito 2011) in 24 state capitals and the Federal District. The prevalence of treatment for OI and prevalence ratios (PR) with confidence intervals of 95% (95%CI) were calculated. There were 29,463 emergency room visits due to accidental injuries in the population above 18 years of age. The prevalence of OI was 33.4% and was positively and significantly associated with the male gender, age 30-59 years old, industrial workers, agricultural sector or repair and maintenance services. The occurrence of OI was significantly higher in attendance for objects falling on people (PR = 3.37, 95% CI 2.80 to 4.05) and injuries due to perforating object (PR = 3.01, 95% CI 2.50-3.65). The results support the surveillance of external causes and direct public policies to promote occupational health.

CT Findings of Disease with Elevated Serum D-Dimer Levels in an Emergency Room Setting

International Nuclear Information System (INIS)

Choi, Ji Youn; Kwon, Woo Cheol; Kim, Young Ju

2012-01-01

Pulmonary embolism and deep vein thrombosis are the leading causes of elevated serum D-dimer levels in the emergency room. Although D-dimer is a useful screening test because of its high sensitivity and negative predictive value, it has a low specificity. In addition, D-dimer can be elevated in various diseases. Therefore, information on the various diseases with elevated D-dimer levels and their radiologic findings may allow for accurate diagnosis and proper management. Herein, we report the CT findings of various diseases with elevated D-dimer levels in an emergency room setting, including an intravascular contrast filling defect with associated findings in a venous thromboembolism, fracture with soft tissue swelling and hematoma formation in a trauma patient, enlargement with contrast enhancement in the infected organ of a patient, coronary artery stenosis with a perfusion defect of the myocardium in a patient with acute myocardial infarction, high density of acute thrombus in a cerebral vessel with a low density of affected brain parenchyma in an acute cerebral infarction, intimal flap with two separated lumens in a case of aortic dissection, organ involvement of malignancy in a cancer patient, and atrophy of a liver with a dilated portal vein and associated findings.

CT Findings of Disease with Elevated Serum D-Dimer Levels in an Emergency Room Setting

Energy Technology Data Exchange (ETDEWEB)

Choi, Ji Youn; Kwon, Woo Cheol; Kim, Young Ju [Dept. of Radiology, Wonju Christian Hospital, Yensei University Wonju College of Medicine, Wonju (Korea, Republic of)

2012-01-15

Pulmonary embolism and deep vein thrombosis are the leading causes of elevated serum D-dimer levels in the emergency room. Although D-dimer is a useful screening test because of its high sensitivity and negative predictive value, it has a low specificity. In addition, D-dimer can be elevated in various diseases. Therefore, information on the various diseases with elevated D-dimer levels and their radiologic findings may allow for accurate diagnosis and proper management. Herein, we report the CT findings of various diseases with elevated D-dimer levels in an emergency room setting, including an intravascular contrast filling defect with associated findings in a venous thromboembolism, fracture with soft tissue swelling and hematoma formation in a trauma patient, enlargement with contrast enhancement in the infected organ of a patient, coronary artery stenosis with a perfusion defect of the myocardium in a patient with acute myocardial infarction, high density of acute thrombus in a cerebral vessel with a low density of affected brain parenchyma in an acute cerebral infarction, intimal flap with two separated lumens in a case of aortic dissection, organ involvement of malignancy in a cancer patient, and atrophy of a liver with a dilated portal vein and associated findings.

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

Science.gov (United States)

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.

Impact of visual art on patient behavior in the emergency department waiting room.

Science.gov (United States)

Nanda, Upali; Chanaud, Cheryl; Nelson, Michael; Zhu, Xi; Bajema, Robyn; Jansen, Ben H

2012-07-01

Wait times have been reported to be one of the most important concerns for people visiting emergency departments (EDs). Affective states significantly impact perception of wait time. There is substantial evidence that art depicting nature reduces stress levels and anxiety, thus potentially impacting the waiting experience. To analyze the effect of visual art depicting nature (still and video) on patients' and visitors' behavior in the ED. A pre-post research design was implemented using systematic behavioral observation of patients and visitors in the ED waiting rooms of two hospitals over a period of 4 months. Thirty hours of data were collected before and after new still and video art was installed at each site. Significant reduction in restlessness, noise level, and people staring at other people in the room was found at both sites. A significant decrease in the number of queries made at the front desk and a significant increase in social interaction were found at one of the sites. Visual art has positive effects on the ED waiting experience. Copyright © 2012 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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.

PACS 2000: quality control using the task allocation chart

Science.gov (United States)

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.

PACS and diagnostic imaging service delivery-A UK perspective

International Nuclear Information System (INIS)

Sutton, Laurence N.

2011-01-01

This review sets out the current position with regard to the implementation of PACS throughout the United Kingdom and the impact this has had on improving patient care. In December 2007 England had implemented full hospital-wide PACS in all hospitals: a major achievement in the relatively short time period of three years. The different approaches used by each country of the UK to achieve full national PACS are described in addition to the current issues with the sharing of images and reports across different healthcare organisations with regard to technical solutions, clinical safety and governance. The review gives insight into the changing methods of service delivery to address increasing demand pressures on diagnostic imaging services and how the national PACS implementation, specifically in England, has made a significant contribution to measures to improve efficiencies. The role of Teleradiology is discussed in the context of supporting local patient services rather than undermining them and the concept of cross-healthcare reporting 'Grids' is described. Finally, in the summary it is recognised that the vast wealth of knowledge accumulated during the national implementations has placed the UK in a strong position to facilitate full national data sharing across all healthcare organisations to improve patient care.

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

Science.gov (United States)

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.

Predictors of Frequent Emergency Room Visits among a Homeless Population.

Science.gov (United States)

Thakarar, Kinna; Morgan, Jake R; Gaeta, Jessie M; Hohl, Carole; Drainoni, Mari-Lynn

2015-01-01

Homelessness, HIV, and substance use are interwoven problems. Furthermore, homeless individuals are frequent users of emergency services. The main purpose of this study was to identify risk factors for frequent emergency room (ER) visits and to examine the effects of housing status and HIV serostatus on ER utilization. The second purpose was to identify risk factors for frequent ER visits in patients with a history of illicit drug use. A retrospective analysis was performed on 412 patients enrolled in a Boston-based health care for the homeless program (HCH). This study population was selected as a 2:1 HIV seronegative versus HIV seropositive match based on age, sex, and housing status. A subgroup analysis was performed on 287 patients with history of illicit drug use. Chart data were analyzed to compare demographics, health characteristics, and health service utilization. Results were stratified by housing status. Logistic models using generalized estimating equations were used to predict frequent ER visits. In homeless patients, hepatitis C was the only predictor of frequent ER visits (OR 4.49, phomeless patients. HIV seropositivity did not predict frequent ER visits, likely because HIV seropositive HCH patients are engaged in care. In patients with history of illicit drug use, hepatitis C and mental health disorders predicted frequent ER visits. Supportive housing for patients with mental health disorders and hepatitis C may help prevent unnecessary ER visits in this population.

[The Effects of Violence Coping Program Based on Middle-Range Theory of Resilience on Emergency Room Nurses' Resilience, Violence Coping, Nursing Competency and Burnout].

Science.gov (United States)

Lee, Seung Min; Sung, Kyung Mi

2017-06-01

The purpose of this study was to examine the effects of a violence coping program (VCP) based on Polk's middle-range theory of resilience on nursing competency, resilience, burnout, and the ability to cope with violence in nurses working in emergency rooms. A quasi-experimental study, with a nonequivalent control group and a pretest-posttest design, was conducted. Participants were 36 nurses who worked in emergency rooms and had experienced violence; 18 nurses from D hospital and 18 nurses from C hospital were assigned to the experimental and control groups, respectively. The experimental group received the VCP twice per week for 8 weeks. Levels of resilience, F=59.41, pnursing competency, F=59.41 pburnout, F=52.74, pburnout and improving resilience, active coping behavior, and nursing competency. Therefore, it would be a useful intervention for improving the quality of nursing care provided in emergency rooms. © 2017 Korean Society of Nursing Science

Secure vendor environment (SVE) for PACS

Science.gov (United States)

Honeyman-Buck, Janice; Frost, Meryll

2005-04-01

A Secure Vendor Environment (SVE) was created to protect radiology modalities from network intrusion, worms, viruses, and other forms of damaging attacks. Many vendors do not attempt any form of network security and if an institution demands a non-standard and secure installation, a future system upgrade could and frequently does eliminate any security measures installed during the initial installation. The SVE isolates the vendor equipment behind a virtual firewall on a private network that is invisible to the outside world. All interactions must go though a device containing two network interface cards called an Application Processor that acts as a store-and forward router, performs DICOM repair, proxies modality worklist, and isolates the vendor modalities. A small VPN appliance can open the device temporarily for remote access by vendor engineers. Prior to the routine installation of the SVE, vendor equipment was often attacked by hostile network intruders and viruses or worms, sometimes rendering the equipment unusable until the vendor could reload the system. The resulted in considerable clinical downtime and loss of revenue. Since the relatively low cost SVE solution has routinely been installed with all new equipment, no intrusions have occurred, although our network sniffers and intrusion detectors indicate that we are constantly being scanned for vulnerability. Purpose: To provide a secure network for vendor equipment in a PACS environment while allowing vendor access for upgrades and system repairs. Method: The network administrators at our university believe that network security should be implemented at the machine level rather than relying on a firewall. A firewall solution could conceivably block unwanted intrusion from outside the university network, but would still allow literally thousands of potential network users to get through to the PACS network. All the PACS archive, display and routing systems are individually protected from intrusion, but

Image acquisition for the pediatric radiology PACS module

International Nuclear Information System (INIS)

Ho, B.K.; Morioka, C.; Mankovich, N.J.; Stewart, B.; Huang, H.K.

1987-01-01

The prototype PACS module implemented at UCLA's pediatric radiology section has multi-modality access to image data from any of the three types of sources: digital modalities (i.e. CT, MR, and DSA), the Fuji Computed Radiography unit (FCR), and laser film digitizers. An interface unit was built to facilitate real-time data transfer from the FCR to the VAX11/750 which serves as the PACS host computer. The design of the interface unit, methods for linking to digital modalities, and characteristics of two film digitizers are described

Usefulness of technetium-99m tetrofosmin single-photon emission computed tomography for short-term risk stratification in patients with acute chest pain in the emergency room

International Nuclear Information System (INIS)

Kawahito, Michitomo; Kondo, Makoto; Abe, Yoshiteru

2003-01-01

High-risk patients with acute coronary syndrome are difficult to distinguish from low-risk patients with chest pain in the emergency room. Technetium-99 m ( 99m Tc) tetrofosmin single-photon emission computed tomography (SPECT) was investigated to exclude high-risk patients with chest pain in the emergency room. 99m Tc-tetrofosmin SPECT was evaluated using a four-point scoring system in 228 patients (144 men, 84 women, mean age 68±12 years) with chest pain. Negative was defined as the myocardial segments with a defect score (DS) of 99m Tc-tetrofosmin; no significance (NS)), 84.9% (NS) and 60.4% (p 99m Tc-tetrofosmin SPECT is a useful method to exclude high-risk patients among patients with chest pain in the emergency room. (author)

Predicting the success of noninvasive positive pressure ventilation in emergency room for patients with acute heart failure.

Science.gov (United States)

Shirakabe, Akihiro; Hata, Noritake; Yokoyama, Shinya; Shinada, Takuro; Kobayashi, Nobuaki; Tomita, Kazunori; Kitamura, Mitsunobu; Nozaki, Ayaka; Tokuyama, Hideo; Asai, Kuniya; Mizuno, Kyoichi

2011-01-01

Non-invasive positive pressure ventilation (NPPV) for acute heart failure (AHF) is increasingly used to avoid endotracheal intubation (ETI). We therefore reviewed our experience using respirator management in the emergency room for AHF, and evaluated the predictive factors in the success of NPPV in the emergency room. Three-hundred forty-three patients with AHF were analyzed. The AHF patients were assigned to either BiPAP-Synchrony (B-S; Respironics, Merrysville, PA, USA) period (2005-2007, n = 176) or BiPAP-Vision (B-V; Respironics) period (2008-2010, n = 167). The rate of carperitide use was significantly increased and dopamine use was significantly decreased in the B-V period. The total length of hospital stay was significantly shorter in the B-V period. AHF patients were also assigned to a failed trial of NPPV followed by ETI (NPPV failure group) or an NPPV success group in the emergency room for each period. NPPV was successfully used in 48 cases in the B-S period, and in 111 cases in the B-V period. Fifty-seven ETI patients included 45 direct ETI and 11 NPPV failure cases in the B-S period, and 16 ETI patients included 10 direct ETI and 6 NPPV failure cases in the B-V period. The pH values were significantly lower in the NPPV failure than in the NPPV success for both periods (7.19 ± 0.10 vs. 7.28 ± 0.11, B-S period, p successful estimates of NPPV with a high sensitivity and specificity, and the aortic blood gas level was above 7.03 pH when using the B-V system. Copyright © 2011 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Poor Compliance with Sepsis Guidelines in a Tertiary Care Children’s Hospital Emergency Room

OpenAIRE

Benjamin Louis Moresco; Benjamin Louis Moresco; Clinton Woosley; Clinton Woosley; Morris Sauter; Utpal Bhalala; Utpal Bhalala

2018-01-01

ObjectivesThis study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER) of a tertiary care children’s hospital.MethodsThis was a retrospective, observational study of children (0–18 years old) in The Children’s Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for “severe sepsis” and “shocks.” Patients in the adhere...

Clinically useful predictors for premature mortality among psychiatric patients visiting a psychiatric emergency room

DEFF Research Database (Denmark)

Aagaard, Jørgen; Buus, Niels; Wernlund, Andreas Glahn

2016-01-01

OBJECTIVE: The aim of this study was to examine changes in the distribution of causes of death and mortality rates among psychiatric patients visiting a psychiatric emergency room (PER), to determine clinically useful predictors for avoiding premature mortality among these patients and to discuss...... linked to the Cause of Death Register and the Central Psychiatric Research Register, and logistic predictor analyses for premature death were performed. RESULTS: The standardised mortality ratio (SMR) of all visitors compared to the general Danish population was approximately 5. Overall, patients...

PACS infrastructure supporting e-learning

Energy Technology Data Exchange (ETDEWEB)

Mildenberger, Peter, E-mail: milden@radiologie.klinik.uni-mainz.de [University Medicine Mainz, Johannes Gutenberg-University Mainz, Langenbeckstr 1, Mainz (Germany); Brueggemann, Kerstin; Roesner, Freya; Koch, Katja; Ahlers, Christopher [University Medicine Mainz, Johannes Gutenberg-University Mainz, Langenbeckstr 1, Mainz (Germany)

2011-05-15

Digital imaging is becoming predominant in radiology. This has implications for teaching support, because conventional film-based concepts are now obsolete. The IHE Teaching File and Clinical Study Export (TCE) profile provides an excellent platform to enhance PACS infrastructure with educational functionality. This can be supplemented with dedicated e-learning tools.

PACS infrastructure supporting e-learning

International Nuclear Information System (INIS)

Mildenberger, Peter; Brueggemann, Kerstin; Roesner, Freya; Koch, Katja; Ahlers, Christopher

2011-01-01

Digital imaging is becoming predominant in radiology. This has implications for teaching support, because conventional film-based concepts are now obsolete. The IHE Teaching File and Clinical Study Export (TCE) profile provides an excellent platform to enhance PACS infrastructure with educational functionality. This can be supplemented with dedicated e-learning tools.

A demanding web-based PACS supported by web services technology

Science.gov (United States)

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

2006-03-01

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

Investment alternative: the status quo or PACS?

Science.gov (United States)

Vanden Brink, John A.; Cywinski, Jozef K.

1990-08-01

While the cost of Picture Archiving and Communication Systems (PACS) can be substantial, the cost of continuing with present manual methods may become prohibitive in growing departments as the need for additional space and personnel (both technical and professional) to meet the increasing requirements for all image management activities continues to grow. This will occur simultaneously with increasing pressures on problems of the present system, i.e., lost films, lost revenues, delayed reporting and longer diagnostic cycle times. Present methods of image archiving communication and management i.e. the relationship of procedure volume to VFE requirements for professional and technical personnel, costs of film, film storage space, and other performance factors are analyzed based on the database created by the Technology Marketing Group (TMG) computerized cost analysis model applied to over 50 US hospitals. Also, the model is used to provide the projected cost of present methods of film management for an average US 400 +bed hospital based on ten year growth rate assumptions. TMG PACS Tracking data provides confirmation of staffmg pattern correlation to procedure volume. The data presented in the paper provides a basis for comparing the investment in maintaining the status quo to an investment in PACS.

Focused Cardiac Ultrasound Using a Pocket-Size Device in the Emergency Room

Directory of Open Access Journals (Sweden)

Frederico José Neves Mancuso

2014-12-01

Full Text Available Background: Cardiovascular urgencies are frequent reasons for seeking medical care. Prompt and accurate medical diagnosis is critical to reduce the morbidity and mortality of these conditions. Objective: To evaluate the use of a pocket-size echocardiography in addition to clinical history and physical exam in a tertiary medical emergency care. Methods: One hundred adult patients without known cardiac or lung diseases who sought emergency care with cardiac complaints were included. Patients with ischemic changes in the electrocardiography or fever were excluded. A focused echocardiography with GE Vscan equipment was performed after the initial evaluation in the emergency room. Cardiac chambers dimensions, left and right ventricular systolic function, intracardiac flows with color, pericardium, and aorta were evaluated. Results: The mean age was 61 ± 17 years old. The patient complaint was chest pain in 51 patients, dyspnea in 32 patients, arrhythmia to evaluate the left ventricular function in ten patients, hypotension/dizziness in five patients and edema in one patient. In 28 patients, the focused echocardiography allowed to confirm the initial diagnosis: 19 patients with heart failure, five with acute coronary syndrome, two with pulmonary embolism and two patients with cardiac tamponade. In 17 patients, the echocardiography changed the diagnosis: ten with suspicious of heart failure, two with pulmonary embolism suspicious, two with hypotension without cause, one suspicious of acute coronary syndrome, one of cardiac tamponade and one of aortic dissection. Conclusion: The focused echocardiography with pocket-size equipment in the emergency care may allow a prompt diagnosis and, consequently, an earlier initiation of the therapy.

Focused Cardiac Ultrasound Using a Pocket-Size Device in the Emergency Room

Energy Technology Data Exchange (ETDEWEB)

Mancuso, Frederico José Neves, E-mail: frederico.mancuso@grupofleury.com.br [Disciplina de Cardiologia - Escola Paulista de Medicina - Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil); Disciplina de Medicina de Urgência - Escola Paulista de Medicina - Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil); Siqueira, Vicente Nicoliello; Moisés, Valdir Ambrósio [Disciplina de Cardiologia - Escola Paulista de Medicina - Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil); Gois, Aécio Flavio Teixeira [Disciplina de Medicina de Urgência - Escola Paulista de Medicina - Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil); Paola, Angelo Amato Vincenzo de; Carvalho, Antonio Carlos Camargo; Campos, Orlando [Disciplina de Cardiologia - Escola Paulista de Medicina - Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil)

2014-12-15

Cardiovascular urgencies are frequent reasons for seeking medical care. Prompt and accurate medical diagnosis is critical to reduce the morbidity and mortality of these conditions. To evaluate the use of a pocket-size echocardiography in addition to clinical history and physical exam in a tertiary medical emergency care. One hundred adult patients without known cardiac or lung diseases who sought emergency care with cardiac complaints were included. Patients with ischemic changes in the electrocardiography or fever were excluded. A focused echocardiography with GE Vscan equipment was performed after the initial evaluation in the emergency room. Cardiac chambers dimensions, left and right ventricular systolic function, intracardiac flows with color, pericardium, and aorta were evaluated. The mean age was 61 ± 17 years old. The patient complaint was chest pain in 51 patients, dyspnea in 32 patients, arrhythmia to evaluate the left ventricular function in ten patients, hypotension/dizziness in five patients and edema in one patient. In 28 patients, the focused echocardiography allowed to confirm the initial diagnosis: 19 patients with heart failure, five with acute coronary syndrome, two with pulmonary embolism and two patients with cardiac tamponade. In 17 patients, the echocardiography changed the diagnosis: ten with suspicious of heart failure, two with pulmonary embolism suspicious, two with hypotension without cause, one suspicious of acute coronary syndrome, one of cardiac tamponade and one of aortic dissection. The focused echocardiography with pocket-size equipment in the emergency care may allow a prompt diagnosis and, consequently, an earlier initiation of the therapy.

Focused Cardiac Ultrasound Using a Pocket-Size Device in the Emergency Room

International Nuclear Information System (INIS)

Mancuso, Frederico José Neves; Siqueira, Vicente Nicoliello; Moisés, Valdir Ambrósio; Gois, Aécio Flavio Teixeira; Paola, Angelo Amato Vincenzo de; Carvalho, Antonio Carlos Camargo; Campos, Orlando

2014-01-01

Cardiovascular urgencies are frequent reasons for seeking medical care. Prompt and accurate medical diagnosis is critical to reduce the morbidity and mortality of these conditions. To evaluate the use of a pocket-size echocardiography in addition to clinical history and physical exam in a tertiary medical emergency care. One hundred adult patients without known cardiac or lung diseases who sought emergency care with cardiac complaints were included. Patients with ischemic changes in the electrocardiography or fever were excluded. A focused echocardiography with GE Vscan equipment was performed after the initial evaluation in the emergency room. Cardiac chambers dimensions, left and right ventricular systolic function, intracardiac flows with color, pericardium, and aorta were evaluated. The mean age was 61 ± 17 years old. The patient complaint was chest pain in 51 patients, dyspnea in 32 patients, arrhythmia to evaluate the left ventricular function in ten patients, hypotension/dizziness in five patients and edema in one patient. In 28 patients, the focused echocardiography allowed to confirm the initial diagnosis: 19 patients with heart failure, five with acute coronary syndrome, two with pulmonary embolism and two patients with cardiac tamponade. In 17 patients, the echocardiography changed the diagnosis: ten with suspicious of heart failure, two with pulmonary embolism suspicious, two with hypotension without cause, one suspicious of acute coronary syndrome, one of cardiac tamponade and one of aortic dissection. The focused echocardiography with pocket-size equipment in the emergency care may allow a prompt diagnosis and, consequently, an earlier initiation of the therapy

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

Science.gov (United States)

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.

Completion and Testing of PACS SWIR Channel

Data.gov (United States)

National Aeronautics and Space Administration — PACS SWIR has important technological innovations that will be necessary to meet the mission requirements for wide FOV, hyperangle capability, high polarimetric...

Picture archiving and communication system planning as a whole practice in step by step

International Nuclear Information System (INIS)

Luo Min; Luo Song; Lei Weiyong; Wen Hongyu; Wu Hongxing; Wang Xiaolin; Wang Xuejian

2002-01-01

Objective: To discuss the whole design and to carry through the implement project in building picture archiving and communication system (PACS). Methods: All modalities with or without DICOM were integrated into PACS to store the whole images and share those resources. Windows NT and SQL 7.0 were used on the servers to store all kinds of patient image files, and those images could be viewed on all the web-based clinical workstations and the license was up to 100. RAID 5 online HDD which had the capability to store images for 3 months and DLT long term archive storage up to 7 T in size were built in the system. The PACS already finished the integration with RIS and HIS to expand images to the whole hospital and ready to be an imaging center of one area. Results: The founded typical PACS connected hospital equipments at present and realized primary no-film mode in department of radiology. The PACS had extended to the whole hospital clinical rooms, surgery, and emergency treatment room, etc. The PACS was connected to the HIS and networks of other hospitals. The center of image data was established, realizing the connection among the center of image data together with current area and other area hospitals. The PACS was easy to use for the doctors and improved the work efficiency. Conclusion: The practice has proved that current project related PACS planning as a whold practice in step by step is viable and successful

Influence map baserad Ms. Pac-Man och Ghost Kontroller

OpenAIRE

Svensson, Johan

2012-01-01

This thesis will cover the use oftheinfluence map technique applied to the retro game Ms. Pac-Man. A game thatis easy to learn but hard to master. The Ms. Pac-Man controller is implemented with five main parameters that alters the behaviour of the controller while the Ghost controller have three parameters. The experimental results of the controllers is explored to using the alterations of the parameters to find its peak of performance. The conclusion from using the influence map for this gam...

Superfine powdered activated carbon (S-PAC) coatings on microfiltration membranes: Effects of milling time on contaminant removal and flux.

Science.gov (United States)

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

Picture archiving and communication systems (PACS) in clinical practice

International Nuclear Information System (INIS)

Carreno Pedemonte, J.C.; Piqueras Pardellans, J.; Lucaya Layret, J.

1994-01-01

Picture archiving and communication systems (PACS) were developed as a technological response to the complex management of the growing amount of information generated by the different diagnostic imaging methods. This article documents the process of the progressive implementation, starting in January 1991, of the first complete PACS installed in our country. The system installed in our center is composed of acquisition modules for all the imaging methods (computed radiography, ultrasound, computed tomography, digital fluoroscopy and magnetic resonance), a central processing unit, an automatic optical disk for storage and a network of image viewing and diagnostic stations. The preliminary results obtained with its implementation demonstrate that PACS provide a series of functional advantages, especially at the image storage and display levels. In spite of these conveniences, the present high costs of acquisition and maintenance, together with certain technical problems as a result of its complexity, will signify that its generalized application for all imaging methods will not become a reality at most centers in the near future

PACS: Picture Archiving and Communication Systems

International Nuclear Information System (INIS)

Gell, G.; Schneider, G.H.; Becker, M.; Wiltgen, M.

1988-01-01

A growing number of medical imaging modalities produces images that are initially calculated and stored as digital information in a computer. For diagnosis, archiving and communication a hardcopy (usually on X-ray film) is produced from these data. It is estimated that in 1995 about 80% of all imaging procedures will generate digital images. This trend leads to the development of systems, where the X-ray film is not only replaced in his function as a radiation detector, but also in his other functions as the medium for image presentation, image communication and image archiving. In short, one wants a completely digital picture archiving and communication system (PACS). The rationale behind PACS efforts is to achieve better functionality and to save costs, mainly by reducing the consumption of expensive X-ray films and the need for storage space for film archives. 7 refs., 2 figs. (Author)

Integration of radiology and hospital information systems (RIS, HIS) with PACS

International Nuclear Information System (INIS)

Mosser, H.; Urban, M.; Hruby, W.; Duerr, M.; Rueger, W.

1992-01-01

PACS development has now reached a stage where it can clearly be stated that the technology for storage, networking and display in a fully digital environment is available. This is reflected by an already large and rapidly increasing number of PACS installations in USA, Western Europe and Japan. Such installations consist of a great variety of information systems, more or less interconnected, like PACS, HIS, RIS and other departmental systems, differing in both hardware and software. Various data -even if they only concern one person- are stored in different systems distributed in the hospital. The integration of all digital systems into a functional unit is determined by the radiologist's need of quick access to all relevant information regardless where it is stored. The interconnection and functional integration of all digital systems in the hospital determine the clinical benefits of PACS. This paper describes the radiologist's requirements concerning this integration, and presents some realistic solutions such as the Siemens ISI (Information System Interface), and a mobile viewing station for the wards (visitBox). (author). 9 refs., 4 figs

Development and practice for a PACS-based interactive teaching model for CT image

International Nuclear Information System (INIS)

Tian Junzhang; Jiang Guihua; Zheng Liyin; Wang Ling; Wenhua; Liang Lianbao

2002-01-01

Objective: To explore the interactive teaching model for CT imaging based on PACS, and provide the clinician and young radiologist with continued medical education. Methods: 100 M trunk net was adopted in PACS and 10 M was exchanged on desktop. Teaching model was installed in browse and diagnosis workstation. Teaching contents were classified according to region and managed according to branch model. Text data derived from authoritative textbooks, monograph, and periodicals. Imaging data derived from cases proved by pathology and clinic. The data were obtained through digital camera and scanner or from PACS. After edited and transformed into standard digital image through DICOM server, they were saved in HD of PACS image server with file form. Results: Teaching model for CT imaging provided kinds of cases of CT sign, clinic characteristics, pathology and distinguishing diagnosis. Normal section anatomy, typical image, and its notation could be browsed real time. Teaching model for CT imaging could provide reference to teaching, diagnosis and report. Conclusion: PACS-based teaching model for CT imaging could provide interactive teaching and scientific research tool and improve work quality and efficiency

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

Science.gov (United States)

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.

Manejo da asma aguda em adultos na sala de emergência: evidências atuais Management of acute asthma in adults in the emergency room: current evidence

Directory of Open Access Journals (Sweden)

Paulo de Tarso Roth Dalcin

2009-01-01

Full Text Available Asma é uma doença com uma alta prevalência em nosso meio e ao redor do mundo. Embora novas opções terapêuticas tenham sido recentemente desenvolvidas, parece haver um aumento mundial na sua morbidade e mortalidade. Em muitas instituições, as exacerbações asmáticas ainda se constituem em uma emergência médica muito comum. As evidências têm demonstrado que o manejo da asma aguda na sala de emergência concentra decisões cruciais que podem determinar o desfecho desta situação clínica. Nesta revisão, enfocaremos a avaliação e o tratamento do paciente com asma aguda na sala de emergência, descrevendo uma estratégia apropriada para o seu manejo. Serão consideradas as seguintes etapas: diagnóstico, avaliação da gravidade, tratamento, avaliação das complicações, decisão sobre onde se realizará o tratamento adicional e orientações por ocasião da alta da emergência. Espera-se que estas recomendações contribuam para que o médico clínico tome as decisões apropriadas durante o manejo da asma aguda na sala de emergência.Asthma is a disease with high prevalence in our country and worldwide. Although new therapeutic approaches have been developed recently, there seems to be a global increase in morbidity and mortality from asthma. In many institutions, asthma exacerbation is still a common medical emergency. Clinical evidence demonstrates that management of acute asthma in the emergency room entails crucial decisions that could determine the clinical outcome. In this review, the authors focus on assessment and treatment of patients with acute asthma and outline an appropriate management strategy. Diagnosis, severity assessment, treatment, complications, decision about where additional treatment will take place and orientations on discharge from the emergency will be considered. It is expected that these recommendations will help physicians to make the appropriate decisions about care of acute asthma in the emergency

PACS spectroscopy of OH/IR stars

NARCIS (Netherlands)

Lombaert, R.; de Vries, B.L.; Decin, L.; Blommaert, J.A.D.L.; Royer, Pierre; De Beck, E.; de Koter, A.; Waters, L.B.F.M.

2011-01-01

Observations of high-excitation molecular emission lines can greatly increase our understanding of AGB winds, as they trace the innermost regions of the circumstellar envelope. The PACS spectrometer on-board the Herschel Space Telescope1, provides for the first time the spectral resolution and

Lessons learned from a whole hospital PACS installation. Picture Archiving and Communication System.

Science.gov (United States)

Pilling, J R

2002-09-01

The Norfolk and Norwich University Hospital has incorporated a fully filmless Picture Archiving and Communication System (PACS) as part of a new hospital provision using PFI funding. The PACS project has been very successful and has met with unanimous acclaim from radiologists and clinicians. A project of this size cannot be achieved without learning some lessons from mistakes and recognising areas where attention to detail resulted in a successful implementation. This paper considers the successes and problems encountered in a large PACS installation.

A study on reduction effect of processing wastewater by introduction of PACS

International Nuclear Information System (INIS)

Ko, Shin Kwan; Yang, Han Jun; Han, Dong Kyoon; Kim, Wook Dong; Kang, Bung Sam

2007-01-01

There are some positive effects by the introduction of PACS (Picture Archiving Communication System). This study is to analyze the mutual relation between before and after of the introduction of PACS in terms of the environment effect. It is supposed to cause the reduction of developing and fixing wastewater according to the increase in the rate of a non-film. This study also show the amount of wastewater. Target places were the department of image medicine (diagnostic radiation) of the general hospitals in Seoul and Gyeonggido, which are equipped with full PACS. The authors examined questionnaires on the number of projection, the number of indirect projection, the amount of the film used, the number of radiation image CD loan, the amount of the developing and fixing solution used, the change of the amount of fixing wastewater. According to the analysis, we analyzed the change of the amount of developing and fixing solution per a film and the change of the amount of developing and fixing wastewater which is supposed to be reduced proportionally by the introduction of PACS. We got conclusion as below after analyzing 8 hospitals except the largest and the least amount of examination, film used, developing and fixing solution and the amount of developing and fixing wastewater in order to decrease the deviation from 10 general hospitals located in Seoul and Gyeonggido. We compared data one year before adopting PACS Versus 3 years after adopting PACS. The frequencies of examination increased to 7,357.7 cases per month but the amount of film used decreased to 90%, from 42,774.4 to 4,181.88 after adopting the PACS. 3 years after adopting PACS, monthly average amount of developing solution used decreased to 92% and the monthly average amount of fixing solution decreased to 86%. Monthly average amount of developing solution used per film increased to 1.49 times and fixing solution increased as much as three times. Monthly average wastewater for developing decreased to 88

PACS and its hospital-wide implementation: A case study at the Madigan Army Medical Center

International Nuclear Information System (INIS)

Choi, Hyung Sik; Kim, Yong Min; Smith, Donald V.; Bender, Gregory N.

1993-01-01

PACS represents the future of radiology in modern hospitals. Workstations and databases can be developed to substantially increase clinician's productivity, improve diagnostic accuracy, and make a large amount of knowledge and patient information available on-line to the physician. Currently, there are several hospitals in the process of implementing a total PACS system. They include Madigan Army Medical Center (Tacoma, Washington), VA Hospital in Baltimore, and Hammersmith Hospital in London (1). In order to provide the radiologist, the clinicians, and other health personnel in Korea with the general concept of PACS and its up-to-date status report, we describe the MDIS system being implemented in MAMC (Madigan Army Medical Center) which is the first hospital-wide large-scale PACS in the world. The major PACS components in MAMC have been installed since March 1992 and the full system implementation will be completed by summer 1993. The goal of the MDIS system in MAMC is to increase to more than 90% filmless by the end of 1993. In this paper, we discuss the introduction and background of PACS and its potential benefits, the current status of PACS installation in MAMC and the future plan, and the flow of image data and text information in MAMC

Cost-effective data storage/archival subsystem for functional PACS

Science.gov (United States)

Chen, Y. P.; Kim, Yongmin

1993-09-01

Not the least of the requirements of a workable PACS is the ability to store and archive vast amounts of information. A medium-size hospital will generate between 1 and 2 TBytes of data annually on a fully functional PACS. A high-speed image transmission network coupled with a comparably high-speed central data storage unit can make local memory and magnetic disks in the PACS workstations less critical and, in an extreme case, unnecessary. Under these circumstances, the capacity and performance of the central data storage subsystem and database is critical in determining the response time at the workstations, thus significantly affecting clinical acceptability. The central data storage subsystem not only needs to provide sufficient capacity to store about ten days worth of images (five days worth of new studies, and on the average, about one comparison study for each new study), but also supplies images to the requesting workstation in a timely fashion. The database must provide fast retrieval responses upon users' requests for images. This paper analyzes both advantages and disadvantages of multiple parallel transfer disks versus RAID disks for short-term central data storage subsystem, as well as optical disk jukebox versus digital recorder tape subsystem for long-term archive. Furthermore, an example high-performance cost-effective storage subsystem which integrates both the RAID disks and high-speed digital tape subsystem as a cost-effective PACS data storage/archival unit are presented.

Development of an object-oriented software based on fuzzy-logic for controlling temperatures in PAC experiments

Energy Technology Data Exchange (ETDEWEB)

Lapolli, Andre L.; Yamagishi, Sueli; Domienikan, Claudio; Schoueri, Roberto M.; Carbonari, Artur W.; Saxena, Rajendra N., E-mail: alapolli@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

2009-07-01

The Hyperfine Interaction Laboratory at Instituto de Pesquisas Energeticas e Nucleares (IPEN) has been using Perturbed Angular Correlation (PAC) technique for studying material science for more than 20 years. One of the important aspects of the research involves the study of the behavior of measured properties of samples as a function of temperature. For temperatures higher than room temperature a small resistance furnace is used to heat the sample. The need to carry out the PAC measurement at predefined temperatures steps in a programmed manner is obvious. The present work describes a procedure for the furnace temperature control and automatic data acquisition at different temperatures based on fuzzy logic. The procedure consists in determining the linguistic input (temp, DELTAtemp) and output (pow) variables and their pertinence functions. After defining the variables, an object.oriented program is written in Java language which is an interface between principal data acquisition program and electronic temperature controller of the mini furnace. In addition to the implementation of the class that involves the fuzzy logic and classes with strategic algorithms defined for each temperature range there are classes of communication between systems based on modbus protocol RTU (Remote Terminal Unit) connected to serial interface RS-488. In this manner the applied technology for the development of software permits higher software life requiring only small alterations or implementation of classes in the use with new equipment. (author)

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

Science.gov (United States)

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.

Identification and initial management of intoxication by alcohol and other drugs in the pediatric emergency room

Directory of Open Access Journals (Sweden)

Thiago Gatti Pianca

Full Text Available Abstract Objective: To review the screening, diagnosis, evaluation, and treatment of intoxication by alcohol and other drugs in children and adolescents in the emergency scenario. Data source: This was a narrative literature review. Data summary: The detection of this problem in the emergency room can be a challenge, especially when its assessment is not standardized. The intentional and episodic use of large amounts of psychoactive substances by adolescents is a usual occurrence, and unintentional intoxication is more common in children younger than 12 years. The clinical picture in adolescents and children differs from that in adults and some particularities are important in the emergency scenario. After management of the acute condition, interventions targeting the adolescent at risk may be effective. Conclusion: The diagnosis and treatment of intoxication by alcohol and other drugs in adolescents and children in the emergency scenario requires a systematic evaluation of the use of these drugs. There are few specific treatments for intoxication, and the management comprehends support measures and management of related clinical complications.

Identification and initial management of intoxication by alcohol and other drugs in the pediatric emergency room.

Science.gov (United States)

Pianca, Thiago Gatti; Sordi, Anne Orgle; Hartmann, Thiago Casarin; von Diemen, Lisia

To review the screening, diagnosis, evaluation, and treatment of intoxication by alcohol and other drugs in children and adolescents in the emergency scenario. This was a narrative literature review. The detection of this problem in the emergency room can be a challenge, especially when its assessment is not standardized. The intentional and episodic use of large amounts of psychoactive substances by adolescents is a usual occurrence, and unintentional intoxication is more common in children younger than 12 years. The clinical picture in adolescents and children differs from that in adults and some particularities are important in the emergency scenario. After management of the acute condition, interventions targeting the adolescent at risk may be effective. The diagnosis and treatment of intoxication by alcohol and other drugs in adolescents and children in the emergency scenario requires a systematic evaluation of the use of these drugs. There are few specific treatments for intoxication, and the management comprehends support measures and management of related clinical complications. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Prepare to protect: Operating and maintaining a tornado safe room.

Science.gov (United States)

Herseth, Andrew; Goldsmith-Grinspoon, Jennifer; Scott, Pataya

2017-06-01

Operating and maintaining a tornado safe room can be critical to the effective continuity of business operations because a firm's most valuable asset is its people. This paper describes aspects of operations and maintenance (O&M) for existing tornado safe rooms as well as a few planning and design aspects that affect the ultimate operation of a safe room for situations where a safe room is planned, but not yet constructed. The information is based on several Federal Emergency Management Agency safe room publications that provide guidance on emergency management and operations, as well as the design and construction of tornado safe rooms.

Control room human engineering influences on operator performance

International Nuclear Information System (INIS)

Finlayson, F.C.

1977-01-01

Three general groups of factors influence operator performance in fulfilling their responsibilities in the control room: (1) control room and control system design, informational data displays (operator inputs) as well as control board design (for operator output); (2) operator characteristics, including those skills, mental, physical, and emotional qualities which are functions of operator selection, training, and motivation; (3) job performance guides, the prescribed operating procedures for normal and emergency operations. This paper presents some of the major results of an evaluation of the effect of human engineering on operator performance in the control room. Primary attention is given to discussion of control room and control system design influence on the operator. Brief observations on the influences of operator characteristics and job performance guides (operating procedures) on performance in the control room are also given. Under the objectives of the study, special emphasis was placed on the evaluation of the control room-operator relationships for severe emergency conditions in the power plant. Consequently, this presentation is restricted largely to material related to emergency conditions in the control room, though it is recognized that human engineering of control systems is of equal (or greater) importance for many other aspects of plant operation

PACS: Do clinical users benefit from it as a training adjunct? | van ...

African Journals Online (AJOL)

Although a PACS relates specifically to the archiving and retrieval of radiological images and reports, it became clear from the feedback received from medical clinicians (who ... The advantages of PACS as a positive training adjunct were highlighted in the areas of multi-site viewing and consultation, the possibility of image ...

First experience with the traumatological PACS project at the University of Innsbruck department of Radiology

International Nuclear Information System (INIS)

Peer, S.; Peer, R.; Jaschke, W.; Vogl, R.; Baldauf, E.

1998-01-01

Radiography in an emergency setting is a demanding task, in technical as well as in logistical terms. Rapid acquisition of high quality radiographs under difficult conditions, for example severely injured patients with multi-organ trauma is important. All image data and radiological reports must be transmitted to the trauma surgeon as soon as possible. To meet these needs with the promising means of modern X-ray technology, we decided to implement a completely digital X-ray division inside the new outpatient trauma department. In the setting of an outpatient emergency department digital radiography and PACS cannot be realised without problems. We present our first experience with the installation and 10 months filmless routine in the X-ray division for traumatology outpatients at the university of Innsbruck department of radiology. (orig.) [de

Operator interface design considerations for a PACS information management system

Science.gov (United States)

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.

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

Science.gov (United States)

Horii, Steven C.

2007-03-01

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

Combined PACS and intranet information system in a University Hospital; Kombiniertes PACS und Intranet-Informationssystem an einem Universitaetsklinikum

Energy Technology Data Exchange (ETDEWEB)

Heiss, D.; Pfluger, T.; Pfeifer, K.J.; Hahn, K. [Muenchen Univ. (Germany). Inst. fuer Radiologische Diagnostik; Koenig, A.; Endres, S. [Muenchen Univ. (Germany). Medizinische Klinik Innenstadt

2000-06-01

Purpose: The Department of Radiology at the University Hospital Innenstadt Munich provides all clinical departments of a large university hospital with several radiology units at different locations. During the last four years all units have been fully digitalized with a stepwise installation of a PACS. The PACS also processes images from the Nuclear Medicine Department. Methods: As image modalities, archive systems and review workstations, we use devices from multiple vendors, which are integrated into a consistent system using the DICOM standard. The hospital has developed its own RIS and an intranet information system, which provides access to all reports and images from radiology for all clinical departments inside the hospital. Additionally, other clinical information such as laboratory results or ECG examinations are available through the system. Results: After one year of operation, the system succeeded in the clinical routine work as the primary source for radiological reports and images as well as for laboratory values. Conclusion: The advantages of digitalization were, besides reduction of film cost, especially optimizations of work flow with access to digital images from every where at any time. (orig.) [German] Ziel: Das Institut fuer Radiologische Diagnostik am Universitaetsklinikum Muenchen - Innenstadt versorgt mit mehreren, dezentral gelegenen Roentgenbereichen alle klinischen Abteilungen eines grossen Universitaetsklinikums. In einem Projekt der vergangenen vier Jahre wurden alle Bereiche durch die schrittweise Installation eines PACS vollstaendig digitalisiert. Dabei wurden auch nuklearmedizinische Bilddaten aus der Klinik und Poliklinik fuer Nuklearmedizin im System verarbeitet. Methoden: Eingesetzt wurden als Bilderzeuger, Archivsystem und Befundungsstationen Geraete unterschiedlicher Hersteller, die dank des DICOM Standards in einem einheitlichen System integriert sind. Neben dem PACS wurde von Mitarbeitern der Klinik ein RIS und ein Intranet

The impact of a picture archiving and communication system (PACS) upon an intensive care unit

International Nuclear Information System (INIS)

Watkins, Jessamy; Weatherburn, Gwyn; Bryan, Stirling

2000-01-01

Objective: The aim of the study was to assess the effect of the introduction of PACS (Picture Archiving and Communication System) upon image availability in an Intensive Care Unit (ICU) and the consequent impact upon the behaviour of the ICU physicians, in terms of the initiation of image-based clinical actions. Design: A before and after study was used to compare the speed of image availability prior to, and following, the implementation of a hospital-wide PACS. Setting: The research was part of an economic evaluation of PACS at Hammersmith Hospital, West London. Patients and participants: All ICU patients who were X-rayed during two pre-PACS and one post-PACS data collection periods were included within the study. Measurements: The times of: the X-ray request; acquisition; availability on ICU; and of any image-based clinical action taken by the ICU physician were recorded by radiographers and ICU physicians. Results: PACS significantly reduced the time between request and image availability on ICU for routine X-rays but did not have any measurable impact upon the time clinical actions were initiated by ICU physicians. The data on non-routine images were statistically inconclusive. Conclusions: This study shows that PACS significantly improves the speed of delivery of routine images to the ICU, but it appears that the instigation of image-based clinical actions is determined by other organisational factors in ICU, such as ward rounds, rather than the availability of the image for viewing. Further work is required on non-routine X-rays to clarify the impact of PACS on physician behaviour in clinically urgent situations

A strongly quasiconvex PAC-Bayesian bound

DEFF Research Database (Denmark)

Thiemann, Niklas; Igel, Christian; Wintenberger, Olivier

2017-01-01

We propose a new PAC-Bayesian bound and a way of constructing a hypothesis space, so that the bound is convex in the posterior distribution and also convex in a trade-off parameter between empirical performance of the posterior distribution and its complexity. The complexity is measured by the Ku...

Design criteria for a data base management system for a PACS at Georgetown University Hospital

International Nuclear Information System (INIS)

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

1986-01-01

A major goal of a radiologic picture archival and communication system (PACS) is to increase the availability of the data to the users who require access to them. This is done by providing the data in a digital form which can be readily communicated and archived. In this manner, the PACS can be seen as a specific example of a data base managements system (DBMS). The PACS/DBMS should organize the data base in such a way as to provide its users with the data they require in a timely and efficient manner. The ability to integrate the variety of data into common data base should lead to a more complete and relevant representation of the available information. A PACS/DBMS is not only unique in the types of data contained in the data base and its different users but also in the volume of data that are entered into the system and transferred within the system each day. Consideration of these characteristics leads to the definition of functional criteria for the PACS/DBMS. This report discusses the criteria that will be used in the design of a DBMS for a PACS at Georgetown University Hospital. (Auth.)

Peligros del átomo pacífico

Directory of Open Access Journals (Sweden)

Juan Zarco de Gea

1962-07-01

Full Text Available Expuestas en el artículo anterior las ventajas que el hombre puede obtener del uso de la energía atómica para fines pacíficos: industria, agricultura, medicina, investigación científica, etc., parece oportuno examinar ahora el reverso de la medalla y estudiar los inconvenientes de ese mismo uso pacífico de las fuerzas atómicas; inconvenientes, dicho sea de paso, que también existen en el aprovechamiento de otras fuerzas naturales, físicas o químicas, en las minas, fábricas, laboratorios y otras muchas empresas de toda índole; pero tratándose de las energías nucleares entran en juego factores nuevos y especiales, que llevan el asunto a terrenos diferentes: moral, político, de salud pública, etc.

Bibliographic database of PACS-related articles from the SPIE literature

Science.gov (United States)

Shile, Peter E.; Freiermuth, Jennifer

1996-05-01

Publications of the International Society of Optical Engineering (SPIE) contain much of the relevant literature on Picture Archiving and Communications Systems (PACS) and related topics. In fact, many PACS-related articles indexed by the National Library of Medicine contain references to articles published by SPIE. Unfortunately, SPIE publications themselves are not indexed by the National Library of Medicine and thus can not be identified through Medline. The lack of a convenient mechanism for searching the SPIE literature is problematic for researchers in medical imaging. With the recent introduction on SPIE's Internet server of their Abstracts Online service and their In-CiteTM title and author searching software, the SPIE literature has become more accessible. However, the searching process is still a cumbersome and time consuming process, and it is not possible to perform key word searches of manuscript abstracts. In this paper we present results of our work on developing a mechanism to more thoroughly search SPIE publications for PACS-related articles.

Listening to "How the Patient Presents Herself": A Case Study of a Doctor-Patient Interaction in an Emergency Room

Science.gov (United States)

Delbene, Roxana

2015-01-01

This is a case-study based on a micro-ethnography analyzing a doctor-patient interaction in an emergency room (ER) in New York City. Drawing on the framework of narrative medicine (Charon, 2006), the study examines how a phenomenological approach to listening to the patient facilitated the patient's narrative orientation not only to relevant…

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

International Nuclear Information System (INIS)

Satyawali, Yamini; Balakrishnan, Malini

2009-01-01

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 8 L reactor was equipped with a submerged 30 μm 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.

[Neonatological emergencies in delivery room] [Article in Italian] • Il neonatologo ed alcune emergenze in sala parto

OpenAIRE

Antonio Boldrini; Rosa Teresa Scaramuzzo

2014-01-01

Introduction: In the delivery room the neonatologist may deal with emergencies, not always predictable by pre-natal diagnosis. Among these dangerous situations, we include: i) extremely preterm birth of a newborn very/extremely low birth weight and ii) shoulder dystocia in term newborns. We will discuss in details these two clinical scenarios. Methods: We reviewed the main recent papers about resuscitation of very/extremely low birth weight preterm newborns and about dystocia of shoulder repo...

The effects of PACS on radiographer's work practice

International Nuclear Information System (INIS)

Larsson, W.; Aspelin, P.; Bergquist, M.; Hillergard, K.; Jacobsson, B.; Lindskoeld, L.; Wallberg, J.; Lundberg, N.

2007-01-01

This paper identifies and analyses the effects of picture archiving and communication systems (PACS) on radiographers' work practice. It shows that the introduction of PACS did not simply entail the transfer of data and information from the analogue world to the digital world, but it also led to the introduction of new ways of communicating, and new activities and responsibilities on the part of radiography staff. Radiographers are called upon to work increasingly independently, and individual practitioners require higher levels of professional expertise. In all, this paper demonstrates that new technical solutions sometimes lead to substantial changes in responsibilities in work. In this example, the radiographers' work practice has become more highly scientific and they are enjoying a higher level of prestige

Sphere-pac fuel development program. First semi-annual progress report, October 1979-March 1980

International Nuclear Information System (INIS)

Felt, R.E.

1980-05-01

Development of processes by Exxon Nuclear Company, Inc. for fabricating spherical particle nuclear fuel (sphere-pac) during October 1979 through March 1980 is reported. The program surveyed available technology to develop an initial flowsheet as a design basis for process development. An 0.1 ton/day pilot plant was built to develop and demonstrate the fabrication of sphere-pac fuel. Process and equipment efforts have been directed towards the demonstration of processes and equipment necessary to fabricate sphere-pac fuel on a commercial scale

Merits of usability testing for PACS selection

NARCIS (Netherlands)

Jorritsma, Wiard; Cnossen, Fokie; van Ooijen, Peter M. A.

Objectives: To compare the usability of different Picture Archiving and Communication System (PACS) workstations, determine whether a usability test has added value with respect to the traditional way of comparing PACSs based on functional requirements, and to evaluate the appropriateness of a

PACS for surgery and interventional radiology: features of a Therapy Imaging and Model Management System (TIMMS).

Science.gov (United States)

Lemke, Heinz U; Berliner, Leonard

2011-05-01

Appropriate use of information and communication technology (ICT) and mechatronic (MT) systems is viewed by many experts as a means to improve workflow and quality of care in the operating room (OR). This will require a suitable information technology (IT) infrastructure, as well as communication and interface standards, such as specialized extensions of DICOM, to allow data interchange between surgical system components in the OR. A design of such an infrastructure, sometimes referred to as surgical PACS, but better defined as a Therapy Imaging and Model Management System (TIMMS), will be introduced in this article. A TIMMS should support the essential functions that enable and advance image guided therapy, and in the future, a more comprehensive form of patient-model guided therapy. Within this concept, the "image-centric world view" of the classical PACS technology is complemented by an IT "model-centric world view". Such a view is founded in the special patient modelling needs of an increasing number of modern surgical interventions as compared to the imaging intensive working mode of diagnostic radiology, for which PACS was originally conceptualised and developed. The modelling aspects refer to both patient information and workflow modelling. Standards for creating and integrating information about patients, equipment, and procedures are vitally needed when planning for an efficient OR. The DICOM Working Group 24 (WG-24) has been established to develop DICOM objects and services related to image and model guided surgery. To determine these standards, it is important to define step-by-step surgical workflow practices and create interventional workflow models per procedures or per variable cases. As the boundaries between radiation therapy, surgery and interventional radiology are becoming less well-defined, precise patient models will become the greatest common denominator for all therapeutic disciplines. In addition to imaging, the focus of WG-24 is to serve

PACS for surgery and interventional radiology: Features of a Therapy Imaging and Model Management System (TIMMS)

International Nuclear Information System (INIS)

Lemke, Heinz U.; Berliner, Leonard

2011-01-01

Appropriate use of information and communication technology (ICT) and mechatronic (MT) systems is viewed by many experts as a means to improve workflow and quality of care in the operating room (OR). This will require a suitable information technology (IT) infrastructure, as well as communication and interface standards, such as specialized extensions of DICOM, to allow data interchange between surgical system components in the OR. A design of such an infrastructure, sometimes referred to as surgical PACS, but better defined as a Therapy Imaging and Model Management System (TIMMS), will be introduced in this article. A TIMMS should support the essential functions that enable and advance image guided therapy, and in the future, a more comprehensive form of patient-model guided therapy. Within this concept, the 'image-centric world view' of the classical PACS technology is complemented by an IT 'model-centric world view'. Such a view is founded in the special patient modelling needs of an increasing number of modern surgical interventions as compared to the imaging intensive working mode of diagnostic radiology, for which PACS was originally conceptualised and developed. The modelling aspects refer to both patient information and workflow modelling. Standards for creating and integrating information about patients, equipment, and procedures are vitally needed when planning for an efficient OR. The DICOM Working Group 24 (WG-24) has been established to develop DICOM objects and services related to image and model guided surgery. To determine these standards, it is important to define step-by-step surgical workflow practices and create interventional workflow models per procedures or per variable cases. As the boundaries between radiation therapy, surgery and interventional radiology are becoming less well-defined, precise patient models will become the greatest common denominator for all therapeutic disciplines. In addition to imaging, the focus of WG-24 is to serve

Refinement of atomic position in purely ionic materials using PAC spectroscopy

International Nuclear Information System (INIS)

Eslami, E.; Saramad, S.; Moussavi-Zarandi, A.

2000-01-01

In pure ionic solids by means of electric field gradients at substitutional radioactive probe the positions of all atoms in the unit cell can be determined by PAC method with an accuracy of 0.3 Pm which is typically 5 times better than the data available from X ray and neutron diffraction experiments. In the case of oxides where to our knowledge no diffraction analysis exists, the PAC analysis predicts the atomic parameters

Seismic simulation and functional performance evaluation of a safety related, seismic category I control room emergency air cleaning system

International Nuclear Information System (INIS)

Manley, D.K.; Porco, R.D.; Choi, S.H.

1985-01-01

Under a nuclear contract MSA was required to design, manufacture, seismically test and functionally test a complete Safety Related, Seismic Category I, Control Room Emergency Air Cleaning System before shipment to the Yankee Atomic Electric Company, Yankee Nuclear Station in Rowe, Massachusetts. The installation of this system was required to satisfy the NRC requirements of NUREG-0737, Section III, D.3.4, ''Control Room Habitability''. The filter system tested was approximately 3 ft. wide by 8 ft. high by 18 ft. long and weighed an estimated 8300 pounds. It had a design flow rate of 3000 SCFM and contained four stages of filtration - prefilters, upstream and downstream HEPA filters and Type II sideload charcoal adsorber cells. The filter train design followed the guidelines set forth by ANSI/ASME N509-1980. Seismic Category I Qualification Testing consisted of resonance search testing and triaxial random multifrequency testing. In addition to ANSI/ASME N510-1980 testing, triaxial response accelerometers were placed at specific locations on designated prefilters, HEPA filters, charcoal adsorbers and test canisters along with accelerometers at the corresponding filter seal face locations. The purpose of this test was to demonstrate the integrity of the filters, filter seals, and monitor seismic response levels which is directly related to the system's ability to function during a seismic occurrence. The Control Room Emergency Air Cleaning System demonstrated the ability to withstand the maximum postulated earthquake for the plant site by remaining structurally sound and functional

Preliminary application in teaching of medical imaging with picture archiving and communication systems

International Nuclear Information System (INIS)

Wei Yuqing; Hu Jian; Wang Xuejian; Cao Jun; Tong Juan; Shen Guiquan; Luo Min; Luo Song

2003-01-01

Objective: To evaluate PACS (picture archiving and communication systems) in the teaching of medical imaging. Methods: Large screen multimedia reading room and electronic study room were built with GE PACS and Angel RIS (radiology information system) and end-term picture-word work-station. Pictures and words of PACS were unloaded directly for teaching and teaching image bank and test image bank. Results: Large screen multimedia reading room, classroom, and electronic study room were built successfully. Valuable information of nearly 5000 patients in the teaching imaging bank of PACS was accumulated. Classic medical imaging teaching mode was changed. Real-time and multi-mode teaching were realized, and teaching effect was greatly improved. The PACS-based teaching model was accepted pleasantly by students. Conclusion: PACS is very useful to improve the teaching quality of medical imaging and it is worth to popularize

Hospital hero: a game for reducing stress and anxiety of children while waiting in emergency room

OpenAIRE

Tranquada, Sara Patrícia Fernandes

2014-01-01

This report tells a story which started as an idea that came to us to fight the battle-cry feeling commonly known as stress and anxiety. Before creating the solution of the idea, we first need to understand the feelings underneath and its effects on our well-being. Throughout the course of our lives, we experience states of weakness and fear. These feelings can arise, for instance, while we are in an emergency room. Needless to say, how much it would have imaginable effects on children,...

In vivo biological evaluation of 131I radiolabeled-paclitaxel glucuronide (131I-PAC-G)

International Nuclear Information System (INIS)

Aslan, O.; Biber Muftuler, F.Z.; Yurt Kilcar, A.; Ichedef, C.; Unak, P.

2012-01-01

Paclitaxel (PAC) is a natural occurring diterpene alkoloid originally isolated from the bark of Taxus Brevifolia. It is one of the most important antitumor agents for clinical treatment of ovarian, breast non-small cell lung and prostate cancers. It is known that these types of cancer cells have high β-glucuronidase enzyme which can catalyze the hydrolysis of glucuronides. This is why the synthesis compounds which undergo glucuronidation come into question in the imaging and therapy of these cancer cells. The aim of current study is conjugation of glucuronic acid (G) to the starting substance PAC, labeling with 131 I and to perform its in vivo biological evaluation. Glucuronic acid derived paclitaxel compound [paclitaxel-glucuronide (PAC-G)] was labeled with 131 I using iodogen method. According to thin layer radio chromatography (TLRC) method, the radiochemical yield of 131 I-PAC-G was 84.30 ± 7.40% (n=10). The biodistribution of 131 I-PAC-G in healthy female and male Wistar Albino rats has been investigated. Imaging studies on male Balb-C mice were performed by using the Kodak FX PRO in vivo Imaging System. The range of the breast/blood, breast/muscle; ovary/blood, ovary/muscle ratios is approximately between 1.29 and 11.34 in 240 min, and between 0.71 and 8.24 in 240 min for female rats. The prostate/blood and prostate/muscle ratio is between 1.94 and 6.95 in 30 min for male rats. All these experimental studies indicate that 131 I-PAC-G may potentially be used in breast, ovary and prostate tissues as an imaging agent. Also it is thought that 131 I-PAC-G bears a therapy potential because of the 131 I radionuclide and can be improved with further investigations. (orig.)

Introduction to PAC/PAD

International Nuclear Information System (INIS)

Mahnke, H.E.

1988-01-01

Both methods, Perturbed Angular Correlation (PAC) utilizing radioactive probes and Perturbed Angular Distribution (PAD) following nuclear reactions measure hyperfine interaction parameters and allow to study magnetism on a rather local scale. While both techniques are based on the same theory the underlying concepts are quite different. Examples on local moments, influence of the nearest-neighbor to the magnetic field in ferromagnets, knight shift in nonmagnetic materials, and magnetism in high-temperature superconductors and related oxides illustrate the recent developments within the methods and the improvements in their sensitivity and resolution. (orig.)

Archival storage solutions for PACS

Science.gov (United States)

Chunn, Timothy

1997-05-01

While they are many, one of the inhibitors to the wide spread diffusion of PACS systems has been robust, cost effective digital archive storage solutions. Moreover, an automated Nearline solution is key to a central, sharable data repository, enabling many applications such as PACS, telemedicine and teleradiology, and information warehousing and data mining for research such as patient outcome analysis. Selecting the right solution depends on a number of factors: capacity requirements, write and retrieval performance requirements, scaleability in capacity and performance, configuration architecture and flexibility, subsystem availability and reliability, security requirements, system cost, achievable benefits and cost savings, investment protection, strategic fit and more.This paper addresses many of these issues. It compares and positions optical disk and magnetic tape technologies, which are the predominant archive mediums today. Price and performance comparisons will be made at different archive capacities, plus the effect of file size on storage system throughput will be analyzed. The concept of automated migration of images from high performance, high cost storage devices to high capacity, low cost storage devices will be introduced as a viable way to minimize overall storage costs for an archive. The concept of access density will also be introduced and applied to the selection of the most cost effective archive solution.

Effect of PAC addition on immersed ultrafiltration for the treatment of algal-rich water

Energy Technology Data Exchange (ETDEWEB)

Zhang Yan, E-mail: zhang.yan113@163.com [State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, 73 Huanghe Road, Nangang District, Harbin 150090 (China); Tian Jiayu; Nan Jun; Gao Shanshan; Liang Heng; Wang Meilian; Li Guibai [State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, 73 Huanghe Road, Nangang District, Harbin 150090 (China)

2011-02-28

The aim of this study was to evaluate the effect of powdered activated carbon (PAC) addition on the treatment of algal-rich water by immersed ultrafiltration (UF), in terms of permeate quality and membrane fouling. Experiments were performed with a hollow-fiber polyvinyl chloride ultrafiltration membrane at a laboratory scale, 20-25 deg, C and 10 L/(m{sup 2} h) constant permeate flux. UF could achieve an absolute removal of Microcystis aeruginosa cells, but a poor removal of algogenic organic matter (AOM) released into water, contaminants responsible for severe membrane fouling. The addition of 4 g/L PAC to the immersed UF reactor significantly alleviated the development of trans-membrane pressure and enhanced the removal of dissovled organic carbon (by 10.9 {+-} 1.7%), UV{sub 254} (by 27.1 {+-} 1.7%), and microcystins (expressed as MC-LR{sub eq}, by 40.8 {+-} 4.2%). However, PAC had little effect on the rejection of hydrophilic high molecular weight AOM such as carbohydrates and proteins. It was also identified that PAC reduced the concentrations of carbohydrates and proteins in the reactor due to decreased light intensity, as well as the MC-LR{sub eq} concentration by PAC adsorption.

Study of Radiologic Technologists' Perceptions of Picture Archiving and Communication System (PACS) Competence and Educational Issues in Western Australia.

Science.gov (United States)

Floyd, Daniel M; Trepp, Errol R; Ipaki, Maryam; Ng, Curtise K C

2015-06-01

Although the implementation of picture archiving and communication system (PACS) could increase productivity of radiology departments, this depends on factors such as the PACS competence of radiologic technologists (RTs). The purpose of this study was to investigate the RTs' perceptions of PACS competence and educational issues in Western Australia (WA). A hardcopy questionnaire was distributed to WA RTs for obtaining their perceptions of PACS competence and educational issues. Descriptive (percentage of frequency, mean and standard deviation) and inferential statistics (t test and analysis of variance) were used to analyze the responses of the multiple choice and five-point scale questions from the returned questionnaires. The questionnaire response rate was 57.7% (173 out of 300). The mean values of all PACS competence questions except questions 2e-g are in the range of 3.9-4.9, i.e., around competent to very competent. Participants indicated they received adequate PACS training (mean 3.8). Statistically significant variables influencing RTs' perceptions of their PACS competence and educational issues including the age (p education received (p system, and received adequate training. However, future PACS education programs should be tailored to different RTs' groups. For example, multiple training modules might be necessary to support the PACS competence development of older RTs and those with lower general computer literacy.

Development of an object-oriented software based on fuzzy-logic for controlling temperatures in PAC experiments

International Nuclear Information System (INIS)

Lapolli, Andre L.; Yamagishi, Sueli; Domienikan, Claudio; Schoueri, Roberto M.; Carbonari, Artur W.; Saxena, Rajendra N.

2009-01-01

The Hyperfine Interaction Laboratory at Instituto de Pesquisas Energeticas e Nucleares (IPEN) has been using Perturbed Angular Correlation (PAC) technique for studying material science for more than 20 years. One of the important aspects of the research involves the study of the behavior of measured properties of samples as a function of temperature. For temperatures higher than room temperature a small resistance furnace is used to heat the sample. The need to carry out the PAC measurement at predefined temperatures steps in a programmed manner is obvious. The present work describes a procedure for the furnace temperature control and automatic data acquisition at different temperatures based on fuzzy logic. The procedure consists in determining the linguistic input (temp, Δtemp) and output (pow) variables and their pertinence functions. After defining the variables, an object.oriented program is written in Java language which is an interface between principal data acquisition program and electronic temperature controller of the mini furnace. In addition to the implementation of the class that involves the fuzzy logic and classes with strategic algorithms defined for each temperature range there are classes of communication between systems based on modbus protocol RTU (Remote Terminal Unit) connected to serial interface RS-488. In this manner the applied technology for the development of software permits higher software life requiring only small alterations or implementation of classes in the use with new equipment. (author)

Reasons for Picture Archiving and Communication System (PACS ...

African Journals Online (AJOL)

Tintswalo Brenda Mahlaola

Background: The Picture Archiving and Communication System (PACS) has led to an in- ... incidents in which sensitive information was intentionally shared via social media. .... confidentiality of electronic data in terms of medical ethics,.

A comparative cost analysis of picture archiving and communications systems (PACS versus conventional radiology in the private sector

Directory of Open Access Journals (Sweden)

Indres Moodley

2015-03-01

Aim: To undertake an incremental cost analysis of PACS compared with conventional radiology to determine productivity gains, if any, at two private hospitals in Durban. Method: An incremental cost analysis for chest radiographs, computed tomography and magnetic resonance imaging brain scans with and without contrast were performed. The overall incremental cost for PACS in comparison with a conventional radiology site was determined. The net present value was also determined to evaluate the capital budgeting requirements for both systems. Results: The incremental cost of both capital and the radiology information system for installing PACS shows an expected increase. The incremental PACS image cost shows a reduction. Conclusion: The study provides a benchmark for the cost incurred when implementing PACS. It also provides a decision framework for radiology departments that plan to introduce PACS and helps to determine the feasibility of its introduction.

The sorting protein PACS-2 promotes ErbB signalling by regulating recycling of the metalloproteinase ADAM17

DEFF Research Database (Denmark)

Dombernowsky, Sarah Louise; Samsøe-Petersen, Jacob; Petersen, Camilla Hansson

2015-01-01

The metalloproteinase ADAM17 activates ErbB signalling by releasing ligands from the cell surface, a key step underlying epithelial development, growth and tumour progression. However, mechanisms acutely controlling ADAM17 cell-surface availability to modulate the extent of ErbB ligand release....... PACS-2 co-localizes with ADAM17 on early endosomes and PACS-2 knockdown decreases the recycling and stability of internalized ADAM17. Hence, PACS-2 sustains ADAM17 cell-surface activity by diverting ADAM17 away from degradative pathways. Interestingly, Pacs2-deficient mice display significantly reduced...

Ergonomic design in the operating room: information technologies

Science.gov (United States)

Morita, Mark M.; Ratib, Osman

2005-04-01

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

The emergency room at the Rotunda Hospital: evidence of an improving service over the past 3 years.

LENUS (Irish Health Repository)

Talukdar, S

2014-12-01

This is a retrospective review of the Rotunda Hospital Emergency Room (ER) documentation with respect to attendances for a 4-month period (August-November) in both 2009 and 2012. The aim was to quantify the workload and assess the quality of care offered to patients attending the ER over the two time periods and to highlight any improvements in care after changes were implemented following the initial 2009 review.

The Obstetrics Gynecology and Children's Hospital Emergency ...

African Journals Online (AJOL)

EB

The efficiency of emergency rooms is becoming increasingly important and has been addressed by legislation. Prompt emergency room service is expected when patients present to an emergency room with urgent health problems. However, depending on various factors, the wait times for access to health services can be ...

Knowledge barriers to PACS adoption and implementation in hospitals.

Science.gov (United States)

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.

Authenticity techniques for PACS images and records

Science.gov (United States)

Wong, Stephen T. C.; Abundo, Marco; Huang, H. K.

1995-05-01

Along with the digital radiology environment supported by picture archiving and communication systems (PACS) comes a new problem: How to establish trust in multimedia medical data that exist only in the easily altered memory of a computer. Trust is characterized in terms of integrity and privacy of digital data. Two major self-enforcing techniques can be used to assure the authenticity of electronic images and text -- key-based cryptography and digital time stamping. Key-based cryptography associates the content of an image with the originator using one or two distinct keys and prevents alteration of the document by anyone other than the originator. A digital time stamping algorithm generates a characteristic `digital fingerprint' for the original document using a mathematical hash function, and checks that it has not been modified. This paper discusses these cryptographic algorithms and their appropriateness for a PACS environment. It also presents experimental results of cryptographic algorithms on several imaging modalities.

Knowledge of the management of paediatric dental traumas by non-dental professionals in emergency rooms in South Araucanía, Temuco, Chile.

Science.gov (United States)

Díaz, Jaime; Bustos, Luís; Herrera, Samira; Sepulveda, Jaqueline

2009-12-01

The objective of this study was to investigate the level of knowledge and attitudes regarding first aid for dental trauma in children (TDI) by non-dental professionals and paramedical technicians of hospital emergency rooms in the South Araucanía Health Service, Chile, which was attained through application of a survey. Samples were collected from people with occupations in the respective emergency rooms. The participants were 82 people that were interviewed using a questionnaire regarding management of dental trauma. Paramedic technicians, general and specialist doctors, and nurses were included in this survey. The appraisal covered diverse aspects: birth date, age, sex, years of experience in the emergency room, and questions regarding specific dental trauma topics, which focused on crown fractures, luxation injuries in permanent dentition, avulsion in primary and permanent teeth, and the respective emergency treatments. Of the participants, 78.1% reported to have been presented with a TDI patient. The majority (90.2%) had not received formal training on TDI. These results revealed a wide distribution of responses. The overall dental trauma knowledge among the participants was relatively poor. For crown fractures management 54.9% indicated that they would ask the affected child about the crown remnants. In regard to transport and storage medium of avulsed permanent teeth, only 9.8% of the participants answered correctly and 43.9% of respondents stated that they would not replant an avulsed permanent tooth, since that procedure is considered the responsibility of a dentist. The majority of the respondents were not knowledgeable regarding TDI or the management and benefits of timely care, particularly in cases of avulsed permanent teeth. Therefore, formal education and training on the topic is suggested during undergraduate studies.

PACS or the future of the radiologist's working place

International Nuclear Information System (INIS)

Meyer-Ebrecht, D.

1988-01-01

PACS (picture archiving and communication systems) is a synonym for the replacement of the traditional photographic film by means of technologies that will communicate and store images exclusively in digital form. Digital mass storage will replace the film archives and will be linked to all image sources by means of a data communication network. More significantly, PACS will also introduce a novel type of image-evaluation modality, the diagnostic image work station. Images will be displayed on TV monitors. In addition, a variety of support functions will become available for image handling and processing. The replacement of the light box by a digital work station will definitely cause dramatic changes in the radiologist's work. (orig.) [de

Problems facing the radiologist tendering for a hospital wide PACS system

International Nuclear Information System (INIS)

Pilling, John

1999-01-01

As PACS becomes a reality the practical difficulties of installing the new technology become evident. The practical issues of developing a strategy, understanding the market, writing a business case, and an outline based specification are considered. The complexities of European procurement, the evaluation of responses, the contracting process and the problems of implementation, training, assessing the benefits and foreseeing the problems are covered. Provided there is careful attention to detail a hospital can expect to implement a successful PACS system

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

NARCIS (Netherlands)

Olthof, A. W.; van Ooijen, P. M. A.

The purpose of this work is to demonstrate the possibility of implementation of a PACS-integrated peer review system based on RADPEER T classification providing a step-wise implementation plan utilizing features already present in the standard PACS implementation and without the requirement of

Diagnostic image workstations ofr PACS

International Nuclear Information System (INIS)

Meyer-Ebrecht, D.; Fasel, B.; Dahm, M.; Kaupp, A.; Schilling, R.

1990-01-01

Image workstations will be the 'window' to the complex infrastructure of PACS with its intertwined image modalities (image sources, image data bases and image processing devices) and data processing modalities (patient data bases, departmental and hospital information systems). They will serve for user-to-system dialogues, image display and local processing of data as well as images. Their hardware and software structures have to be optimized towards an efficient throughput and processing of image data. (author). 10 refs

Predictors of Frequent Emergency Room Visits among a Homeless Population.

Directory of Open Access Journals (Sweden)

Kinna Thakarar

Full Text Available Homelessness, HIV, and substance use are interwoven problems. Furthermore, homeless individuals are frequent users of emergency services. The main purpose of this study was to identify risk factors for frequent emergency room (ER visits and to examine the effects of housing status and HIV serostatus on ER utilization. The second purpose was to identify risk factors for frequent ER visits in patients with a history of illicit drug use.A retrospective analysis was performed on 412 patients enrolled in a Boston-based health care for the homeless program (HCH. This study population was selected as a 2:1 HIV seronegative versus HIV seropositive match based on age, sex, and housing status. A subgroup analysis was performed on 287 patients with history of illicit drug use. Chart data were analyzed to compare demographics, health characteristics, and health service utilization. Results were stratified by housing status. Logistic models using generalized estimating equations were used to predict frequent ER visits.In homeless patients, hepatitis C was the only predictor of frequent ER visits (OR 4.49, p<0.01. HIV seropositivity was not predictive of frequent ER visits. In patients with history of illicit drug use, mental health (OR 2.53, 95% CI 1.07-5.95 and hepatitis C (OR 2.85, 95% CI 1.37-5.93 were predictors of frequent ER use. HIV seropositivity did not predict ER use (OR 0.45, 95% CI 0.21 - 0.97.In a HCH population, hepatitis C predicted frequent ER visits in homeless patients. HIV seropositivity did not predict frequent ER visits, likely because HIV seropositive HCH patients are engaged in care. In patients with history of illicit drug use, hepatitis C and mental health disorders predicted frequent ER visits. Supportive housing for patients with mental health disorders and hepatitis C may help prevent unnecessary ER visits in this population.

APPC - A new standardised coding system for trans-organisational PACS retrieval

International Nuclear Information System (INIS)

Fruehwald, F.; Lindner, A.; Mostbeck, G.; Hruby, W.; Fruehwald-Pallamar, J.

2010-01-01

As part of a general strategy to integrate the health care enterprise, Austria plans to connect the Picture Archiving and Communication Systems (PACS) of all radiological institutions into a nationwide network. To facilitate the search for relevant correlative imaging data in the PACS of different organisations, a coding system was compiled for all radiological procedures and necessary anatomical details. This code, called the Austrian PACS Procedure Code (APPC), was granted the status of a standard under HL7. Examples are provided of effective coding and filtering when searching for relevant imaging material using the APPC, as well as the planned process for future adjustments of the APPC. The implementation and how the APPC will fit into the future electronic environment, which will include an electronic health act for all citizens in Austria, are discussed. A comparison to other nationwide electronic health record projects and coding systems is given. Limitations and possible use in physical storage media are contemplated. (orig.)

Predicting nonrecovery among whiplash patients in the emergency room and in an insurance company setting.

Science.gov (United States)

Rydman, Eric; Ponzer, Sari; Ottosson, Carin; Järnbert-Pettersson, Hans

2017-04-01

To construct and validate a prediction instrument for early identification of patients with a high risk of delayed recovery after whiplash injuries (PPS-WAD) in an insurance company setting. Prospective cohort study. On the basis of a historic cohort (n = 130) of patients with a whiplash injury identified in an emergency room (ER, model-building set), we used logistic regression to construct an instrument consisting of two demographic variables (i.e. questions of educational level and work status) and the patient-rated physical and mental status during the acute phase to predict self-reported nonrecovery after 6 months. We evaluated the instrument's ability to predict nonrecovery in a new cohort (n = 204) of patients originating from an insurance company setting (IC, validation set). The prediction instrument had low reproducibility when the setting was changed from the ER cohort to the IC cohort. The overall percentage of correct predictions of nonrecovery in the ER cohort was 78 % compared with 62 % in the IC cohort. The sensitivity and specificity in relation to nonrecovery were both 78 % in the ER cohort. The sensitivity and specificity in the insurance company setting was lower, 67 and 50 %. Clinical decision rules need validation before they are used in a new setting. An instrument consisting of four questions with an excellent possibility of identifying patients with a high risk of nonrecovery after a whiplash injury in the emergency room was not as useful in an insurance company setting. The importance and type of the risk factors for not recovering probably differ between the settings, as well as the individuals.

Improving the performance of an aerobic membrane bioreactor (MBR) treating pharmaceutical wastewater with powdered activated carbon (PAC) addition.

Science.gov (United States)

Kaya, Yasemin; Bacaksiz, A Murat; Golebatmaz, Ugur; Vergili, Ilda; Gönder, Z Beril; Yilmaz, Gulsum

2016-04-01

In this study, the effects of organic loading rate (OLR) and the addition of powdered activated carbon (PAC) on the performance and membrane fouling of MBR were conducted to treat real pharmaceutical process wastewater. Over 145 days of operation, the MBR system was operated at OLRs ranging from 1 to 2 kg COD m(-3) day(-1) without sludge wasting. The addition of PAC provided an improvement in the flux, despite an increase in the OLR:PAC ratio. The results demonstrated that the hybrid PAC-MBR system maintained a reduced amount of membrane fouling and steadily increased the removal performance of etodolac. PAC addition reduced the deposition of extracellular polymeric substance and organic matter on the membrane surface and resulted an increase in COD removal even at higher OLRs with low PAC addition. Membrane fouling mechanisms were investigated using combined adsorption fouling models. Modified fouling index values and normalized mass transfer coefficient values indicated that predominant fouling mechanism was cake adsorption.

Medical Data Manager an Interface between PACS and the gLite Data Management System

CERN Document Server

Montagnat, Johan; Texier, Romain; Nienartowicz, Krzysztof; Baud, Jean-Philippe

2008-01-01

The medical imaging community uses the DICOM image format and protocol to store and exchange data. The Medical Data Manager (MDM) is an interface between DICOM compliant systems such as PACS and the EGEE Data Management System. It opens hospital imaging networks to the world scale Grid while protecting sensitive medical data. It can be accessed transparently from any gLite service. It is an important milestone towards adoption of Grid technologies in the medical imaging community. Hospitals continuously produce tremendous amounts of image data that is managed by local PACS (Picture Archiving and Communication Systems). These systems are often limited to a local network access although the community experiences a growing interest for data sharing and remote processing. Indeed, patient data is often spread out different medical data acquisition centers. Furthermore, researchers in the area often need to analyze large populations whose data can be gathered through federations of PACS. Opening PACS to the outer I...

THE ZN-SITE IN BOVINE COPPER, ZINC SUPEROXIDE-DISMUTASE STUDIED BY CD-111 PAC

DEFF Research Database (Denmark)

Kofod, Pauli; Bjerrum, Morten J.; Bauer, Rogert

1991-01-01

The active site in bovine copper, zinc superoxide dismutase (Cu2. Zn2 SOD) has been studied by 111Cd time differential Perturbed Angular Correlation (PAC) on enzyme with Zn2+ replaced by excited 'Cd2+. The PAC spectra obtained for both the oxidized and the reduced form of Cu2Cd2SOD show...... no asymmetry between the two Zn-sites in the dimeric enzyme. The spectv further reveal that a significant change has taken place at the Zn-site in the reduced form compared to the oxidized form. Semi-empirical calculations based on the Angular Overlap Model (AOM) and coordinates from the crystal structure...... of the native enzyme are in agreement with the experimental PAC data of the oxidized enzyme. The results indicate that Cd2+ coordinates in the same manner as Zn2+ and that the crystal structure of SOD is valid for the enzyme in solution. The PAC spectrum of the reduced enzyme can be explained by extending...

The guarantee of the consistency of patient information through modality worklist among PACS, RIS and imaging equipments

International Nuclear Information System (INIS)

Luo Min; Peng Chenglin; Wang Xiaolin; Luo Song; Lei Wenyong; Wang Kang; Wang Xuejian; Wen Hongyu; Wu Hongxing

2003-01-01

Objective: To realize the consistency of patient information through modality worklist among picture archiving and communication system (PACS), radiology information systems (RIS), and imaging equipments. Methods: Many digital modalities including GE Signa 1.5 T MR system, digital mammography, Agfa digital radiography, computed radiography, GE CT, and etc were installed in our hospital. Since the GE PACS system was in English version, the images were saved and the information was managed to PACS without a truly worklist. Two months later, while still using the previous PACS, the consistency of patient information was resolved through modality worklist by adopting the international advanced approach to realize thread worklist of digital imaging and communication in medicine. The information in Chinese will be transformed into information in English in RIS system and saved as the English information to worklist. Results: After the implementation and integration of PACS and RIS was achieved in my hospital, the consistency of patient information was guaranteed through modality worklist between RIS and imaging equipments and the first-rate effect was acquired. The patient information could be checked, edited, and created by using the Chinese RIS system on all diagnostic workstations. Conclusion: The consistency of patient information through modality worklist was realized among PACS, RIS, and imaging equipments, yet at present, the question of guarantee the consistency of patient information must be thought over in PACS building

Study of hyperfine parameters in Co-doped tin dioxide using PAC spectroscopy

International Nuclear Information System (INIS)

Ramos, Juliana M.; Carbonari, Artur W.; Martucci, Thiago; Costa, Messias S.; Saxena, Rajendra N.; Vianden, R.; Kessler, P.; Geruschke, T.; Steffens, M.

2011-01-01

PAC technique has been used to measure the hyperfine interactions in nano-structured powder samples of semiconducting SnO 2 doped with Co. The aim of this work is to compare the results of PAC measurements using two different techniques of introducing the radioactive 111 In probe nuclei in the sample of SnO 2 doped with Co. The perturbed gamma-gamma angular correlation (PAC) spectroscopy is used for the measurements of the magnetic hyperfine field (MHF) and the electric field gradient (EFG) at 111 Cd sites in SnO 2 doped with 1% and 2% Co. The measurement of EFG is used to study the defects introduced in the semiconductor material and also for the identification of different phases formed within the compound. The techniques utilized for introducing the radioactive 111 In in the sample are the ion-implantation using radioactive ion beam of 111 In and the chemical process in which 111 InCl 3 solution is added during the preparation of SnO 2 doped with Co using sol gel method. The ion-implantation of 111 In in SnO 2 doped with Co was carried out using the University of Bonn ion-implanter with beam energy of 160 keV. The PAC measurements were carried out with four BaF 2 detector gamma spectrometer in the temperature range of 10-295 K. The results show no significant difference in the values of hyperfine parameters. Both techniques show practically the same electric quadrupole interaction for the substitutional site. The results were compared with previous PAC and Moessbauer measurements of SnO 2 powder samples using 111 In- 111 Cd probe. (author)

Effect of oxygen plasma treatment on adhesion improvement of Au deposited on Pa-c substrates

International Nuclear Information System (INIS)

Lee, Jeong Hoon; Hwang, Kyo Seon; Kim, Tae Song; Seong, Jin Wook; Yoon, Ki Hyun; Ahn, Sae Young

2004-01-01

Adhesion of gold on parylene C (Pa-c) is a major hurdle in achieving reliable and durable performance for biosensor application due to the hydrophobicity of Pa-c. It is, therefore, imperative to put efforts to improve adhesion between Au and Pa-c. In this reseach, oxygen plasma treatment for adhesion improvement was performed on Pa-c surfaces at various plasma powers and times. To analyze the relation of surface energy and roughness to adhesion promotion, we used several techniques such as contact-angle, surface-energy, surface-roughness, and adhesion analyses. As the oxygen plasma power and time were increased, the surface roughness of Pa-c increased. Also, Au films had larger and more uniform grain sizes as the oxygen plasma power and time were increased. Untreated surfaces revealed a contact angle of 108 .deg. , but the contact angle drastically decreased in the initial stage of oxygen plasma treatment and slowly decreased with increasing power and time to values of 27.3 and 34, respectively. From the adhesion analysis, adhesion was improved as the plasma power or time was increased. The improvement of adhesion is related to an increase in roughness as well as carbonyl groups.

Protective benefits of mindfulness in emergency room personnel.

Science.gov (United States)

Westphal, Maren; Bingisser, Martina-Barbara; Feng, Tianshu; Wall, Melanie; Blakley, Emily; Bingisser, Roland; Kleim, Birgit

2015-04-01

Recent meta-analyses have found that mindfulness practice may reduce anxiety and depression in clinical populations and there is growing evidence that mindfulness may also improve well-being and quality of care in health professionals. This study examined whether mindfulness protects against the impact of work-related stress on mental health and burnout in emergency room (ER) nurses. ER nurses (N=50) were recruited from an urban teaching hospital in Switzerland and completed a survey on work-related stressors, mindfulness, burnout, depression, and anxiety. The most frequently reported work-related stressor was interpersonal conflict. Nurses working more consecutive days since last taking time off were at greater risk for depression and those reporting more work-related interpersonal conflicts were at greater risk for burnout. Mindfulness was associated with reduced anxiety, depression, and burnout. Mindfulness was a significant predictor of anxiety, depression, and burnout and moderated the impact of work-related stressors on mental health and burnout. The sample is limited to nurses and results need to be replicated in other groups (e.g., medical staff or ambulance workers). We assessed clinical symptoms with questionnaires and it would be desirable to repeat this assessment with clinical diagnostic interviews. The findings have implications for stress management in ER nurses and health professionals working in comparable settings (e.g., urgent care). The robust associations between mindfulness and multiple indices of psychological well-being suggest that ER staff exposed to high levels of occupational stress may benefit from mindfulness practice to increase resistance to mental health problems and burnout. Copyright © 2015 Elsevier B.V. All rights reserved.

Determination of octanol-water partition coefficients of polar polycyclic aromatic compounds (N-PAC) by high performance liquid chromatography

DEFF Research Database (Denmark)

Helweg, C.; Nielsen, T.; Hansen, P.E.

1997-01-01

Prediction of 1-octanol water partition coefficients for a range of polar N-PAC from HPLC capacity coefficients has been investigated. Two commercially available columns, an ODS column and a Diol column were tested with water-methanol eluents. The best prediction of log K-ow for N-PAC was achieve...... with size and log K-ow for N-PAC was 1.1-1.3 lower than log K-ow for the equivalent PAH. Shielding of the nitrogen atom in the N-PAC compounds caused an increase in log K-ow. (C) 1997 Elsevier Science Ltd....

Photo-dynamics of the lyophilized photo-activated adenylate cyclase NgPAC2 from the amoeboflagellate Naegleria gruberi NEG-M strain

Energy Technology Data Exchange (ETDEWEB)

Penzkofer, A., E-mail: alfons.penzkofer@physik.uni-regensburg.de [Fakultät für Physik, Universität Regensburg, Universitätsstrasse 31, D-93053 Regensburg (Germany); Tanwar, M.; Veetil, S.K.; Kateriya, S. [Department of Biochemistry, University of Delhi South Campus, Benito Juarez Road, New Delhi 110021 (India); Stierl, M.; Hegemann, P. [Institut für Biologie/Experimentelle Biophysik, Humboldt Universität zu Berlin, Invalidenstrasse 42, D-10115 Berlin (Germany)

2013-09-23

Highlights: • Lyophilizing of NgPAC2 from Naegleria gruberi caused loss of BLUF domain activity. • Photo-induced tyrosine to flavin electron transfer in lyophilized NgPAC2. • Photo-induced Tyr–Tyr cross-linking to o,o′-dityrosine in lyophilized NgPAC2. • Photo-induced partial flavin cofactor reduction in lyophilized NgPAC2. • Two NgPAC2 conformations with fast and slow photo-induced electron transfer. - Abstract: The absorption and emission spectroscopic behavior of lyophilized photo-activated adenylate cyclase NgPAC2 from the amoeboflagellate Naegleria gruberi NEG-M strain consisting of a BLUF domain (BLUF = Blue Light sensor Using Flavin) and a cyclase homology domain was studied in the dark, during blue-light exposure and after blue-light exposure at a temperature of 4 °C. The BLUF domain photo-cycle dynamics observed for snap-frozen NgPAC2 was lost by lyophilization (no signaling state formation with flavin absorption red-shift). Instead, blue-light photo-excitation of lyophilized NgPAC2 caused sterically restricted Tyr–Tyr cross-linking (o,o′-ditysosine formation) and partial flavin cofactor reduction.

Photo-dynamics of the lyophilized photo-activated adenylate cyclase NgPAC2 from the amoeboflagellate Naegleria gruberi NEG-M strain

International Nuclear Information System (INIS)

Penzkofer, A.; Tanwar, M.; Veetil, S.K.; Kateriya, S.; Stierl, M.; Hegemann, P.

2013-01-01

Highlights: • Lyophilizing of NgPAC2 from Naegleria gruberi caused loss of BLUF domain activity. • Photo-induced tyrosine to flavin electron transfer in lyophilized NgPAC2. • Photo-induced Tyr–Tyr cross-linking to o,o′-dityrosine in lyophilized NgPAC2. • Photo-induced partial flavin cofactor reduction in lyophilized NgPAC2. • Two NgPAC2 conformations with fast and slow photo-induced electron transfer. - Abstract: The absorption and emission spectroscopic behavior of lyophilized photo-activated adenylate cyclase NgPAC2 from the amoeboflagellate Naegleria gruberi NEG-M strain consisting of a BLUF domain (BLUF = Blue Light sensor Using Flavin) and a cyclase homology domain was studied in the dark, during blue-light exposure and after blue-light exposure at a temperature of 4 °C. The BLUF domain photo-cycle dynamics observed for snap-frozen NgPAC2 was lost by lyophilization (no signaling state formation with flavin absorption red-shift). Instead, blue-light photo-excitation of lyophilized NgPAC2 caused sterically restricted Tyr–Tyr cross-linking (o,o′-ditysosine formation) and partial flavin cofactor reduction

Automatically measuring brain ventricular volume within PACS using artificial intelligence.

Science.gov (United States)

Yepes-Calderon, Fernando; Nelson, Marvin D; McComb, J Gordon

2018-01-01

The picture archiving and communications system (PACS) is currently the standard platform to manage medical images but lacks analytical capabilities. Staying within PACS, the authors have developed an automatic method to retrieve the medical data and access it at a voxel level, decrypted and uncompressed that allows analytical capabilities while not perturbing the system's daily operation. Additionally, the strategy is secure and vendor independent. Cerebral ventricular volume is important for the diagnosis and treatment of many neurological disorders. A significant change in ventricular volume is readily recognized, but subtle changes, especially over longer periods of time, may be difficult to discern. Clinical imaging protocols and parameters are often varied making it difficult to use a general solution with standard segmentation techniques. Presented is a segmentation strategy based on an algorithm that uses four features extracted from the medical images to create a statistical estimator capable of determining ventricular volume. When compared with manual segmentations, the correlation was 94% and holds promise for even better accuracy by incorporating the unlimited data available. The volume of any segmentable structure can be accurately determined utilizing the machine learning strategy presented and runs fully automatically within the PACS.

Otolaryngology-specific emergency room as a model for resident training.

Science.gov (United States)

Sethi, Rosh K V; Kozin, Elliott D; Remenschneider, Aaron K; Lee, Daniel J; Gliklich, Richard E; Shrime, Mark G; Gray, Stacey T

2015-01-01

There is a paucity of data on junior resident training in common otolaryngology procedures such as ear debridement, nasal and laryngeal endoscopy, epistaxis management, and peritonsillar abscess drainage. These common procedures represent a critical aspect of training and are necessary skills in general otolaryngology practice. We sought to determine how a dedicated otolaryngology emergency room (ER) staffed by junior residents and a supervising attending provides exposure to common otolaryngologic procedures. Retrospective review. Diagnostic and procedural data for all patients examined in the Massachusetts Eye and Ear Infirmary ER between January 2011 and September 2013 were evaluated. A total of 12,234 patients were evaluated. A total of 5,673 patients (46.4%) underwent a procedure. Each second-year resident performed over 450 procedures, with the majority seen Monday through Friday (75%). The most common procedures in our study included diagnostic nasolaryngoscopy (52.0%), ear debridement (34.4%), and epistaxis control (7.0%) An otolaryngology-specific ER provides junior residents with significant diagnostic and procedural volume in a concentrated period of time. This study demonstrates utility of a unique surgical education model and provides insight into new avenues of investigation for otolaryngology training. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Frequent visitors at the psychiatric emergency room - A literature review.

Science.gov (United States)

Schmidt, Manuela

2018-03-01

Frequent visitors at the psychiatric emergency room (PER) constitute a small subgroup of patients, yet they are responsible for a disproportionate number of visits and thus claim considerable resources. Their needs are often left unmet and their repetitive visits reflect their dissatisfaction as well as that of PERs' staff. Motivated by these dilemmas, this study systematically reviews the literature about frequent visitors at PER and seeks to answer two questions: What characterizes frequent visitors at PER in the literature? and What characterizes PER in the literature? Based on 29 studies, this paper offers answers to the two questions based on a strength weakness opportunities and threats (SWOT) analysis. The results of the review and subsequent analysis of the literature revealed the multiplicity and complexity of frequent visitors' characteristics and how they appear to converge. Commonalities were more difficult to identify in PER characteristics. In some cases, this happened because the characteristics were poorly described or were context specific. As a result, it was not easy to compare the studies on PER. Based on SWOT and the findings of the analysis, the paper proposes new venues of research and suggests how the field of mental health might develop by taking into account its opportunities and threats.

Analysis of bacterial contamination on surface of general radiography equipment and CT equipment in emergency room of radiology

Energy Technology Data Exchange (ETDEWEB)

Hong, Dong Hee; KIm, Hyeong Gyun [Dept. of Radiological Science, Far East University, Eumseong (Korea, Republic of)

2016-09-15

We aim to offer basic materials about infection management through conducting bacterial contamination test about general radiography equipment and CT equipment installed in ER of three general hospitals with 100 sickbeds or more located in Gyeongsangbuk-do Province, and suggest management plan. It had been conducted from 1st December 2015 to 31st December, and objects were general radiography equipment and CT equipment of emergency room located in Gyeongsangbuk-do Province. For general radiography equipment, sources were collected from 4 places such as upper side of control box which employees use most, upper side of exposure button, whole upper side of table which is touching part of patient's skin, upper side of stand bucky's grid, and where patients put their jaws on. For CT equipment, sources were collected from 3 places such as upper side of control box which radiography room employees use most, X-ray exposure button, whole upper side of table which is touching part of patient's skin, and gantry inner. Surface contamination strain found at general radiography equipment in emergency room of radiology are Providencia stuartii(25%), Stenotrophomonas maltophilia(18%), Enterobacter cloacae(8%), Pseudomonas species(8%), Staphylococcus epidermidis(8%), Gram negative bacilli(8%), and ungrown bacteria at incubator after 48 hours of incubation (67%) which is the biggest. Most bacteria were found at upper side of stand bucky-grid and stand bucky of radiology's general radiography equipment, and most sources of CT equipment were focused at patient table, which means it is contaminated by patients who have various diseases, and patients who have strains with decreased immunity may get severe diseases. Thus infection prevention should be made through 70% alcohol disinfection at both before test and after test.

Analysis of bacterial contamination on surface of general radiography equipment and CT equipment in emergency room of radiology

International Nuclear Information System (INIS)

Hong, Dong Hee; KIm, Hyeong Gyun

2016-01-01

We aim to offer basic materials about infection management through conducting bacterial contamination test about general radiography equipment and CT equipment installed in ER of three general hospitals with 100 sickbeds or more located in Gyeongsangbuk-do Province, and suggest management plan. It had been conducted from 1st December 2015 to 31st December, and objects were general radiography equipment and CT equipment of emergency room located in Gyeongsangbuk-do Province. For general radiography equipment, sources were collected from 4 places such as upper side of control box which employees use most, upper side of exposure button, whole upper side of table which is touching part of patient's skin, upper side of stand bucky's grid, and where patients put their jaws on. For CT equipment, sources were collected from 3 places such as upper side of control box which radiography room employees use most, X-ray exposure button, whole upper side of table which is touching part of patient's skin, and gantry inner. Surface contamination strain found at general radiography equipment in emergency room of radiology are Providencia stuartii(25%), Stenotrophomonas maltophilia(18%), Enterobacter cloacae(8%), Pseudomonas species(8%), Staphylococcus epidermidis(8%), Gram negative bacilli(8%), and ungrown bacteria at incubator after 48 hours of incubation (67%) which is the biggest. Most bacteria were found at upper side of stand bucky-grid and stand bucky of radiology's general radiography equipment, and most sources of CT equipment were focused at patient table, which means it is contaminated by patients who have various diseases, and patients who have strains with decreased immunity may get severe diseases. Thus infection prevention should be made through 70% alcohol disinfection at both before test and after test

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

Science.gov (United States)

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.

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

Science.gov (United States)

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.

Economic impact of an integrated RIS/PACS system in a university hospital

International Nuclear Information System (INIS)

Kroeger, M.; Wetekam, V.; Nissen-Meyer, S.; Reiser, M.

1999-01-01

Problem: The goal of the current article is to demonstrate how qualitative and monetary effects resulting from an integrated RIS/PACS installation can be evaluated. Results: The sample analysis of a RIS/PACS solution specially designed for a university hospital demonstrates positive qualitative and monetary effects of the system. Under ideal conditions the payoff time of the investments is reached after 4 years of an assumed 8 years effective life of the system. Furthermore, under conservative assumptions, the risk analysis shows a probability of 0% for realising a negative net present value at the end of the payoff time period. Conclusion: It should be pointed out that the positive result of this sample analysis will not necessarily apply to other clinics or hospitals. However, the same methods may be used for the individual evaluation of the qualitative and monetary effects of a RIS/PACS installation in any clinic. (orig.) [de

Study of hyperfine parameters in Co-doped tin dioxide using PAC spectroscopy

Energy Technology Data Exchange (ETDEWEB)

Ramos, Juliana M.; Carbonari, Artur W.; Martucci, Thiago; Costa, Messias S.; Saxena, Rajendra N. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Vianden, R.; Kessler, P.; Geruschke, T.; Steffens, M., E-mail: vianden@hiskp.uni-bonn.d [Rheinische Friedrich-Wilhelms-Universitaet Bonn (HISKP- Bonn) (Germany). Helmholtz - Institut fuer Strahlen- und Kernphysik

2011-07-01

PAC technique has been used to measure the hyperfine interactions in nano-structured powder samples of semiconducting SnO{sub 2} doped with Co. The aim of this work is to compare the results of PAC measurements using two different techniques of introducing the radioactive {sup 111}In probe nuclei in the sample of SnO{sub 2} doped with Co. The perturbed gamma-gamma angular correlation (PAC) spectroscopy is used for the measurements of the magnetic hyperfine field (MHF) and the electric field gradient (EFG) at {sup 111}Cd sites in SnO{sub 2} doped with 1% and 2% Co. The measurement of EFG is used to study the defects introduced in the semiconductor material and also for the identification of different phases formed within the compound. The techniques utilized for introducing the radioactive {sup 111}In in the sample are the ion-implantation using radioactive ion beam of {sup 111}In and the chemical process in which {sup 111}InCl{sub 3} solution is added during the preparation of SnO{sub 2} doped with Co using sol gel method. The ion-implantation of {sup 111}In in SnO{sub 2} doped with Co was carried out using the University of Bonn ion-implanter with beam energy of 160 keV. The PAC measurements were carried out with four BaF{sub 2} detector gamma spectrometer in the temperature range of 10-295 K. The results show no significant difference in the values of hyperfine parameters. Both techniques show practically the same electric quadrupole interaction for the substitutional site. The results were compared with previous PAC and Moessbauer measurements of SnO{sub 2} powder samples using {sup 111}In-{sup 111}Cd probe. (author)

PACS and the digital storage of medical images

International Nuclear Information System (INIS)

Perry, J.R.; Johnston, R.E.; Pizer, S.M.; Lowendorf, D.D.; Rogers, D.C.; Thompson, B.C.; Parrish, D.M.; Brenton, B.C.; Staab, E.V.

1986-01-01

An application of computers in medicine is developing wherein large amounts of digital information in the form of images must be stored, retrieved, and displayed quickly. In radiology this application most commonly goes by the acronym PACS which stands for picture archival and communications system. Estimates of the storage requirements for radiologic images strongly suggest that we should think in terms of terabytes per year for a 150,000 procedure/year, 600 bed hospital. Transmission of patient image data files (a single X-ray image pair may be 12.6 Mbytes) arouses concern over transmission speeds, user waiting tolerances and a communications standard. An important accord is being reached between users and equipment manufacturers in radiology for a standard communications protocol, called the proposed ACR-NEMA standard. Features of PACS which require high speed computational abilities include a lexicon for report generation and image reconstruction, compression, enhancement and 3D display

Effect of powdered activated carbon dosage on sludge properties and membrane bioreactor performance in a hybrid MBR-PAC system.

Science.gov (United States)

Zhang, Shi; Zuo, Xingtao; Xiong, Juan; Ma, Cong; Hu, Bo

2017-12-22

An improved insight into the effect of powdered activated carbon (PAC) on membrane fouling is crucial to the MBR performance. Sludge key property, soluble microbial products (SMP) and transmembrane pressure (TMP) were monitored. The membrane fouling rate in the MBRs was also analyzed based on TMP profile and resistance-in-series model. PAC reduced the membrane filtration resistance and significantly decreased the fouling rate. The sludge filterability was improved by extending the filtration time by almost twofold. PAC affected the SMP release and protein/polysaccharide (carbohydrate) was in a lower ratio. Fourier transform infrared (FTIR) analysis indicated that PAC decreased the impact of organic carbon, and reduced the proteins' and polysaccharides' absorption and deposition on the membrane surface and in the pores. The degree of reversible and irreversible fouling was related to the PAC content added into the MBRs. At the optimum dosage of 2 g/L, the results signified the PAC potential as a mitigation strategy of membrane fouling.

[Domestic and family violence against women: a case-control study with victims treated in emergency rooms].

Science.gov (United States)

Garcia, Leila Posenato; Duarte, Elisabeth Carmen; Freitas, Lúcia Rolim Santana de; Silva, Gabriela Drummond Marques da

2016-01-01

This study aimed to identify factors associated with treatment of victims of domestic and family violence in emergency rooms in Brazil. This is a case-control study based on the Surveillance System for Violence and Accidents (VIVA), 2011. Women ≥ 18 years who were victims of family and domestic violence were selected as cases and compared to accident victims (controls). Adjusted odds ratios were estimated by unconditional logistic regression. 623 cases and 10,120 controls were included. Risk factors according to the adjusted analysis were younger age (18-29 years), low schooling, lack of paid work, alcohol consumption, having sought treatment in a different health service, and violence on weekends or at night or in the early morning hours. The study concludes that domestic and family violence shows alcohol consumption as a strongly associated factor. Days and hours with the highest ocurrence reveal the need to adjust emergency services to treat victims.

Pulmonary Artery Catheter (PAC Accuracy and Efficacy Compared with Flow Probe and Transcutaneous Doppler (USCOM: An Ovine Cardiac Output Validation

Directory of Open Access Journals (Sweden)

Robert A. Phillips

2012-01-01

Full Text Available Background. The pulmonary artery catheter (PAC is an accepted clinical method of measuring cardiac output (CO despite no prior validation. The ultrasonic cardiac output monitor (USCOM is a noninvasive alternative to PAC using Doppler ultrasound (CW. We compared PAC and USCOM CO measurements against a gold standard, the aortic flow probe (FP, in sheep at varying outputs. Methods. Ten conscious sheep, with implanted FPs, had measurements of CO by FP, USCOM, and PAC, at rest and during intervention with inotropes and vasopressors. Results. CO measurements by FP, PAC, and USCOM were 4.0±1.2 L/min, 4.8±1.5 L/min, and 4.0±1.4 L/min, respectively, (=280, range 1.9 L/min to 11.7 L/min. Percentage bias and precision between FP and PAC, and FP and USCOM was −17 and 47%, and 1 and 36%, respectively. PAC under-measured Dobutamine-induced CO changes by 20% (relative 66% compared with FP, while USCOM measures varied from FP by 3% (relative 10%. PAC reliably detected −30% but not +40% CO changes, as measured by receiver operating characteristic area under the curve (AUC, while USCOM reliably detected ±5% changes in CO (AUC>0.70. Conclusions. PAC demonstrated poor accuracy and sensitivity as a measure of CO. USCOM provided equivalent measurements to FP across a sixfold range of outputs, reliably detecting ±5% changes.

(PACS) data security breaches: Intentional versus non-intentional ...

African Journals Online (AJOL)

Background: The Picture Archiving and Communication System (PACS) has led to an increase in breached health records and violation of patient confidentiality. The South African constitution makes provision for human dignity and privacy, virtues which confidentiality seeks to preserve. Confidentiality thus constitutes a ...

PENURUNAN TOKSISITAS LEACHATE (AIR LINDI DARI TPAS PUTRI CEMPO MOJOSONGO SURAKARTA DENGAN PAC (POLY ALUMINUM CHLORIDE (Toxicity Reduction of Leachate from Putri Cempo Municipal Landfill (TPAS Mojosongo Surakarta with PAC (Poly Aluminium Chloride

Directory of Open Access Journals (Sweden)

Dwi Astuti

2010-03-01

Full Text Available ABSTRAK Tujuan penelitian ini adalah menetapkan persen penurunan toksisitas sesudah diperlakukan dengan PAC. Rancangan penelitian ini adalah eksperimen murni dengan pretest-posttest with control group design. Populasi dalam penelitian ini adalah air lindi yang berasal dari TPAS Putri Cempo MPAC: 25,06% (24 jam; 21,07% (48 jam; 17,49% (72 jam; dan 14,97% (96 jam. (2 Dengan perlakuan PAC: 89,44% (24 jam; 63,73% (48 jam; 49,99% (72 jam; dan 40,96% (96 jam. Sehingga persentase penurunan toksisitasnya adalah: 64,38% (24 jam, 42,66% (48 jam, 32,50% (72 jam, dan 25,99% (96 jam.    ABSTRACT The aims of the current study were to determine percentage of leachate toxicity reduction after treatment with PAC. The experimental design used was true experimental study with pretest-posttest with control group design. Population in this study was leachate from Putri Cempo Landfill (TPAS Putri Cempo Mojosongo Surakarta. The sample was 250 litres leachate obtained from the landfill outlet by quota sampling method. The results revealed the leachate toxicity based on LC50 24-96 hours were: (1 without PAC treatment: 25.06% (24 hours, 21.07% (48 hours, 17.49% (72 hours, and 14.97% (96 hours; (2 with PAC treatment: 89.44% (24 hours, 63.73% (48 hours, 49.99% (72 hours, and 40.96% (96 hours. Therefore, the toxicity reductions were: 64.38% (24 hours, 42.66% (48 hours, 32.50% (72 hours, and 25.99% (96 hours.

PacIOOS Ocean Gliders: SeaGlider 139: Mission 2

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — As a part of PacIOOS, ocean gliders provide very detailed information about the physical and chemical condition of the waters around the Hawaiian Islands....

PacIOOS Ocean Gliders: SeaGlider 139: Mission 7

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — As a part of PacIOOS, ocean gliders provide very detailed information about the physical and chemical condition of the waters around the Hawaiian Islands....

PacIOOS Ocean Gliders: SeaGlider 114: Mission 4

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — As a part of PacIOOS, ocean gliders provide very detailed information about the physical and chemical condition of the waters around the Hawaiian Islands....

PacIOOS Ocean Gliders: SeaGlider 139: Mission 3

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — As a part of PacIOOS, ocean gliders provide very detailed information about the physical and chemical condition of the waters around the Hawaiian Islands....

PacIOOS Ocean Gliders: SeaGlider 523: Mission 1

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — As a part of PacIOOS, ocean gliders provide very detailed information about the physical and chemical condition of the waters around the Hawaiian Islands....

PacIOOS Ocean Gliders: SeaGlider 139: Mission 1

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — As a part of PacIOOS, ocean gliders provide very detailed information about the physical and chemical condition of the waters around the Hawaiian Islands....

PacIOOS Ocean Gliders: SeaGlider 523: Mission 4

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — As a part of PacIOOS, ocean gliders provide very detailed information about the physical and chemical condition of the waters around the Hawaiian Islands....

PacIOOS Ocean Gliders: SeaGlider 139: Mission 6

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — As a part of PacIOOS, ocean gliders provide very detailed information about the physical and chemical condition of the waters around the Hawaiian Islands....

PacIOOS Ocean Gliders: SeaGlider 139: Mission 8

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — As a part of PacIOOS, ocean gliders provide very detailed information about the physical and chemical condition of the waters around the Hawaiian Islands....

PacIOOS Ocean Gliders: SeaGlider 139: Mission 9

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — As a part of PacIOOS, ocean gliders provide very detailed information about the physical and chemical condition of the waters around the Hawaiian Islands....

PacIOOS Ocean Gliders: SeaGlider 523: Mission 3

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — As a part of PacIOOS, ocean gliders provide very detailed information about the physical and chemical condition of the waters around the Hawaiian Islands....

PacIOOS Ocean Gliders: SeaGlider 114: Mission 3

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — As a part of PacIOOS, ocean gliders provide very detailed information about the physical and chemical condition of the waters around the Hawaiian Islands....

Programa de Aceleração do Crescimento (PAC: um estudo descritivo sobre os desperdícios ativos e passivos = Growth Acceleration Program (PAC: a descriptive study of active and passive waste

Directory of Open Access Journals (Sweden)

Daniele Silva Rodrigues

2018-03-01

Full Text Available Em 2007, o governo brasileiro implementou o Programa de Aceleração do Crescimento (PAC, com o objetivo de incentivar o crescimento econômico do Brasil e investimentos nas áreas de saneamento, habitação, transporte, energia e recursos hídricos. Tal programa, em sua primeira etapa (2007-2010, contribuiu de modo determinante para o aumento da oferta de empregos e da geração de renda no Brasil. No entanto, de acordo com Instituto Trata Brasil, 86% das obras de esgotamento sanitário provenientes do PAC estavam paralisadas, atrasadas ou não iniciadas até dezembro de 2012. Ainda, em 2008 e 2009, por meio da edição especial do Programa de Fiscalização por Sorteios Públicos, a Controladoria Geral da União (CGU constatou diversas irregularidades em 110 municípios brasileiros contemplados com recursos do PAC. Nesse contexto, o objetivo do estudo foi analisar as irregularidades constatadas pela CGU, na aplicação dos recursos federais destinados às áreas de saneamento e habitação dos municípios brasileiros por meio da primeira etapa do PAC. A principal fonte de dados da pesquisa foram os relatórios dos auditores da CGU advindos do PAC e dados do Censo 2000, disponibilizados pelo IBGE. Técnicas de análise de conteúdo foram utilizadas para classificar as irregularidades constatadas pela CGU em desperdício ativo (corrupção e passivo (má gestão e estatísticas descritivas para analisar o perfil das irregularidades e dos municípios auditados. Observou-se que os desperdícios mais frequentes nos municípios auditados são os classificados como Superfaturamento e Licitação Fraudada (classificados como desperdício ativo e Má Administração e Licitação Irregular, na modalidade de desperdício passivo. In 2007, the Brazilian government implemented the Growth Acceleration of Program (PAC, with the objective of encouraging Brazil's economic growth, with investments in the areas of sanitation, housing, transportation, energy and

Altered circadian food anticipatory activity rhythms in PACAP receptor 1 (PAC1) deficient mice

DEFF Research Database (Denmark)

Hannibal, Jens; Georg, Birgitte; Fahrenkrug, Jan

2016-01-01

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...

Is PACS feasible for a major department of radiology

International Nuclear Information System (INIS)

Bautz, W.; Kolbe, J.

1986-01-01

Picture Archiving and Communication Systems (PACS) are getting more and more important for Departments of Radiology with the increasing spread of digital imaging methods. To determine the demands made on such systems, we calculated the digital image data volume for all examinations carried out in 1983 at the Department of Medical Radiology of the University of Tuebingen. 20.37% of all examinations were performed with digitalised equipment. Plain radiography takes the lion's share among the total number of image data. If digitalisation is based on a spatial resolution of 8 Lp/mm, the share is 98.4% of the total image data volume of 7123 GByte. This figure is far in excess of the estimates stated in literature. The possibilities of image data reduction and feasibility of a major PACS are discussed. (orig.) [de

Effect of Poly Aluminium Chloride (PAC) on some blood constituents of Nile Tilapia (Oreochromis niloticus)

International Nuclear Information System (INIS)

Adam, H. M.; Agab, H.

2006-01-01

Poly aluminium chloride (PAC) is an urban drinking water purification substance that was introduced recently in Sudan and used to substitute polymer poly diallyl dimethyl aluminium chloride (DADMAC) and aluminium sulphate in water purification treatments. This study was conducted to determine its effects on fish health, which is is considered a biological indicator and an essential component of fresh water ecosystem. In this experiment, PAC was used in three different concentrations (0.1, 0.2 and 0.3 ml/1) in experimental tanks to achieve the desirable doses for the study. The tanks were populated by Nile Tilapia fingerlings (Oreochromis niloticus) with an average weight ranging between 70 and 100 grams. Exposure of this fish to PAC resulted in an immediate signification reduction (P<0.01) in haemoglobin concentration, erythrocytes count, packed cell volume, mean corpuscular volume and mean corpuscular haemoglobin concentration of experimental fingerlings blood. The degree of reduction in these parameters was directly proportional to the concentration of PAC used. (Author)

In vivo biological evaluation of {sup 131}I radiolabeled-paclitaxel glucuronide ({sup 131}I-PAC-G)

Energy Technology Data Exchange (ETDEWEB)

Aslan, O.; Biber Muftuler, F.Z.; Yurt Kilcar, A.; Ichedef, C.; Unak, P. [Ege Univ., Izmir (Turkey). Dept. of Nuclear Applications

2012-07-01

Paclitaxel (PAC) is a natural occurring diterpene alkoloid originally isolated from the bark of Taxus Brevifolia. It is one of the most important antitumor agents for clinical treatment of ovarian, breast non-small cell lung and prostate cancers. It is known that these types of cancer cells have high {beta}-glucuronidase enzyme which can catalyze the hydrolysis of glucuronides. This is why the synthesis compounds which undergo glucuronidation come into question in the imaging and therapy of these cancer cells. The aim of current study is conjugation of glucuronic acid (G) to the starting substance PAC, labeling with {sup 131}I and to perform its in vivo biological evaluation. Glucuronic acid derived paclitaxel compound [paclitaxel-glucuronide (PAC-G)] was labeled with {sup 131}I using iodogen method. According to thin layer radio chromatography (TLRC) method, the radiochemical yield of {sup 131}I-PAC-G was 84.30 {+-} 7.40% (n=10). The biodistribution of {sup 131}I-PAC-G in healthy female and male Wistar Albino rats has been investigated. Imaging studies on male Balb-C mice were performed by using the Kodak FX PRO in vivo Imaging System. The range of the breast/blood, breast/muscle; ovary/blood, ovary/muscle ratios is approximately between 1.29 and 11.34 in 240 min, and between 0.71 and 8.24 in 240 min for female rats. The prostate/blood and prostate/muscle ratio is between 1.94 and 6.95 in 30 min for male rats. All these experimental studies indicate that {sup 131}I-PAC-G may potentially be used in breast, ovary and prostate tissues as an imaging agent. Also it is thought that {sup 131}I-PAC-G bears a therapy potential because of the {sup 131}I radionuclide and can be improved with further investigations. (orig.)

FUJI - a comparative irradiation test with pellet, sphere-pac, and vipac fuel

International Nuclear Information System (INIS)

Hellwig, C.; Bakker, K.; Ozawa, T.; Nakamura, M.; Kihara, Y.

2004-01-01

Particle fuels such as sphere-pac and vipac fuels have been considered as promising fuel systems for fast reactors, due to their inherent potential in remote operation, cost reduction and incineration of minor actinides or low-decontaminated plutonium. The FUJI test addresses the questions of fabrication of MOX particle fuels with high Pu content (20%) and its irradiation behaviour during the start-up phase. Four kinds of fuel, i.e. MOX sphere-pac, MOX vipac, MOX pellet and Np-MOX sphere-pac fuel, have been and will be simultaneously irradiated under identical conditions in the High Flux Reactor in Petten. First results show that the particle fuel undergoes a dramatic structure change already at the very beginning of the irradiation when the maximum power is reached. The structural changes, i.e. the formation of a central void and the densification of fuel, decrease the fuel central temperature. Thus the fast and strong restructuring helps to prevent central fuel melting at high power levels. (authors)

Application of Nano PAC on Mitigating Membrane Fouling by Surface Properties Optimization

Directory of Open Access Journals (Sweden)

Mi Hairong

2016-01-01

Full Text Available Membrane material has been widely accepted owing to the ability in water treatment, but the membrane fouling problem in using process is seriously restricted the promotion of membrane technology. So in this research nano PAC flocculant is added into the raw water to reach the goals of strengthening treatment efficiency and mitigating membrane fouling. According to the TMP change, it results that the PAC dosage of 45mg/L can realize the purpose to mitigate membrane fouling best. Compared with MBR, the MCBR is 16 days tardiness at the change of TMP, 1/3 gel layer filtration resistance less and 3.5% C element content fewer. The sum of C, O and N elements content, in addition, in the gel layer pollutants is more than 95%. That means membrane pollution is mainly caused by organic matter and nano PAC has the effect on surface properties optimization and membrane fouling mitigating.

Role Allocations and Communications of Operators during Emergency Operation in Advanced Main Control Rooms

International Nuclear Information System (INIS)

Lee, June Seung

2009-01-01

The advanced main control room (MCR) in GEN III + nuclear power plants has been designed by adapting modern digital I and C techniques and an advanced man machine interface system (MMIS). Large Display Panels (LDPs) and computer based workstations are installed in the MCR. A Computerized Procedure System (CPS) and Computerized Operation Support System (COSS) with high degrees of automation are supplied to operators. Therefore, it is necessary to set up new operation concepts in advanced MCRs that are different from those applied in conventional MCRs regarding role allocations and communications of operators. The following presents a discussion of the main differences between advanced MCRs and conventional MCRs from the viewpoint of role allocations and communications. Efficient models are then proposed on the basis of a task analysis on a series of emergency operation steps

PacIOOS Nearshore Sensor 06 (NS06): Pohnpei, Micronesia

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

PacIOOS Nearshore Sensor 08 (NS08): Koror, Palau

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

PacIOOS Nearshore Sensor 11 (NS11): Saipan, CNMI

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

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

Science.gov (United States)

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

1993-10-01

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

ATTENTION TO THE EMERGENCY ROOM WITH EMPHASIS ON PRE-HOSPITAL CARE: INTEGRATIVE REVIEW

Directory of Open Access Journals (Sweden)

B. S. Santos

2017-08-01

Full Text Available The study aims to identify the factors, which influence positively and negatively the implementation of public policies geared to the needs in scope of mobile, found in the publications of brazilian researchers since the implementation of the National Policy of Attention to the Emergency room in Brazil. This is a study of Integrative Literature Review. Composing the basis of methodology, have been used official documents to guide the findings that comprised the conceptual bases of the study and to guide the Integrative Review were used publications that report on the issue in question respecting all steps of the protocol review. The results show the changes in the organizational structure of the Service Mobile Emergency, given the regionalization as something positive for the growth of this service modality and discuss prematurely early articulation between the sectors that make up the public health system in Brazil. In conclusion, the policies of attention to the urgencies, in particular within mobile, have favored beneficially all of the users who require this type of care, in the meantime, make the necessary reflections about this theme in the attempt of a better understanding of the regionalization process and coordination among the municipalities that will offer the mobile care so as to ensure continuity of care through the mechanisms of reference and counter-reference

A model for the Acceptance of emerging technology “Pacs” in Iran’s hospitals

Directory of Open Access Journals (Sweden)

Fatemeh Saghafi

2017-03-01

Full Text Available Development of Pacs is new opportunity for changing in the health system. Pacs including emerging technologies that provide accessibility to medical images via the network. Patient health records will be available through detailed video and film in everywhere and any time and with minimal cost. There is no trustee Pacs now in Iran and officials are looking to set up a center for the development Pacs. Under these conditions, identifying factors affecting the adoption of this technology will be very necessary and useful. This study is a correlation –descriptive research that was conducted in 1393. In this research TAM model is used for technology adoption. Variables affecting the technology extracted from the literature and these variables have been prioritized by the Delphi method and expert’s opinion. The model is analyzed by the structural equation method. Data’s was collected by a questionnaire including 16 items of the questionnaire that in this area was mined and were localized for Pacs technology. The target population was 130 of professionals. results of this study at medical centers using of Pacs technology confirmed, the effect of perceived financial costs on behavioral intention of Pacs (t-value = 12/31, the effect of compatibility on perceived usefulness by users (t-value = 8/74, the effect of image on perceived usefulness by users (t-value = 5/69, the effect of the image on the perceived ease of use (t-value = 12/74. According to the findings of this study, the factors affecting the acceptance Pacs were identified from the perspective of users' behavior. The results can be useful in planning of health system for the fair use of health cares and development and equipping of health centers.

Toshiba General Hospital PACS for routine in- and outpatient clinics

Science.gov (United States)

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

1996-05-01

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

Estado del Medio Ambiente Marino y Costero del Pacífico Sudeste.

OpenAIRE

Andrade V., Héctor; Guitiérres S., Sixto; Andrade C., Héctor

2014-01-01

El presente documento contiene los antecedentes sistematizados sobre el Estado del Medio Ambiente Marino Costero del Pacífico Sudeste en base a los informes nacionales de consultoría elaborados entre 2011 y 2012 en Panamá, Colombia, Ecuador, Perú y Chile y cuya finalidad fue establecer un estado actualizado del medio marino a nivel regional, en el marco del Programa CONPACSE III de la Comisión Permanente de Pacífico Sur. Los principales contaminantes presentes en las aguas marinas costeras de...

Manual sobre el desarrollo integral de la Cuenca Pacífica Colombiana

OpenAIRE

Cardona, Jose Gerardo

2010-01-01

En el presente documento nos ocupamos en trazar las pautas que consideramos deben seguirse para los trabajos de investigación científica y tecnológica, indispensables para los programas de desarrollo agroforestal y pecuario de la Cuenca del Pacífico Colombiano; advirtiendo que nuestras sugerencias no tienen carácter dogmático, sencillamente constituyen, a nuestro juicio, complemento al diagnóstico y propuestas consignados en el Manual Nº 1 El Litoral Pacífico Colombiano, referentes a los sect...

Conhecimento sobre anticoagulantes orais e seu manejo por médicos de pronto atendimento Emergency-room doctors' knowledge about oral anticoagulants and its management

Directory of Open Access Journals (Sweden)

Larissa Periotto Borlina

2010-06-01

Full Text Available Contexto: Desde sua descoberta, os anticoagulantes orais (AO têm sido cada vez mais estudados e aplicados em diferentes doenças. No entanto, eles apresentam reações medicamentosas com fármacos que trazem riscos ao paciente. Objetivo: Identificar o nível de conhecimento dos médicos plantonistas de pronto atendimento sobre os AO e suas interações, medicamentosas ou não, e verificar se o médico frentista está preparado para integrar o conteúdo teórico com a rotina de urgências. Método: Aplicou-se um questionário a 100 médicos atuantes em pronto atendimentos de dois hospitais públicos e três privados em Curitiba. Visou-se saber se o médico frentista questiona ao paciente sobre o uso de AO. Também, avaliou-se o conhecimento do profissional e seu interesse em saber mais sobre: AO (quais deles conhecia; exames para controle; sinergismo com AO; e manejo das complicações. Resultados: Dos 100 entrevistados, 60% declararam perguntar ao paciente sobre o uso de AO, 81% tinham conhecimento insuficiente a respeito do sinergismo de algumas substâncias apresentadas e os AO, 15% desconheciam qual exame é utilizado para acompanhamento dos pacientes anticoagulados, 50,7% não sabiam os nomes comercias dos AO, 4% desconheciam seu antídoto, e 92% manifestaram interesse em melhorar seus conhecimentos sobre os AO. Conclusão: É BAIXo o número de médicos que atende em pronto atendimentos que conhece sobre os AO e que sabe manejar pacientes anticoagulados. É alta a porcentagem de médicos que não perguntam aos pacientes sobre o uso de AO e que desconhecem princípios do sinergismo medicamentoso, sendo que a maioria se interessou em melhorar seus conhecimentos sobre os anticoagulantes.Background: Since its discovery, oral anticoagulants (OA have been increasingly studied and used to treat different diseases. However, OA may cause adverse drug interactions that bring risks for patients. Objective: To identify the emergency room doctors

Guidelines for control room systems design. Working material. Report

International Nuclear Information System (INIS)

1993-01-01

This report contains comprehensive technical and methodological information and recommendations for the benefit of Member States for advice and assistance in ''NPP control room systems'' design backfitting existing nuclear power plants and design for future stations. The term ''Control Room Systems'' refers to the entire human/machine interface for the nuclear stations - including the main control room, back-ups control room and the emergency control rooms, local panels, technical support centres, operating staff, operating procedures, operating training programs, communications, etc. Refs, figs and tabs

Fitting PAC spectra with a hybrid algorithm

Energy Technology Data Exchange (ETDEWEB)

Alves, M. A., E-mail: mauro@sepn.org [Instituto de Aeronautica e Espaco (Brazil); Carbonari, A. W., E-mail: carbonar@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (Brazil)

2008-01-15

A hybrid algorithm (HA) that blends features of genetic algorithms (GA) and simulated annealing (SA) was implemented for simultaneous fits of perturbed angular correlation (PAC) spectra. The main characteristic of the HA is the incorporation of a selection criterion based on SA into the basic structure of GA. The results obtained with the HA compare favorably with fits performed with conventional methods.

Integration of implant planning workflows into the PACS infrastructure

Science.gov (United States)

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.

EST-PAC a web package for EST annotation and protein sequence prediction

Directory of Open Access Journals (Sweden)

Strahm Yvan

2006-10-01

Full Text Available Abstract 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.

Incremental picture archiving and communication system (PACS) - an appraisal

International Nuclear Information System (INIS)

Nagle, K.

2000-01-01

Digital storage phosphor radiography is slowly being introduced in Australia with more sites making the conversion from film/screen to computed radiography or a fully integrated Picture Archiving and Communication System (PACS). St Vincent's Hospital, Melbourne (SVHM) introduced partial PACS for general radiography in June 1996. This involved networking two Fuji CR Image Plate Readers and an existing Kodak KESPR400 Reader with viewing stations strategically placed in Medical Imaging, Casualty and the Intensive and Coronary Care units. No long-term storage device or archive facility was purchased. This installation coincided with the relocation of the Medical Imaging Department (MID) to a fully equipped new site as well as the introduction of the Kestral Radiology Management System. The transition has involved significant changes to the department's design, workflow and the radiographers' work practices. Copyright (1999) Australian Institute of Radiography

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

Science.gov (United States)

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.

Deletion of pH Regulator pac-3 Affects Cellulase and Xylanase Activity during Sugarcane Bagasse Degradation by Neurospora crassa.

Directory of Open Access Journals (Sweden)

Amanda Cristina Campos Antoniêto

Full Text Available Microorganisms play a vital role in bioethanol production whose usage as fuel energy is increasing worldwide. The filamentous fungus Neurospora crassa synthesize and secrete the major enzymes involved in plant cell wall deconstruction. The production of cellulases and hemicellulases is known to be affected by the environmental pH; however, the regulatory mechanisms of this process are still poorly understood. In this study, we investigated the role of the pH regulator PAC-3 in N. crassa during their growth on sugarcane bagasse at different pH conditions. Our data indicate that secretion of cellulolytic enzymes is reduced in the mutant Δpac-3 at alkaline pH, whereas xylanases are positively regulated by PAC-3 in acidic (pH 5.0, neutral (pH 7.0, and alkaline (pH 10.0 medium. Gene expression profiles, evaluated by real-time qPCR, revealed that genes encoding cellulases and hemicellulases are also subject to PAC-3 control. Moreover, deletion of pac-3 affects the expression of transcription factor-encoding genes. Together, the results suggest that the regulation of holocellulase genes by PAC-3 can occur as directly as in indirect manner. Our study helps improve the understanding of holocellulolytic performance in response to PAC-3 and should thereby contribute to the better use of N. crassa in the biotechnology industry.

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

Science.gov (United States)

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 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.

Canadian ceramic breeder sphere-pac technology: Capability and recent results

International Nuclear Information System (INIS)

Sullivan, J.D.; Brayman, C.L.; Verrall, R.A.; Miller, J.M.; Gierszewski, P.J.; Londry, F.; Slavin, A.

1991-01-01

Sphere-pac ceramic breeders have been under development in Canada for several years. The goal is to fabricate and characterize these materials for use in engineering test reactors and subsequent fusion power reactors. Practical application of sphere-pac beds requires close consideration of both properties and fabrication. The present emphasis of the program is on 1-3 mm diameter Li 2 ZrO 3 spheres, with the future development of binary beds planned. Litre quantities have been produced by methods that are applicable to high production rates. These spheres are being tested for measurement of bulk properties (e.g., thermal conductivity, gas permeability, packing density, tritium release, specific heat) and long-term irradiation exposure. This paper summarizes the status of the work. (orig.)

Emergency Medical Services - Multiple Languages

Science.gov (United States)

... Well-Being 11 - Emergency Room - Amarɨñña / አማርኛ (Amharic) MP3 Siloam Family Health Center Arabic (العربية) Expand Section ... Well-Being 11 - Emergency Room - myanma bhasa (Burmese) MP3 Siloam Family Health Center Dari (دری) Expand Section ...

Increase in productivity by implementation of RIS and PACS throughout a clinic: a case study

International Nuclear Information System (INIS)

Nissen-Meyer, S.; Holzknecht, N.; Wieser, B.; Francke, M.; Kuettner, B.; Weber, J.; Reiser, M.; Adelhard, K.; Villain, S.

2002-01-01

Problem. How are improvements in productivity in connection with RIS/PACS to be defined? What do they cost? To limit the problem to the relevant topics, we first describe the objectives of a radiology department and the identified bottlenecks in the workflow. How to define and assess the improvements is discussed.Methods. The case in question for this study is the RIS/PACS project at the ''Klinikum der Universitaet Muenchen, Campus Grosshadern''. The goals of the project and its present status are reviewed. The project is not yet completed, so this is a ''midterm'' report.Results and discussion. We describe the status of the achieved and not yet achieved goals and of the eliminated bottlenecks. On the plus side, for example, nearly 100% of all digitally generated images (except mammogramms) are digitally archived. They are accessible to the same percentage in radiology via PACS and in the hospital via the webbased intranet image distribution system when needed. In some radiology areas, such as multislice CT, already the reporting can no longer be performed without softcopy image interpretation. However, the full elimination of hardcopy images is still not reality, since the distribution to DICOM viewers for selected requesters with demands for almost reporting quality, high cost image displays is still in the testphase. To reduce film costs, images are being printed on a high resolution paper printer in addition to the intranet distribution during this transition period. On the negative side, due to a lack of job positions in the transcription rooms, about 40% of the reports are still being handwritten by radiologists. Furthermore, the dictated and transcribed reports are usually still not available early enough in the RIS and thereby in the intranet report distribution of the hospital. Here only a speech recognition system can remedy the situation. As soon as this problem is solved and the image distribution to the DICOM viewers works routinely, the reports and

Innovate pin design for Sphere-pac fuel in sodium cooled fast reactors

International Nuclear Information System (INIS)

Pouchon, Manuel A.; Niceno, Bojan; Krepel, Jiri

2011-01-01

The paper discusses a new fuel element type, which combines a particle fuel concept, the Sphere-pac, with a new pin design which features internal cooling. Particle fuels are auspicious when considering a closed fuel cycle, where minor actinide containing fuels must be fabricated. The principle advantage lies in their production simplicity with much less maintenance intensive mechanical devices. Furthermore the Sphere-pac is usually produced by a wet and therefore powder-less route. Therefore the implementation in a remotely controlled and heavily shielded environment becomes easier to realize. Besides the advantages in the production process, the Sphere-pac bears one important disadvantage: the lower thermal conductivity of the particle arrangement, and the therefore higher peak temperatures in the fuel. Consequently a new fuel design is suggested in this paper. It offers an internal cooling channel and therefore smaller maximal fuel distances to the coolant. As the concept is new, the most important aspects are studied; these are the neutronics, the temperature profile in the fuel plus thermal-hydraulics aspects. (author)

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

Science.gov (United States)

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.

The conference hybrid control room

International Nuclear Information System (INIS)

Gieci, A.; Caucik, J.; Macko, J.

2008-01-01

An original concept of a hybrid control room was developed for the Mochovce-3 and Mochovce-4 reactor units which are under construction. The basic idea underlying the concept is that the control room should be a main working place for the operators (reactor operator and turbine operator) and for the shift supervisor, designed as a comprehensive unit desk shaped so that all members of the control room crew are in a face-to-face contact constantly. The main desk consists of three clearly identified areas serving the operators and the unit supervisor as their main working places. A soft control system is installed at the main working places. A separate safety-related working place, designed as a panel with classical instrumentations at the conference hybrid control room, is provided in case of abnormal conditions or emergency situation. Principles of ergonomics and cognitive engineering were taken into account when designing the new conference hybrid control room for the Mochovce-3 and -4 reactor units. The sizes, propositions, shapes and disposition of the equipment at the control room have been created and verified by using virtual reality tools. (orig.)

Utilization of the emergency room: impact of geographic distance

Directory of Open Access Journals (Sweden)

Jae Eun Lee

2007-05-01

Full Text Available The aim of this study was to estimate the distance Mississippi patients must travel to access hospital-based emergency rooms (ERs and to determine whether an association exists between geographic distance and ER utilization. To that end, great circle distances between Census Block Group Centroid Points and 89 hospitals with emergency departments were calculated for the State of Mississippi. Data on the socio-demographic characteristics of each block group came from the 2000 US Census data. Logistic regression analyses were conducted to test if there was any association between ER utilization and travel distance. Compared to the national benchmark of 35.7%, more than one in two (56.7%, or 1,612,762 Mississippians visited ERs in 2003 with an estimated 6.1 miles per person annual travel for this purpose. The majority of the target population (54.9% was found to live within 5 miles of hospitals with ERs. Logistic analyses revealed that block groups associated with less miles traveled to hospitals with ERs had a higher proportion of African Americans, impoverished people, female householders, people with more than 12 years education, people older than 65 years, people with high median house values, and people without employment. Twenty-nine of the 89 hospitals (33% providing ER care in Mississippi were found to be in areas with above-average ER utilization rates. These hospitals served a smaller geographical area (28% of the total but had a greater proportion of visitors (57% and served a higher percentage (37% of the state population. People in areas served by the less utilized ERs traveled more miles to be cared for (7.1 miles vs 5.4 miles; p<0.0001. Logistic regression analysis revealed that shorter distances were associated with increased use of the ERs, even after controlling for socio-demographic factors. The conclusion is that Mississippi ERs are typically located in block groups with higher percentages of disadvantaged residents and that

Methodology for the identification of the factors that can influence the performance of operators of nuclear power plants control room under emergency situations

International Nuclear Information System (INIS)

Paiva, Bernardo Spitz; Santos, Isaac J.A. Luquetti

2009-01-01

In order to minimize the human errors of the operators in a nuclear power plan control room, during emergency situations, it has to be considered the factors which affect the human performance. Work situations adequately projected, compatible with the necessities, capacities and human limitations, taking into consideration the factors which affect the operator performance . This paper aims to develop a methodology for identification of the factors affecting the operator performance under emergency situation, using the aspects defined by the human reliability analysis focusing the judgment done by specialists

Poetry and cultural identity in F. T. Pacéré's writing: from identity ...

African Journals Online (AJOL)

My concern is the socio-cultural characteristics of F. T. Pacéré's poetry and their aesthetic and semantic structuring role. Pacéré's poetry is not just about identity affirmation; it is also about being open to the world, namely other people and other cultures. Through this, it seeks to achieve universal humanism. I conclude my ...

The BWR [Boiling Water Reactor] Emergency Operating Procedures Tracking System (EOPTS): Evaluation by control-room operating crews

International Nuclear Information System (INIS)

Spurgin, A.J.; Orvis, D.D.; Spurgin, J.P.; Luna, C.J.

1990-05-01

This report presents the results of a project sponsored by the Electric Power Research Institute (EPRI) and Taiwan Power Company (TPC) and conducted by APG and TPC to perform evaluation of the Emergency Operating Procedures Tracking System (EOPTS). The EOPTS is an expert system employing artificial intelligence techniques developed by EPRI for Boiling Water Reactor (BWR) plants based on emergency operating procedures (EOPs). EOPTS is a computerized decision aid used to assist plant operators in efficient and reliable use of EOPs. The main objective of this project was to evaluate the EOPTS and determine how an operator aid of this type could noticeably improve the response time and the reliability of control room crews to multi-failure scenarios. A secondary objective was to collect data on how crew performance was affected. Experiments results indicate that the EOPTS measurably improves crew performance over crews using the EOP flow charts. Time-comparison measurements indicate that crews using the EOPTS perform required actions more quickly than do those using the flowcharts. The results indicate that crews using the EOPTS are not only faster and more consistent in their actions but make fewer errors. In addition, they have a higher likelihood of recovering from the errors that they do make. Use of the EOPTS in the control room should result in faster termination and mitigation of accidents and reduced risk of power plant operations. Recommendations are made towards possible applications of the EOPTS to operator training and evaluation, and for the applicability of the evaluation methodology developed for this project to the evaluation of similar operator aides. 17 refs., 14 figs., 14 tabs

Chronic exposure of the oligochaete Lumbriculus variegatus to Polycyclic Aromatic Compounds (PACs): Bioavailability and effects on reproduction

NARCIS (Netherlands)

León Paumen, M.; Stol, P.; ter Laak, T.L.; Kraak, M.H.S.; van Gestel, C.A.M.; Admiraal, W.

2008-01-01

This study aimed to monitor PAC availability to the oligochaete Lumbriculus variegatus during 28 days of exposure to spiked sediments, in order to obtain reliable chronic effect concentrations for reproduction. Sediment toxicity tests were performed using three pairs of PAC isomers: two homocyclic

Chronic exposure of the oligochaete Lumbriculus variegatus to polycyclic aromatic compounds (PACs): bioavailability and effects on reproduction.

NARCIS (Netherlands)

Leon Paumen, M.; Stol, P.; ter Laak, T.L.; Kraak, M.H.S.; van Gestel, C.A.M.; Admiraal, W.

2008-01-01

This study aimed to monitor PAC availability to the oligochaete Lumbriculus variegatus during 28 days of exposure to spiked sediments, in order to obtain reliable chronic effect concentrations for reproduction. Sediment toxicity tests were performed using three pairs of PAC isomers: two homocyclic

Confirmatory factor analysis of the Patient Assessment of Constipation-Symptoms (PAC-SYM) among patients with chronic constipation

DEFF Research Database (Denmark)

Neri, Luca; Conway, Paul Maurice; Basilisco, Guido

2015-01-01

the psychometric properties of PAC-SYM in patients with chronic constipation. METHODS: We enrolled 2,203 outpatients with chronic constipation in two waves. We used wave I sample to test the psychometric properties of the PAC-SYM and wave II sample to cross-validate its factor structure, to assess criterion...... validity, responsiveness to clinical change, and its minimal clinically important difference. RESULTS: Only a minority of patients reported any rectal tearing (38 %). Deletion of such item leads to a 11-item version (M:PAC-SYM). The remaining items in the rectal domain were moderately correlated.......28-0.45), discrimination across Rome III criteria for functional constipation and abdominal pain, and responsiveness to clinical change (β = -0.49; ω (2) = 0.25). M:PAC-SYM minimal clinically important difference was 0.24. CONCLUSION: Our analysis shows that the rectal domain may not represent a relevant cluster...

Factores predictores de uso problemático de alcohol en personas atendidas en una sala de emergencia Predictive factors of alcohol use problems among patients visiting an emergency room

Directory of Open Access Journals (Sweden)

Fabián Fiestas

2011-03-01

Full Text Available Objetivos. Valorar el efecto predictivo de características claves de pacientes atendidos en salas de emergencia para detectar casos de uso problemático de alcohol. Materiales y Métodos. La muestra de estudio estuvo constituida por 371 personas atendidas en el lapso de siete días completos de enero de 2005 en el servicio de emergencia de un hospital público de Lima, Perú. Se aplicó un cuestionario demográfico, el SIDUC/CICAD para uso reciente de sustancias psicoactivas en salas de emergencias (i.e., uso dentro de las seis horas previas a la atención y el AUDIT para uso problemático de alcohol en el último año. El análisis de regresión logística simple y multivariada permitió valorar el efecto predictor de la edad, sexo, especialidad del servicio de atención, presencia de daño físico y el uso reciente de alcohol para detectar casos problemáticos de su uso. Resultados. El odds de tener uso problemático de alcohol en los varones es 26 veces el odds de tener dicho problema entre las mujeres (pObjectives. To assess the predictive effect of key individual-level characteristics to identify cases of alcohol use problems among patients visiting an emergency room. Materials and methods. The study sample was composed of 371 people attending an emergency room in a public hospital in Lima, Peru, during a period of seven complete days in January, 2005. For data gathering, we used a questionnaire for demographic information, the SIDUC/CICAD for recent use (i.e., in the last 6 hours of psychoactive substances before arriving to the emergency room, and the AUDIT, to identify alcohol use problems in the last year. Univariate and multivariate logistic regression models were used to estimate the predictive effect of age, sex, area of attention in the emergency room, presence of physical injuries and recent use of alcohol. Results. The odds of being a case of alcohol use problem for males is 26 times the odds of having that problem for females (p

Feelings of nurses in the reception and risk classification evaluation in the emergency room

Directory of Open Access Journals (Sweden)

Andressa Midori Sakai

2016-05-01

Full Text Available Objective: to reveal feelings of nurses who host with risk assessment and classification in an emergency room of a pubic hospital. Methods: it is a qualitative research approach with 12 nurses interviewed. The data were analyzed, categorized and discussed according to the theoretical framework of work psychodynamics. Results: the nurses expressed feelings of satisfaction in meeting the user needs assistance. They reported feeling as fear, stress and fatigue due to the sharp pace of work, gaps in health care network and situations of violence. They highlighted coping strategies to reduce the burden of this assignment, how to share the completion of the screening with the nursing staff. Conclusion: the host with risk assessment and classification favors the autonomy of nurses and provide greater accountability to this professional users, but the limitations of available resources to solve the complaint of patients generate physical and psychological burden to this worker.

Feelings of nurses in the reception and risk classification evaluation in the emergency room

Directory of Open Access Journals (Sweden)

Andressa Midori Sakai

2016-01-01

Full Text Available Objective: to reveal feelings of nurses who host with risk assessment and classification in an emergency room of a pubic hospital. Methods: it is a qualitative research approach with 12 nurses interviewed. The data were analyzed, categorized and discussed according to the theoretical framework of work psychodynamics. Results: the nurses expressed feelings of satisfaction in meeting the user needs assistance. They reported feeling as fear, stress and fatigue due to the sharp pace of work, gaps in health care network and situations of violence. They highlighted coping strategies to reduce the burden of this assignment, how to share the completion of the screening with the nursing staff. Conclusion: the host with risk assessment and classification favors the autonomy of nurses and provide greater accountability to this professional users, but the limitations of available resources to solve the complaint of patients generate physical and psychological burden to this worker.

What Happens in the Emergency Room?

Science.gov (United States)

... was 4 years old, he loved to play Batman. He'd put on his Batman pajamas and pretend to fly all over the ... swollen) and he had trouble moving his arm. "Batman," she said, "We're going to the emergency ...

PacIOOS Nearshore Sensor 13 (NS13): Kahului, Maui, Hawaii

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

PacIOOS Nearshore Sensor 16 (NS16): Wailupe, Oahu, Hawaii

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

PacIOOS Nearshore Sensor 09 (NS09): Cetti Bay, Guam

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

PacIOOS Nearshore Sensor 15 (NS15): Pago Bay, Guam

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

PacIOOS Nearshore Sensor 07 (NS07): Majuro, Marshall Islands

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

Specification and evaluation of a regional PACS in the SaxTeleMed project

Science.gov (United States)

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.

KIS-RIS-PACS integration: the Marburg approach

International Nuclear Information System (INIS)

Klose, K.J.; Schaefer, C.; Kail, S.; Roethke, M.; Zhang, L.

2005-01-01

When describing the development of data processing at the Department of Radiology at the Philipps University of Marburg, three phases can be identified covering the areas of patient care, education, and research as well as administrative and organizational aspects. The first phase (1987-1995) was centered on radiology and characterized by the early implementation of the radiology information system (RIS) and installation of a picture archiving and communication system (PACS). The experiences gained during this phase led to intensive discussion on application-oriented information processing. The second phase (1996-2000) describes the changes in the general framework brought by Internet technology and international standards. The course was set for the future of data processing in the hospital setting. The phase ended with implementation of a clinical workplace system (KAS) as the basis for a comprehensive electronic patient record and the switch in radiology to an integrated RIS solution. The third phase (2001-2006) addressed further implementation and development of clinical data management in which both regular documentation of patient data and information processing not related to patients are optimized by making use of Intranet/Internet technology. It includes the hospital wide implementation of PACS and the forthcoming phase of information processing increasingly shaped by workflow and decision support. (orig.) [de

Patriot PAC-2 Development and Deployment in The Gulf War

National Research Council Canada - National Science Library

Sherman, J

2003-01-01

.... Patriot PAC-2 is a case study in effective project management that resulted in the extraordinary acceleration in the final stages of development production and deployment in time to play a historic role in the Gulf War...

Workshop for Open Source Universal Picture Archiving and Communication Systems (PACS)

National Research Council Canada - National Science Library

Tohme, Walid G

2006-01-01

.... The "Open Source Universal PACS Archive" workshop focused on current challenges of and open source solutions to the management of images and other clinical information in multi-center settings...

The Protective Role of PAC1-Receptor Agonist Maxadilan in BCCAO-Induced Retinal Degeneration.

Science.gov (United States)

Vaczy, A; Reglodi, D; Somoskeoy, T; Kovacs, K; Lokos, E; Szabo, E; Tamas, A; Atlasz, T

2016-10-01

A number of studies have proven that pituitary adenylate cyclase activating polypeptide (PACAP) is protective in neurodegenerative diseases. Permanent bilateral common carotid artery occlusion (BCCAO) causes severe degeneration in the rat retina. In our previous studies, protective effects were observed with PACAP1-38, PACAP1-27, and VIP but not with their related peptides, glucagon, or secretin in BCCAO. All three PACAP receptors (PAC1, VPAC1, VPAC2) appear in the retina. Molecular and immunohistochemical analysis demonstrated that the retinoprotective effects are most probably mainly mediated by the PAC1 receptor. The aim of the present study was to investigate the retinoprotective effects of a selective PAC1-receptor agonist maxadilan in BCCAO-induced retinopathy. Wistar rats were used in the experiment. After performing BCCAO, the right eye was treated with intravitreal maxadilan (0.1 or 1 μM), while the left eye was injected with vehicle. Sham-operated rats received the same treatment. Two weeks after the operation, retinas were processed for standard morphometric and molecular analysis. Intravitreal injection of 0.1 or 1 μM maxadilan caused significant protection in the thickness of most retinal layers and the number of cells in the GCL compared to the BCCAO-operated eyes. In addition, 1 μM maxadilan application was more effective than 0.1 μM maxadilan treatment in the ONL, INL, IPL, and the entire retina (OLM-ILM). Maxadilan treatment significantly decreased cytokine expression (CINC-1, IL-1α, and L-selectin) in ischemia. In summary, our histological and molecular analysis showed that maxadilan, a selective PAC1 receptor agonist, has a protective role in BCCAO-induced retinal degeneration, further supporting the role of PAC1 receptor conveying the retinoprotective effects of PACAP.

Wilson and Domainwall Kernels on Oakforest-PACS

Science.gov (United States)

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++.

Fire risk assessment for hydrogen at EDG/battery room

Energy Technology Data Exchange (ETDEWEB)

Jee, Moon Hak; Hong, Sung Yull; Choi, Kwang Hee; Jung, Hyun Jong; Park, Kyung Hyum [Korea electric Power Research Institute, Taejon (Korea, Republic of); Song, Jin Bae [KHNP, Wolsong (Korea, Republic of)

2004-07-01

At the design stage of Nuclear Power Plant, the fire hazard analysis for the fire zone or compartment is implemented according to the fire protection requirement and the document is required for the licensing approval. On the basis of fire hazard analysis, the evaluation for the safe shutdown capability is preceded for each fire zone that contains safety-important systems and facilities. The primary philosophy for the fire safety is to secure fire defense-in-depth at Nuclear Power Plants that represents fire prevention, fire protection, and mitigation from fire damage. One of the concerning fire zones that need quantitative fire hazard analysis as well as qualitative fire evaluation at Nuclear Power Plants is the battery room at Emergency Diesel Generator (EDG) Room. For an example, Emergency Power Supply System called as EPS at Wolsong Nuclear Power Plant generates emergency power and supply the electric power to the safety-related systems and essential facilities during the loss of on-site and off-site AC power. For the start of emergency power generator, it needs DC power from the battery units inside the EPS room. For the emergency supply of DC power, the battery at EPS room should be recharged during the standby period to compensate the reduced chemical energy that was converted to the electric energy or depleted through the natural process. During the recharge process, especially at the time of charging current becoming greater than the nominal floating current or at the time of over-charging period, the hydrogen and the oxygen are generated from the positive plate and cathodic part respectively and escaped through the vent holes or crevices. In this context, the fire hazard assessment should be done for the EPS/battery room with quantitative approach and the fire safety evaluation for the explosion of hydrogen gas must be done under the specific fire protection program at Nuclear Power Plants.

Fire risk assessment for hydrogen at EDG/battery room

International Nuclear Information System (INIS)

Jee, Moon Hak; Hong, Sung Yull; Choi, Kwang Hee; Jung, Hyun Jong; Park, Kyung Hyum; Song, Jin Bae

2004-01-01

At the design stage of Nuclear Power Plant, the fire hazard analysis for the fire zone or compartment is implemented according to the fire protection requirement and the document is required for the licensing approval. On the basis of fire hazard analysis, the evaluation for the safe shutdown capability is preceded for each fire zone that contains safety-important systems and facilities. The primary philosophy for the fire safety is to secure fire defense-in-depth at Nuclear Power Plants that represents fire prevention, fire protection, and mitigation from fire damage. One of the concerning fire zones that need quantitative fire hazard analysis as well as qualitative fire evaluation at Nuclear Power Plants is the battery room at Emergency Diesel Generator (EDG) Room. For an example, Emergency Power Supply System called as EPS at Wolsong Nuclear Power Plant generates emergency power and supply the electric power to the safety-related systems and essential facilities during the loss of on-site and off-site AC power. For the start of emergency power generator, it needs DC power from the battery units inside the EPS room. For the emergency supply of DC power, the battery at EPS room should be recharged during the standby period to compensate the reduced chemical energy that was converted to the electric energy or depleted through the natural process. During the recharge process, especially at the time of charging current becoming greater than the nominal floating current or at the time of over-charging period, the hydrogen and the oxygen are generated from the positive plate and cathodic part respectively and escaped through the vent holes or crevices. In this context, the fire hazard assessment should be done for the EPS/battery room with quantitative approach and the fire safety evaluation for the explosion of hydrogen gas must be done under the specific fire protection program at Nuclear Power Plants

The PAC-MAN model: Benchmark case for linear acoustics in computational physics

Science.gov (United States)

Ziegelwanger, Harald; Reiter, Paul

2017-10-01

Benchmark cases in the field of computational physics, on the one hand, have to contain a certain complexity to test numerical edge cases and, on the other hand, require the existence of an analytical solution, because an analytical solution allows the exact quantification of the accuracy of a numerical simulation method. This dilemma causes a need for analytical sound field formulations of complex acoustic problems. A well known example for such a benchmark case for harmonic linear acoustics is the ;Cat's Eye model;, which describes the three-dimensional sound field radiated from a sphere with a missing octant analytically. In this paper, a benchmark case for two-dimensional (2D) harmonic linear acoustic problems, viz., the ;PAC-MAN model;, is proposed. The PAC-MAN model describes the radiated and scattered sound field around an infinitely long cylinder with a cut out sector of variable angular width. While the analytical calculation of the 2D sound field allows different angular cut-out widths and arbitrarily positioned line sources, the computational cost associated with the solution of this problem is similar to a 1D problem because of a modal formulation of the sound field in the PAC-MAN model.

Tratamento da cefaléia em uma unidade de emergência da cidade de Ribeirão Preto Headache treatment in an emergency room of the city of Ribeirão Preto, Brazil

Directory of Open Access Journals (Sweden)

MARCELO EDUARDO BIGAL

1999-09-01

Full Text Available Cefaléia é dos sintomas mais comuns na prática clínica. Acarreta considerável impacto econômico e sobrecarrega as unidades de emergência. A maioria destas, em nosso país, não dispõe de triptans. O presente estudo analisa o tratamento instituído na Unidade de Emergência do Hospital das Clínicas de Ribeirão Preto. Em 1996, 1254 pacientes foram atendidos com esta queixa e 64 necessitaram de internação. Dos pacientes não internados (NI, 77% apresentavam cefaléias primárias, contra 29,7% dos pacientes internados (I. A percentagem de melhora nos pacientes com migrânea com a dipirona endovenosa foi 83,8%, com o diclofenaco intramuscular 66,7% e com a clorpromazina (endovenosa 81,8%. As percentagens de pacientes com cefaléia do tipo tensional que melhoraram, frente às mesmas drogas foram, respectivamente 77,8%, 80% e 100%. Dos NI 16,3% tiveram melhora sem qualquer tratamento medicamentoso. Concluímos que as drogas utilizadas apresentam perfis semelhantes de eficácia e custo, podendo ser utilizadas em unidades básicas de saúde. O maior inconveniente é a administração parenteral.Headache is one of the most common symptoms observed in clinical practice. It has a considerable economic impact and overburdens emergency rooms. In Brazil, most emergency rooms have no tryptans. The present study analyses the treatment provided by the Emergency Room of the University Hospital of Ribeirão Preto. In 1996, 1254 patients were treated for headache and 64 of them required hospitalization. Of the non-hospitalized (NH patients, 77% had primary headache, as opposed to 29.7% of hospitalized patients. Of the patients with migraine, 83.6% improved with intravenous dipyrone, 66.7% improved with intramuscular diclofenac and 81.8% improved with intravenous chlorpromazine. The percentages of patients with tension-type headache who improved with the same drugs were 77.8%, 80% and 100%, respectively. Among NH patients, 16.3% improved without any

Internacional : el Pacífico. Océano del siglo XXI (Coyuntura)

OpenAIRE

Salgado Tamayo, Wilma

1997-01-01

El impresionante crecimiento económico de los países del Pacífico asiático en los últimos veinte años, que contrasta con el lento crecimiento de los países industrializados, ha llevado a muchos autores a sostener que el centro de gravedad de la economía mundial se está desplazando desde la Cuenca del Atlántico hacia la Cuenca del Pacífico y en ese sentido convertirse en el Océano del Siglo XXI. Un análisis más detallado, muestra sin embargo que en la Cuenca del Pacifico confluyen países y reg...

Thermal performance of annular-coated and sphere-pac LWR fuel rod designs

International Nuclear Information System (INIS)

Guenther, R.J.; Hsieh, K.A.; Barner, J.O.; Freshley, M.D.

1980-01-01

Two FCI-resistant UO 2 fuel rod designs are being compared to a reference design in irradiation tests in the Halden Boiling Water Reactor (HBWR) as part of the DOE-sponsored Fuel Performance Improvement Program (FPIP). The primary fuel design (annular-coated-pressurized) incorporates annular pellets, a graphite coating on the inner surface of the Zircaloy cladding, and pressurized helium fill gas. Also being investigated is an 87% smear density sphere-pac design with pressurized helium fill gas. The solid pellet (reference) and annular-coated designs described had helium fill gas at approx. 100 kPa and the sphere-pac rods were pressurized at approx. 455 kPa

First results of Herschel-PACS observations of Neptune

NARCIS (Netherlands)

Lellouch, E.; Hartogh, P.; Feuchtgruber, H.; Vandenbussche, B.; de Graauw, Th.; Moreno, R.; Jarchow, C.; Cavalie, T.; Orton, G.; Banaszkiewicz, M.; Blecka, M. I.; Bockelee-Morvan, D.; Crovisier, J.; Encrenaz, T.; Fulton, T.; Kueppers, M.; Lara, L. M.; Lis, D. C.; Medvedev, A. S.; Rengel, M.; Sagawa, H.; Swinyard, B.; Szutowicz, S.; Bensch, F.; Bergin, E.; Billebaud, F.; Biver, N.; Blake, G. A.; Blommaert, J. A. D. L.; Cernicharo, J.; Courtin, R.; Davis, G. R.; Decin, L.; Encrenaz, P.; Gonzalez, A.; Jehin, E.; Kidger, M.; Naylor, D.; Portyankina, G.; Schieder, R.; Sidher, S.; Thomas, N.; de Val-Borro, M.; Verdugo, E.; Waelkens, C.; Aarts, H.; Comito, C.; Kawamura, J. H.; Maestrini, A.; Peacocke, T.; Teipen, R.; Tils, T.; Wildeman, K.; Walker, H.; Blake, G.A.

2010-01-01

We report on the initial analysis of a Herschel-PACS full range spectrum of Neptune, covering the 51-220 mu m range with a mean resolving power of similar to 3000, and complemented by a dedicated observation of CH(4) at 120 mu m. Numerous spectral features due to HD (R(0) and R(1)), H(2)O, CH(4),

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

Science.gov (United States)

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.

Value of contrast enhanced CT scanning in the non-trauma emergency room patient

International Nuclear Information System (INIS)

Wood, L.P.; Parisi, M.; Finch, I.J.

1990-01-01

To determine the value of performing contrast CT in addition to non-contrast CT in the evaluation of acute non-traumatic central nervous system disorders, we retrospectively reviewed 322 cases originating from the emergency room at our institution. The most common indication for scanning was seizure activity (34% of total), followed by headache (30%), focal neurological deficit (10%), and altered mental status (8%). 75% of the noncontrast scans were normal. The contrast enhanced scan revealed abnormalities not evident on the non-contrast scan in only three of these cases, and the information did not alter patient management. We conclude that in the acute setting, if a non-contrast CT is normal, a contrast study is usually unnecessary. Therefore, given the additional risks of contrast infusion, the contrast study, if needed, is generally best obtained at a later date, after more careful evaluation of the patient's history and medical records. If the non-contrast CT scan is abnormal, a contrast enhanced CT scan may be beneficial, but, again, is often not needed to direct acute patient management. (orig.)

Emergency management of major bleeding in a case of maxillofacial trauma and anticoagulation: utility of prothrombin complex concentrates in the shock room

Directory of Open Access Journals (Sweden)

Alessandro Morotti

2015-03-01

Full Text Available Life-threatening bleeding in anticoagulation with Warfarin is an emergency challenging issue. Several approaches are available to treat bleeding in either over-anticoagulation or propeanticoagulation, including vitamin K, fresh frozen plasma and prothrombin complex concentrates (PCC administration. In coexisting trauma-induced bleeding and anticoagulation, reversal of anticoagulation must be a rapid and highly effective procedure. Furthermore the appropriate treatment must be directly available in each shock rooms to guarantee the rapid management of the emergency. PCC require a simple storage, rapid accessibility, fast administration procedures and high effectiveness. Here we report the utility of PCC in management of a craniofacial trauma in proper-anticoagulation.

Radiation Protection Elephants in the Room

International Nuclear Information System (INIS)

Vetter, R. J.

2004-01-01

As our system of radiological protection evolves, several significant issues loom within radiation protection discussions and publications. These issues influence the nature of epidemiological and radiobiological research and the establishment of radiation protection recommendations, standards, and regulations. These issues are like the proverbial e lephants in the room . They are large, and it is unwise to ignore them. This paper discusses the impact of three young elephants as they make their presence increasingly obvious: increased cancer susceptibility from early-life exposure to radiation, terrorism and fear of radiation, and patient safety. Increased cancer susceptibility from early-life exposure to radiation is emerging as a discussion topic related to the safety of computed tomography (CT) and other medical modalities. Shortly after publication of CT dose data, manufacturers were helping to reduce doses to children by increasing flexibility for adjustment of technique factors. Also, radiation epidemiological data are being used in the development of guidance on exposure to chemical carcinogens during early life. Re-emergence of public fear of radiation has been fueled by threats of radiological dispersion devises and confusing messages about personal decontamination, emergency room acceptance or rejection of contaminated victims, and environmental clean-up. Finally, several professional publications have characterized risk of medical radiation exposure in terms of patient deaths even though epidemiological data do not support such conclusions. All three of these elephants require excellent science and sophisticated data analysis to coax them from the room. Anecdotal communications that confuse the public should be avoided. These are not the only elephants in the room, but these three are making their presence increasingly obvious. This paper discusses the need for radiation protection professionals to rely on good science in the evolution of the system of

Cost-Benefit Analysis of an Otolaryngology Emergency Room Using a Contingent Valuation Approach.

Science.gov (United States)

Naunheim, Matthew R; Kozin, Elliot D; Sethi, Rosh K; Ota, H Gregory; Gray, Stacey T; Shrime, Mark G

2015-10-01

Dedicated otolaryngology emergency rooms (ERs) provide a unique mechanism of health care delivery. Relative costs and willingness to pay (WTP) for these services have not been studied. This study aims to provide a cost-benefit analysis of otolaryngology-specific ER care. Cost-benefit analysis based on contingent valuation surveys. An otolaryngology-specific ER in a tertiary care academic medical center. Adult English-speaking patients presenting to an otolaryngology ER were included. WTP questions were used to assess patient valuations of specialty emergency care. Sociodemographic data, income, and self-reported levels of distress were assessed. State-level and institution-specific historical cost data were merged with WTP data within a cost-benefit analysis framework. The response rate was 75.6%, and 199 patients were included in the final analysis. Average WTP for otolaryngology ER services was $319 greater than for a general ER (95% CI: $261 to $377), with a median value of $200. The historical mean cost per visit at a general ER was $575, and mean cost at the specialty ER was $551 (95% CI: $529 to $574). Subtracting incremental cost from incremental WTP yielded a net benefit of $343. Dedicated otolaryngology ER services are valued by patients for acute otolaryngologic problems and have a net benefit of $343 per patient visit. They appear to be a cost-beneficial method for addressing acute otolaryngologic conditions. This study has implications for ER-based otolaryngologic care and direct-to-specialist services. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

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

Directory of Open Access Journals (Sweden)

Aldosari Bakheet

2012-05-01

Full Text Available Abstract 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

A study of consumer attitudes about health care: the role of the emergency room.

Science.gov (United States)

Stratmann, W C; Ullman, R

1975-12-01

Contrary to the traditional role of the emergency room (ER) as a care source for the treatment of urgent medical needs, it is evident that substantial numbers of people now use the ER for the treatment of nonurgent problems. In this paper, we report on public opinion about the role of the ER, the accessibility of medical care, and factors that prompt the use of the ER rather than other sources of care. The data result from a community survey of households (N = 521) in the area of Rochester, New York, representative of a population of about 580,000 people. The findings, which relate ER utilization to source of payment, use of other sources of care, demographic variables, and consumer attitudes illustrate the rationality of the patient's use of ER facilities and reflect the patient's view of the ER as a place to obtain medical treatment when other sources are not available.

A step towards PACS: The DS-1000 traumatology

International Nuclear Information System (INIS)

Schmidt, C.; Deininger, H.K.

1989-01-01

The development of new technologies is changing more and more the medical diagnostic. Analogous procedures are consistently making way for digital methods. 1980, the number of digital procedures amounted to 15%; 1990 according to general estimation, the number will already amount to 50%. It appears significant, within the framework of a new course, to promote the digitalisation not only in technical procedures but also in the organisation area. A central Picture Archiving and Communication System (PACS) is today considered an ideal solution, provided that the complete diagnostic imaging is carried out digitally. In the submitted is a report on a digital working unit for trauma patients. The initial results demonstrate that this concept is more than a promising attempt to replace conventional bone diagnostic in the future. The system presented is capable of demonstrations all clinically relevant changes of the traumatic skeleton, whereby the image quality corresponds approximately to a high-speed film-screen combination. Among the advantages, it should be emphasized in particular, the reduction in radiation, the rapid display of examination results and the integration in a Picture Archiving and Communication System (PACS) without any loos of information. (orig.) [de

Radiological reporting system developed with FileMakerPro. Cooperation with HIS, RIS, and PACS

International Nuclear Information System (INIS)

Kawakami, Satoshi

2004-01-01

This article briefly describes our original radiological reporting system. This system was developed with the widely used database software FileMakerPro (ver 5.5). The reporting system can obtain information about patients and examinations from a radiology information system (RIS) by the Open DataBase Connectivity (ODBC) technique. By clicking the button on the reporting system, the corresponding Digital Imaging and Communications in Medicine (DICOM) images can be displayed on a picture archiving and communication system (PACS) workstation monitor. Reference images in JPEG format can be easily moved from PACS to the reporting system. Reports produced by the reporting system are distributed to the hospital information system (HIS) in Portable Document Format (PDF), through another web server. By utilizing the capacity of FileMakerPro, the human-machine interface of the system has been able to be improved easily. In addition, cooperation with HIS, RIS, and PACS could be constructed. Therefore, this original system would contribute to increasing the efficiency of radiological diagnosis. (author)

Traffic and trend analysis of local- and wide-area networks for a distributed PACS implementation

Science.gov (United States)

Gac, Robert J., Jr.; Harding, Douglas, Jr.; Weiser, John C.; Chacko, Anna K.; Radvany, Martin; Romlein, John R.

2000-05-01

Inductive Modeling Techniques (IMT) in a stand alone, distributed Picture Archiving and Communication System (PACS) or telemedicine environment can be utilized to monitor SNMP (Simple Network Management Protocol) enabled devices such as network switches, servers or workstations. A comprehensive approach using IMT is presented across the stages of the PACS lifecycle: Pre-PACS, Implementation, and Clinical Use. At each stage of the cycle, the results of IMT can be utilized to assist in assessing and forecasting future system loading. This loading represents a clinical trend analysis equating to the clinical workflow and delivery of services. Specific attention is directed to an understanding and thorough depiction of IMT methodology, focusing on the use of SNMP, the Management Information Base (MIB), and the data stream output that is mapped and placed in an object-oriented database and made available for web-based, real time, in-depth viewing and/or analysis. A thorough description of these outputs is presented, spotlighting potential report applications such as system failures; existing system, CPU, workstation, server and LAN/WAN link utilization; packet rates; application isolation; notification of system alarms; fault isolation; high/low bandwidth users; and data transfer rates. These types of data are increasingly required for programming LAN/WAN upgrades as digital imaging and PACS are implemented.

Numbering of vertebrae on MRI using a PACS cross-referencing tool

International Nuclear Information System (INIS)

Paik, Nam Chull; Lim, Chun Soo; Jang, Ho Suk

2012-01-01

Background: For the detection and documentation of numeric variations on spine magnetic resonance imaging (MRI), different techniques have previously been introduced. However, these methods require additional special imaging algorithms, software, or devices. We intend to introduce a vertebral numbering method using the existing picture archiving and communication system (PACS) and MRI system. Purpose: To assess the accuracy of a method for numbering presacral vertebrae based on the cross-referencing of two sagittal MRI series. Material and Methods: This study was a retrospective review of 224 consecutive patients who underwent both lumbar MRI with cervicothoracic scan and whole spine radiographic examinations. A radiologist and a neurosurgeon independently counted the number of presacral vertebrae in a cranial-to-caudal approach with cross-referencing of cervicothoracic and lumbar MRI sagittal series on the PACS workstation. Radiographic numbering from the cervical through the thoracic to the lumbar vertebrae, as a reference standard, was completed independently by the two reviewers. An analysis of the inter-observer and intermodality agreements of radiography and MRI was done. Results: In all cases except one, concordant numbering existed between the two modalities of MRI cross-referencing and radiographs combination. Both observers agreed completely, with no inter-observer discordance. Conclusion: The number of vertebrae could be identified consistently by counting caudally from C2 with cross-referencing cervicothoracic and lumbosacral sagittal MRI scans on the PACS workstation

Numbering of vertebrae on MRI using a PACS cross-referencing tool

Energy Technology Data Exchange (ETDEWEB)

Paik, Nam Chull [Dept. of Radiology, Arumdaun Wooldul Spine Hospital, Ulsan (Korea, Republic of)], e-mail: srsna@freechal.com; Lim, Chun Soo; Jang, Ho Suk [Dept. of Neurosurgery, Arumdaun Wooldul Spine Hospital, Ulsan (Korea, Republic of)

2012-09-15

Background: For the detection and documentation of numeric variations on spine magnetic resonance imaging (MRI), different techniques have previously been introduced. However, these methods require additional special imaging algorithms, software, or devices. We intend to introduce a vertebral numbering method using the existing picture archiving and communication system (PACS) and MRI system. Purpose: To assess the accuracy of a method for numbering presacral vertebrae based on the cross-referencing of two sagittal MRI series. Material and Methods: This study was a retrospective review of 224 consecutive patients who underwent both lumbar MRI with cervicothoracic scan and whole spine radiographic examinations. A radiologist and a neurosurgeon independently counted the number of presacral vertebrae in a cranial-to-caudal approach with cross-referencing of cervicothoracic and lumbar MRI sagittal series on the PACS workstation. Radiographic numbering from the cervical through the thoracic to the lumbar vertebrae, as a reference standard, was completed independently by the two reviewers. An analysis of the inter-observer and intermodality agreements of radiography and MRI was done. Results: In all cases except one, concordant numbering existed between the two modalities of MRI cross-referencing and radiographs combination. Both observers agreed completely, with no inter-observer discordance. Conclusion: The number of vertebrae could be identified consistently by counting caudally from C2 with cross-referencing cervicothoracic and lumbosacral sagittal MRI scans on the PACS workstation.

Experience with PACS in an ATM/Ethernet switched network environment.

Science.gov (United States)

Pelikan, E; Ganser, A; Kotter, E; Schrader, U; Timmermann, U

1998-03-01

Legacy local area network (LAN) technologies based on shared media concepts are not adequate for the growth of a large-scale picture archiving and communication system (PACS) in a client-server architecture. First, an asymmetric network load, due to the requests of a large number of PACS clients for only a few main servers, should be compensated by communication links to the servers with a higher bandwidth compared to the clients. Secondly, as the number of PACS nodes increases, the network throughout should not measurably cut production. These requirements can easily be fulfilled using switching technologies. Here asynchronous transfer mode (ATM) is clearly one of the hottest topics in networking because the ATM architecture provides integrated support for a variety of communication services, and it supports virtual networking. On the other hand, most of the imaging modalities are not yet ready for integration into a native ATM network. For a lot of nodes already joining an Ethernet, a cost-effective and pragmatic way to benefit from the switching concept would be a combined ATM/Ethernet switching environment. This incorporates an incremental migration strategy with the immediate benefits of high-speed, high-capacity ATM (for servers and high-sophisticated display workstations), while preserving elements of the existing network technologies. In addition, Ethernet switching instead of shared media Ethernet improves the performance considerably. The LAN emulation (LANE) specification by the ATM forum defines mechanisms that allow ATM networks to coexist with legacy systems using any data networking protocol. This paper points out the suitability of this network architecture in accordance with an appropriate system design.

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

Science.gov (United States)

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

2002-03-01

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

[Validation of the Physical Appearance Comparison Scale (PACS) in a German Sample: Psychometric Properties and Association with Eating Behavior, Body Image and Self-Esteem].

Science.gov (United States)

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.

Sphere-pac versus pellet UO2 fuel in de Dodewaard BWR

International Nuclear Information System (INIS)

Linde, A. van der.

1989-04-01

Comparative testing of UO 2 sphere-pac and pellet fuel rods under LWR conditions has been jointly performed by the Netherlands Utilities Research Centre (KEMA) in Arnhem, the Netherlands Energy Research Foundation (ECN) at Petten and the Netherlands Joint Nuclear Power Utility (GKN) at Dodewaard. This final report summarizes the highlights of this 1968-1988 program with strong emphasis on the fuel rods irradiated in the Dodewaard BWR. The conclusion reached is that under normal LWR conditions sphere-pac UO 2 in LWR fuel rods offers better resistance against stress corrosion cracking of the cladding, but that under fast, single step, power ramping conditions pellet UO 2 in LWR fuel rods has a better resistance against hoop stress failure of the cladding. 128 figs., 36 refs., 19 tabs

Integration of PACS and HIS info the workflow of a nuclear medicine department. Experience in Regensburg

International Nuclear Information System (INIS)

Maenner, P.; Fuchs, E.; Marienhagen, J.; Schoenberger, J.; Eilles, C.; Tege, B.; Reicherzer, H.G.; Kurz, M.; Boerner, W.

2006-01-01

Aim: the development of new diagnostic techniques and the implementation of a modern quality control management system requires the continuous adaptation of existing data processing tools to the nuclear medicine diagnostic workflow. Furthermore, PACS connected to HIS facilitates and enhances the transfer of data and pictures, and satisfies the legal requirements for data retention as regulated by law. Therefore, the aim of this work is to present the architecture, structure and results of such a system newly installed in a department of nuclear medicine. Methods: initially, the nuclear medicine workflow was carefully analyzed and each step was correlated to the corresponding module. The standard SAP R/3 and IS-H / IS-H*med based software used for patient administration at the University of Regensburg Hospital was adapted to the needs of the Nuclear Medicine Department. The networking of the imaging systems was done by integration of a PACS. Finally, the PACS was connected to the HIS to allow the attachment of images to the medical report. Results, conclusion: by connecting the HIS to the nuclear medicine PACS, the workflow was significantly improved. The data management sequence starting at the reception desk, continuing through the nuclear medical examination, to the physician's final written and image report is clearly structured. Although high demands exist on technical support and administration the integration of PACS and HIS into the nuclear medicine workflow leads to enhanced efficiency and reduction in hospital costs. Patient and data management are considerably improved in this way. (orig.)

PFP Emergency Lighting Study

International Nuclear Information System (INIS)

BUSCH, M.S.

2000-01-01

NFPA 101, section 5-9 mandates that, where required by building classification, all designated emergency egress routes be provided with adequate emergency lighting in the event of a normal lighting outage. Emergency lighting is to be arranged so that egress routes are illuminated to an average of 1.0 footcandle with a minimum at any point of 0.1 footcandle, as measured at floor level. These levels are permitted to drop to 60% of their original value over the required 90 minute emergency lighting duration after a power outage. The Plutonium Finishing Plant (PFP) has two designations for battery powered egress lights ''Emergency Lights'' are those battery powered lights required by NFPA 101 to provide lighting along officially designated egress routes in those buildings meeting the correct occupancy requirements. Emergency Lights are maintained on a monthly basis by procedure ZSR-12N-001. ''Backup Lights'' are battery powered lights not required by NFPA, but installed in areas where additional light may be needed. The Backup Light locations were identified by PFP Safety and Engineering based on several factors. (1) General occupancy and type of work in the area. Areas occupied briefly during a shiftly surveillance do not require backup lighting while a room occupied fairly frequently or for significant lengths of time will need one or two Backup lights to provide general illumination of the egress points. (2) Complexity of the egress routes. Office spaces with a standard hallway/room configuration will not require Backup Lights while a large room with several subdivisions or irregularly placed rooms, doors, and equipment will require Backup Lights to make egress safer. (3) Reasonable balance between the safety benefits of additional lighting and the man-hours/exposure required for periodic light maintenance. In some plant areas such as building 236-Z, the additional maintenance time and risk of contamination do not warrant having Backup Lights installed in all rooms

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

Directory of Open Access Journals (Sweden)

Jens Hannibal

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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.

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

Directory of Open Access Journals (Sweden)

Laurent Oligny

2016-07-01

Full Text Available 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.

Three-tiered integration of PACS and HIS toward next generation total hospital information system.

Science.gov (United States)

Kim, J H; Lee, D H; Choi, J W; Cho, H I; Kang, H S; Yeon, K M; Han, M C

1998-01-01

The Seoul National University Hospital (SNUH) started a project to innovate the hospital information facilities. This project includes installation of high speed hospital network, development of new HIS, OCS (order communication system), RIS and PACS. This project aims at the implementation of the first total hospital information system by seamlessly integrating these systems together. To achieve this goal, we took three-tiered systems integration approach: network level, database level, and workstation level integration. There are 3 loops of networks in SNUH: proprietary star network for host computer based HIS, Ethernet based hospital LAN for OCS and RIS, and ATM based network for PACS. They are linked together at the backbone level to allow high speed communication between these systems. We have developed special communication modules for each system that allow data interchange between different databases and computer platforms. We have also developed an integrated workstation in which both the OCS and PACS application programs run on a single computer in an integrated manner allowing the clinical users to access and display radiological images as well as textual clinical information within a single user environment. A study is in progress toward a total hospital information system in SNUH by seamlessly integrating the main hospital information resources such as HIS, OCS, and PACS. With the three-tiered systems integration approach, we could successfully integrate the systems from the network level to the user application level.

High users of VA emergency room facilities: are outpatients abusing the system or is the system abusing them?

Science.gov (United States)

Schneider, K C; Dove, H G

1983-01-01

A phenomenon well known to emergency room personnel is the high use of ER facilities by a small number of patients. In this study of 335 patients followed in outpatient specialty clinics at a university-affiliated VA medical center, 23% of the patients accounted for 73% of the ER visits. Although some patients may be abusing the system, the problem is difficult to correct because of congressional legislation that deters the VA from providing primary care. Thus, a small subset of patients with chronic medical problems who live close to the hospital are likely to continue to consume a disproportionate amount of ER resources.

Teleradiology and PACS - strategy of the Innsbruck University Hospital; Teleradiologie und PACS - das Konzept des Universitaetsklinikums Innsbruck

Energy Technology Data Exchange (ETDEWEB)

Vogl, R. [HITT - Health Information Technologies Tirol, Innsbruck (Austria)

2005-08-01

Systems for management of digital imaging data are very important and widespread at the Innsbruck University Hospital and constitute a central component of the IT strategies followed by the hospital operating company TILAK (Tyrolean public hospitals). The particular goal is to integrate all imaging data into the electronic medical records and make these available online to each of the approx. 2500 clinic workstations and ensure electronic data exchange with other healthcare services. Teleradiology connections have been established at the University Clinic for Radiology since 1995; these have been continually expanded and linked to the central PACS. An eHealth web portal was recently established to facilitate transfer of images and findings from TILAK hospitals to other healthcare organizations. Registered users can be cleared for a limited time to access all radiological imaging data via this web portal. (orig.) [German] Die Systeme zum digitalen Bilddatenmanagement haben grosse Bedeutung und weite Verbreitung an der Universitaetsklinik Innsbruck und sind zentraler Bestandteil der IT-Strategie der Krankenhausbetreibergesellschaft TILAK (Tiroler Landeskrankenanstalten). Ziel dabei ist es insbesondere, saemtliche Bilddaten in die elektronische Krankengeschichte zu integrieren und von jedem der ca. 2500 klinischen Arbeitsplaetze aus online zugreifbar zu machen sowie den elektronischen Datenaustausch mit anderen Gesundheitsdiensteanbietern zu gewaehrleisten. Seit 1995 bestehen Teleradiologieverbindungen der Universitaetsklinik fuer Radiologie; diese wurden laufend ausgebaut und die Einbindung in das zentrale PACS hergestellt. Zur Kommunikation von Bild- und Befunddaten aus den Krankenhaeusern der TILAK an andere Gesundheitseinrichtungen wurde kuerzlich ein eHealth WebPortal geschaffen, ueber das saemtliche radiologischen Bilddaten durch zeitbefristete Freigaben fuer registrierte Benutzer zugaenglich gemacht werden koennen. (orig.)

PacIOOS Nearshore Sensor 10 (NS10): Maunalua Bay, Oahu, Hawaii

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

PacIOOS Nearshore Sensor 05 (NS05): Pago Pago, American Samoa

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

PacIOOS Nearshore Sensor 04 (NS04): Waikiki Aquarium, Oahu, Hawaii

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

Two year experience with Web connectivity to PACS at a community-based hospital

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Wadley, Brian D.; Hayward, Ulrike; Trambert, Michael; Kywi, Alberto; Hartzman, Steven

2002-05-01

Referring physician web based access to a PACS is evaluated at a community-based hospital. Survey results show 100% perceived improvement in referring physician productivity, and 97% perceived improvement in patient care. Overall satisfaction and perception of ease of use is greater than 90%.Web connectivity to PACS is perceived by 97% to result in decreased visits and calls to the radiology department due to the availability of virtual results, with high value placed on the voice clip summary results by 94% of respondents (the voice clip is a recording made by the radiologist at the time of reading the exam, which summarizes the results of the study).The availability of exams and virtual results via web-based connectivity is perceived to result in increase referrals by 58% of respondents. Web log audit trails are analyzed to evaluate the use of the system by referring physicians. The gross number of cases retrieved over the web for a two-week period is assessed. The number of times a voice clip was played is also evaluated. The results overall show a very positive experience with web connectivity to PACS.

THROES: a caTalogue of HeRschel Observations of Evolved Stars. I. PACS range spectroscopy

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Ramos-Medina, J.; Sánchez Contreras, C.; García-Lario, P.; Rodrigo, C.; da Silva Santos, J.; Solano, E.

2018-03-01

This is the first of a series of papers presenting the THROES (A caTalogue of HeRschel Observations of Evolved Stars) project, intended to provide a comprehensive overview of the spectroscopic results obtained in the far-infrared (55-670 μm) with the Herschel space observatory on low-to-intermediate mass evolved stars in our Galaxy. Here we introduce the catalogue of interactively reprocessed Photoconductor Array Camera and Spectrometer (PACS) spectra covering the 55-200 μm range for 114 stars in this category for which PACS range spectroscopic data is available in the Herschel Science Archive (HSA). Our sample includes objects spanning a range of evolutionary stages, from the asymptotic giant branch to the planetary nebula phase, displaying a wide variety of chemical and physical properties. The THROES/PACS catalogue is accessible via a dedicated web-based interface and includes not only the science-ready Herschel spectroscopic data for each source, but also complementary photometric and spectroscopic data from other infrared observatories, namely IRAS, ISO, or AKARI, at overlapping wavelengths. Our goal is to create a legacy-value Herschel dataset that can be used by the scientific community in the future to deepen our knowledge and understanding of these latest stages of the evolution of low-to-intermediate mass stars. The THROES/PACS catalogue is accessible at http://https://throes.cab.inta-csic.es/

Evaluation of peptide adsorption-controlled liquid chromatography-tandem mass spectrometric (PAC-LC-MS/MS) method for simple and simultaneous quantitation of amyloid β 1-38, 1-40, 1-42 and 1-43 peptides in dog cerebrospinal fluid.

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Goda, Ryoya; Kobayashi, Nobuhiro

2012-05-01

To evaluate the usefulness of the peptide adsorption-controlled liquid chromatography-tandem mass spectrometry (PAC-LC-MS/MS) for reproducible measurement of peptides in biological fluids, simultaneous quantitation of amyloid β 1-38, 1-40, 1-42 and 1-43 peptides (Aβ38, Aβ40, Aβ42 and Aβ43) in dog cerebrospinal fluid (CSF) was tried. Each stable isotope labeled Aβ was used as the internal standard to minimize the influence of CSF matrix on the reproducible Aβ quantitation. To reduce a loss of Aβ during the pretreatment procedures, the dog CSF diluted by water-acetic acid-methanol (2:6:1, v/v/v) was loaded on PAC-LC-MS/MS directly. Quantification of the Aβ in the diluted dog CSF was carried out using multiple reaction monitoring (MRM) mode. The [M+5H(5+)] and b(5+) ion fragment of each peptide were chosen as the precursor and product ions for MRM transitions of each peptide. The calibration curves were drawn from Aβ standard calibration solutions using PAC-LC-MS/MS. Analysis of dog CSF samples suggests that the basal concentration of Aβ38, Aβ40, Aβ42 and Aβ43 in dog CSF is approximately 300, 900, 200 and 30 pM, respectively. This is the first time Aβ concentrations in dog CSF have been reported. Additionally, the evaluation of intra- and inter-day reproducibility of analysis of Aβ standard solution, the freeze-thaw stability and the room temperature stability of Aβ standard solution suggest that the PAC-LC-MS/MS method enables reproducible Aβ quantitation. Copyright © 2012 Elsevier B.V. All rights reserved.

The operating room of the future: observations and commentary.

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Satava, Richard M

2003-09-01

The Operating Room of the Future is a construct upon which to develop the next generation of operating environments for the patient, surgeon, and operating team. Analysis of the suite of visions for the Operating Room of the Future reveals a broad set of goals, with a clear overall solution to create a safe environment for high-quality healthcare. The vision, although planned for the future, is based upon iteratively improving and integrating current systems, both technology and process. This must become the Operating Room of Today, which will require the enormous efforts described. An alternative future of the operating room, based upon emergence of disruptive technologies, is also presented.

CT and MR imaging acquisition performance in a neuroradiology PACS module 1-year clinical experience

International Nuclear Information System (INIS)

Lou, S.L.; Loloyan, M.; Weinberg, W.S.; Valentino, D.J.; Lufkin, R.B.; Hanafee, W.N.; Bentson, J.; Jabour, B.A.; Huang, H.K.

1990-01-01

This paper analyzes the operational efficiency of our neuroradiology PACS compared with conventional film-based management systems. The authors neuroradiology PACS module has been in clinical evaluation for 6 months. Three SUN microcomputers, two PC/ATs, and an automated optical disk library are connected through Ethernet. Software implemented at the TCP/IP level is used to transfer images from MR imagers and CT scanners to a viewing station. Performance measurements include the time elapsed at each stage of the system

PAC1 receptor (ADCYAP1R1 genotype and problematic alcohol use in a sample of young women

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Dragan WŁ

2017-06-01

Full Text Available Wojciech Łukasz Dragan,1 Piotr M Czerski,2 Małgorzata Dragan3 1The Interdisciplinary Center for Behavior Genetic Research, Faculty of Psychology, University of Warsaw, Warsaw, 2Laboratory of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, 3Faculty of Psychology, University of Warsaw, Warsaw, Poland Background: Recent studies revealed the role of the PAC1 (ADCYAP1R1 gene variability in vulnerability to posttraumatic stress disorder in women. Due to the relatively high comorbidity of posttraumatic stress disorder and substance use disorder, we hypothesized about possible associations between PAC1 gene and problematic alcohol use. Method: The sample studied consisted of 491 women aged 18–28 years (mean age =21.76 years; SD =1.83 and the Alcohol Use Disorders Identification Test was used to assess drinking problems. We successfully genotyped 17 single-nucleotide polymorphisms in the PAC1 gene. Results: Single locus analysis revealed a significant (after correction for multiple testing association between intronic polymorphism rs2302475 and problematic alcohol use (P=0.00048; recessive model. This result was strengthened by the haplotype analysis (P=0.00379. Conclusion: Our results suggest that the PACAP/PAC1 signaling system is implicated in the development of problematic alcohol use in women. Keywords: problematic alcohol use, PAC1 gene, AUDIT, HPA axis

Adoption and resistance: reflections on human, organizational, and information technologies in picture archive and communication systems (PACS)

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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.

Changes of workflow in a radiolocigal department with RIS, PACS and flatpanel detectors implementation

International Nuclear Information System (INIS)

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

2002-01-01

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 flatpanel 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 capitalisationfactor 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. Particuarly 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. (orig.) [de

A room of one's own--Being cared for in a hospital with a single-bed room design.

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Persson, Eva; Anderberg, Patrice; Ekwall, Anna Kristensson

2015-06-01

To illuminate patients' experiences of being hospitalised in a hospital with a single-bed room design. Many patients seem to prefer single-bed hospital rooms. However, studies have also shown that patients do see the advantages of multiple-bed rooms. Interviews were conducted with 16 inpatients from a surgical ward in a hospital building with a single-bed room design. A hermeneutical-phenomenological approach guided by van Manen's four life-world existentials was used to analyse the interviews. The essential meaning was that patients felt secure because they could create a personal environment without disruptive elements. The room was private, and this implied feelings of homeliness, which allowed patients to focus on themselves and was thought to facilitate the recovery process. The patients preferred staying in their room, and the relationship with the personnel was central. Feelings of loneliness and isolation could occur and could be frightening. Being hospitalised in a single-bed room meant balancing between feeling secure and feeling insecure. The following four themes emerged: A homely environment, The need for company and security, Time as unpredictable and involving waiting and Focus on healing the body. Patients experienced that a single-bed room allowed them to focus on their recovery, have visitors without disturbing others and create a feeling of homeliness. However, mobilisation is not a natural part of the recovery process when patients have all they need in their rooms. The patients' need for social interaction and confirmation was not satisfied without effort and planning on the part of staff. © 2014 Nordic College of Caring Science.

When to use the emergency room - adult

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... feeling or inability to move Electric shock or lightning strike Severe burn Severe chest pain or pressure ... 2016. American College of Emergency Physicians. Urgent care fact sheet. newsroom.acep.org/fact_sheets?item=30033 . ...

Screening Criteria for a Room Cooling Failure of the AFW MDP Room

International Nuclear Information System (INIS)

Hwang, Mee Jeong; Yoon, Churl; Yang, Joon Eon; Park, Joo Hwan

2006-01-01

In this paper, we performed a heat up calculation for the Auxiliary Feedwater Motor Operated Pump (AFW MDP) room, PAB-077-11A with CFX-10 and RATT when the HVAC (Heating, Ventilation, and Air Condition) system is failed. We also reviewed the operability of the components under a loss of the HVAC. Room cooling failure does not need to be modeled if the components maintain their operability after a loss of a room cooling function during the mission time. ASME Standard describes that a recovery action can be credited if the related recovery action is included in the procedure or there are similar recovery experiences in the plant. However, there is no description about the recovery action of the HVAC in the EOP (Emergency Operation Procedure) of the UCN3, 4 under the situation of a loss of the HVAC. However, if we consider the HVAC failure in the PSA FT model, the problem is that the unavailability induced from a loss of the HVAC is unrealistically high. From a viewpoint of the PSA, it is not true that the related system always fails even if the HVAC system fails. Therefore, we reviewed the necessity of the HVAC model through two cases of a room heat up calculation under the situation of a loss of the HVAC system with conservative and realistic input data respectively

Use of film digitizers to assist radiology image management

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Honeyman-Buck, Janice C.; Frost, Meryll M.; Staab, Edward V.

1996-05-01

The purpose of this development effort was to evaluate the possibility of using digital technologies to solve image management problems in the Department of Radiology at the University of Florida. The three problem areas investigated were local interpretation of images produced in remote locations, distribution of images to areas outside of radiology, and film handling. In all cases the use of a laser film digitizer interfaced to an existing Picture Archiving and Communication System (PACS) was investigated as a solution to the problem. In each case the volume of studies involved were evaluated to estimate the impact of the solution on the network, archive, and workstations. Communications were stressed in the analysis of the needs for all image transmission. The operational aspects of the solution were examined to determine the needs for training, service, and maintenance. The remote sites requiring local interpretation included were a rural hospital needing coverage for after hours studies, the University of Florida student infirmary, and the emergency room. Distribution of images to the intensive care units was studied to improve image access and patient care. Handling of films originating from remote sites and those requiring urgent reporting were evaluated to improve management functions. The results of our analysis and the decisions that were made based on the analysis are described below. In the cases where systems were installed, a description of the system and its integration into the PACS system is included. For all three problem areas, although we could move images via a digitizer to the archive and a workstation, there was no way to inform the radiologist that a study needed attention. In the case of outside films, the patient did not always have a medical record number that matched one in our Radiology Information Systems (RIS). In order to incorporate all studies for a patient, we needed common locations for orders, reports, and images. RIS orders

Perception and Attitude of Emergency Room Resident Physicians toward Middle East Respiratory Syndrome Outbreak

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Mohammed Al Ghobain

2017-01-01

Full Text Available Introduction. Middle East respiratory syndrome (MERS outbreaks have had a considerable negative impact on health systems in Saudi Arabia. We aimed to study the psychological impact of a Middle East respiratory syndrome coronavirus (MERS-CoV outbreak on emergency room resident physicians (ERRPs. Methods. We assessed the MERS-related psychological impact and concerns of ERRPs using a self-report questionnaire. Results. The majority (91% of the ERRPs agreed that their work put them at risk of infection, but most (65% did not agree that they should not be looking after patients infected with MERS. Despite that, 54% of ERRPs reported being afraid of contracting the infection from infected patients and only 4.2% of them were willing to change their current job. The majority of the ERRPs (85% felt that their job would expose their families to risk of infection. Conclusions. Our study demonstrated the considerable psychological impact of MERS outbreaks on ERRPs. The ERRPs’ concerns and the psychological impact of MERS outbreaks should be considered in greater detail by hospital policymakers.

The assessment of Picture Archiving and Communication System based on Canadian Infoway PACS Opinion Survey in Teaching Hospitals of Shiraz University of Medical Sciences

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Fatemeh Bahador

2017-10-01

Full Text Available Introduction: Today the use of information technology in accordance with the rapid environmental changes and flexibility acquisition is necessary and unavoidable. Picture Archiving and Communication System (PACS is one of the medical information technology used in health facilities. PACS provides the images archive and transmission possibility electronically in different units of the teaching and treatment centers. This study aimed to assess the PACS system in teaching hospitals of Shiraz University of Medical Sciences based on a survey of Canadian Infoway. Method: This descriptive cross-sectional study was performed on 53 individuals selected through Two-Stage Stratified Random Sampling. The study population consisted of 156 PACS users in Shiraz University of Medical Sciences hospitals which were equipped with the PACS system in 2015. Data were collected by the valid and reliable customized questionnaire of Canadian Infoway. The reliability was measured by a pilot study on 25 PACS users; Cronbach’s Alpha was estimated 0.78. Data were analyzed using SPSS 18. Also, frequency, mean, standard deviation were used. Results: The results are presented in three sections: environment (Background Variables, benefits and challenges of PACS. As to the system availability, 20.8% of the users in the clinic, 75.5% in the diagnostic imaging department, only 3.8% in offices had access to the PACS. As to system accessibility, 49.1% of the users just had access to tests, 5.7% only to the reports, and 45.3% to both reports and tests. With respect to benefits of PACS, the mean was 4.16 (SD: 0.5 (five-point scale 1-5 estimated, and in challenges, the mean was 3.48(SD: 0.5 (five-point scale 1-5. Conclusion: The results showed that although PACS could eliminate many restrictions concerning the use of radiology images and films, there were challenges in this regard. Users are recommended to have access to PACS in all clinics, physicians’ offices, and diagnostic

Use of submerged anaerobic membrane bioreactor (SAMBR) containing powdered activated carbon (PAC) for the treatment of textile effluents.

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Baêta, B E L; Ramos, R L; Lima, D R S; Aquino, S F

2012-01-01

This work investigated the use of submerged anaerobic membrane bioreactors (SAMBRs) in the presence and absence of powdered activated carbon (PAC) for the treatment of genuine textile wastewater. The reactors were operated at 35 °C with an HRT of 24 h and the textile effluent was diluted (1:10) with nutrient solution containing yeast extract as the source of the redox mediation riboflavin. The results showed that although both SAMBRs exhibited an excellent performance, the presence of PAC inside SAMBR-1 enhanced reactor stability and removal efficiency of chemical oxygen demand (COD), volatile fatty acids (VFA), turbidity and color. The median removal efficiencies of COD and color in SAMBR-1 were, 90 and 94% respectively; whereas for SAMBR-2 (without PAC) these values were 79 and 86%, In addition, the median values of turbidity and VFA were 8 NTU and 8 mg/L for SAMBR-1 and 14 NTU and 26 mg/L for SAMBR-2, indicating that the presence of PAC inside SAMBR-1 led to the production of an anaerobic effluent of high quality regarding such parameters.

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

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

2010-03-01

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

Evaluation of video capture equipment for secondary image acquisition in the PACS.

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Sukenobu, Yoshiharu; Sasagaki, Michihiro; Hirabuki, Norio; Naito, Hiroaki; Narumi, Yoshifumi; Inamura, Kiyonari

2002-01-01

There are many cases in which picture archiving and communication systems (PACS) are built with old-type existing modalities with no DICOM output. One of the methods for interfacing them to the PACS is to implement video capture (/ frame grabber) equipment. This equipment takes analog video signal output from medical imaging modalities, and amplitude of the video signal is A/D converted and supplied to the PACS. In this report, we measured and evaluated the accuracy at which this video capture equipment could capture the image. From the physical evaluation, we found the pixel values of an original image and its captured image were almost equal in gray level from 20%-90%. The change in the pixel values of a captured image was +/-3 on average. The change of gray level concentration was acceptable and had an average standard deviation of around 0.63. As for resolution, the degradation was observed at the highest physical level. In a subjective evaluation, the evaluation value of the CT image had a grade of 2.81 on the average (the same quality for a reference image was set to a grade of 3.0). Abnormalities in heads, chests, and abdomens were judged not to influence diagnostic accuracy. Some small differences were seen when comparing captured and reference images, but they are recognized as having no influence on the diagnoses.

Developing Emergency Room Key Performance Indicators: What to Measure and Why Should We Measure It?

Science.gov (United States)

Khalifa, Mohamed; Zabani, Ibrahim

2016-01-01

Emergency Room (ER) performance has been a timely topic for both healthcare practitioners and researchers. King Faisal Specialist Hospital and Research Center, Saudi Arabia worked on developing a comprehensive set of KPIs to monitor, evaluate and improve the performance of the ER. A combined approach using quantitative and qualitative methods was used to collect and analyze the data. 34 KPIs were developed and sorted into the three components of the ER patient flow model; input, throughput and output. Input indicators included number and acuity of ER patients, patients leaving without being seen and revisit rates. Throughput indicators included number of active ER beds, ratio of ER patients to ER staff and the length of stay including waiting time and treatment time. The turnaround time of supportive services, such as lab, radiology and medications, were also included. Output indicators include boarding time and available hospital beds, ICU beds and patients waiting for admission.

Associations among emergency room visits, parenting styles, and psychopathology among pediatric patients with sickle cell.

Science.gov (United States)

Latzman, Robert D; Shishido, Yuri; Latzman, Natasha E; Elkin, T David; Majumdar, Suvankar

2014-10-01

To examine associations between frequency of emergency room (ER) visits and various parenting styles, both conjointly and interactively, and psychopathological outcomes among pediatric patients with sickle cell disease (SCD). Ninety-eight parents/caregivers of 6- to 18-year-old patients with SCD completed instruments assessing parenting style, child psychopathology, and reported on the frequency of ER visits during the previous year. ER visits were found to significantly explain Withdrawn/Depressed problems and parenting styles were found to incrementally contribute to the explanation of all forms of psychopathology. Further, Permissive parenting was found to explain Rule Breaking Behavior for those patients with low ER visit frequency but not for those with high ER visit frequency. Results of the current study confirm the importance of considering both the frequency of ER visits and parenting style in the explanation of psychopathology among pediatric patients with SCD. Results have important implications for both research and treatment. © 2014 Wiley Periodicals, Inc.

Focused Cardiac Ultrasound Using a Pocket-Size Device in the Emergency Room.

Science.gov (United States)

Mancuso, Frederico José Neves; Siqueira, Vicente Nicoliello; Moisés, Valdir Ambrósio; Gois, Aécio Flavio Teixeira; Paola, Angelo Amato Vincenzo de; Carvalho, Antonio Carlos Camargo; Campos, Orlando

2014-10-28

Background: Cardiovascular urgencies are frequent reasons for seeking medical care. Prompt and accurate medical diagnosis is critical to reduce the morbidity and mortality of these conditions. Objective: To evaluate the use of a pocket-size echocardiography in addition to clinical history and physical exam in a tertiary medical emergency care. Methods: One hundred adult patients without known cardiac or lung diseases who sought emergency care with cardiac complaints were included. Patients with ischemic changes in the electrocardiography or fever were excluded. A focused echocardiography with GE Vscan equipment was performed after the initial evaluation in the emergency room. Cardiac chambers dimensions, left and right ventricular systolic function, intracardiac flows with color, pericardium, and aorta were evaluated. Results: The mean age was 61 ± 17 years old. The patient complaint was chest pain in 51 patients, dyspnea in 32 patients, arrhythmia to evaluate the left ventricular function in ten patients, hypotension/dizziness in five patients and edema in one patient. In 28 patients, the focused echocardiography allowed to confirm the initial diagnosis: 19 patients with heart failure, five with acute coronary syndrome, two with pulmonary embolism and two patients with cardiac tamponade. In 17 patients, the echocardiography changed the diagnosis: ten with suspicious of heart failure, two with pulmonary embolism suspicious, two with hypotension without cause, one suspicious of acute coronary syndrome, one of cardiac tamponade and one of aortic dissection. Conclusion: The focused echocardiography with pocket-size equipment in the emergency care may allow a prompt diagnosis and, consequently, an earlier initiation of the therapy.Fundamento: As urgências cardiovasculares são causas importantes de procura por atendimento médico, sendo fundamentais a rapidez e a precisão no diagnóstico para diminuir sua morbimortalidade. Objetivo: Avaliar o uso da ecocardiografia

Nuevas configuraciones económicas en el Asia-Pacífico y sus consecuencias para América Latina: desde el APEC a la Alianza del Pacífico

Directory of Open Access Journals (Sweden)

Isabel Rodríguez Aranda

2014-06-01

Full Text Available Este artículo analiza las nuevas tendencias en la configuración de los espacios de cooperación económica en la región del Asia-Pacífico que se establecen desde 2004 y se expresan en el Acuerdo Transpacífico de Asociación Económica Estratégica, el Acuerdo de Asociación Transpacífico, el Área de Libre Comercio de la Asociación de Naciones del Sudeste Asiático con China, Japón y Corea del Sur, y la Alianza del Pacífico. Se argumenta que, enesta nueva configuración de subregiones estratégicas, se produce una doble dinámica: por un lado, se impulsa una mayor cooperación económica que permita conformar un área de libre comercio regional en la Cuenca del Pacífico y, por otro, se activan dinámicas de rivalidad en función de los intereses de las principales potencias en la región como son Estados Unidos y China en relación con estas subregiones. También se examina la participación de países latinoamericanos como Perú, Chile, México y Colombia en estos acuerdos.

What Is A Picture Archiving And Communication System (PACS)?

Science.gov (United States)

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.

[Effect of dexmedetomidine on emergence agitation after general anesthesia in children undergoing odontotherapy in day-surgery operating room].

Science.gov (United States)

Lin, Luo; Yueming, Zhang; Meisheng, Li; Jiexue, Wang; Yang, Ji

2017-12-01

To study the effectiveness of dexmedetomidine used for general anesthesia maintenance in children undergoing odontotherapy in day-surgery operating room in reducing the incidence of emergence agitation (EA). Eighty children undergoing odontotherapy and under general anesthesia in day-surgery operating room were randomized into two groups, group A (n=40) and group B (n=40). Each patient in group A was administered with a bolus dose of dexmedetomidine (1.0 μg·kg⁻¹, saline diluted to 10 mL) pump-infused after intubation and a maintenance dose of 0.1-0.4 mL·(kg·h)⁻¹ followed-up until 45 min before the end of operation. Each patient in group B was administered with a bolus dose of normal saline 10 mL pump-infused after intubation and maintenance dose of 0.1-0.4 mL·(kg·h)⁻¹ followed-up until 45 min before the end of operation. Gender, age, weight, physical status according to the American Society of Anesthesiologists, perioperative heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO₂), sufentanil dosage, duration of surgery, time of extubation, time of regaining consciousness, and time to reach modified Aldrete's score≥12 were recorded. Behavior in postanesthesia care unit was rated on the four-point agitation scale. Compared with group B, decreases were observed in HR and MAP at the beginning of operation, in 10 and 30 min, 1 and 2 h after the beginning of operation, and after extubation of group A (Pgeneral anesthesia maintenance in children undergoing odontotherapy in day-surgery operating room, dexmedetomidine results in low incidence of EA during recovery and more stable vital signs.

DICOM-compliant PACS with CD-based image archival

Science.gov (United States)

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

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

Science.gov (United States)

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.

Metabolites in Blood for Prediction of Bacteremic Sepsis in the Emergency Room.

Directory of Open Access Journals (Sweden)

Anna M Kauppi

Full Text Available A metabolomics approach for prediction of bacteremic sepsis in patients in the emergency room (ER was investigated. In a prospective study, whole blood samples from 65 patients with bacteremic sepsis and 49 ER controls were compared. The blood samples were analyzed using gas chromatography coupled to time-of-flight mass spectrometry. Multivariate and logistic regression modeling using metabolites identified by chromatography or using conventional laboratory parameters and clinical scores of infection were employed. A predictive model of bacteremic sepsis with 107 metabolites was developed and validated. The number of metabolites was reduced stepwise until identifying a set of 6 predictive metabolites. A 6-metabolite predictive logistic regression model showed a sensitivity of 0.91(95% CI 0.69-0.99 and a specificity 0.84 (95% CI 0.58-0.94 with an AUC of 0.93 (95% CI 0.89-1.01. Myristic acid was the single most predictive metabolite, with a sensitivity of 1.00 (95% CI 0.85-1.00 and specificity of 0.95 (95% CI 0.74-0.99, and performed better than various combinations of conventional laboratory and clinical parameters. We found that a metabolomics approach for analysis of acute blood samples was useful for identification of patients with bacteremic sepsis. Metabolomics should be further evaluated as a new tool for infection diagnostics.

Youth Versus Adult “Weightlifting” Injuries Presenting to United States Emergency Rooms: Accidental Versus Nonaccidental Injury Mechanisms

Science.gov (United States)

Myer, Gregory D.; Quatman, Carmen E.; Khoury, Jane; Wall, Eric J.; Hewett, Timothy E.

2014-01-01

Myer, GD, Quatman, CE, Khoury, J, Wall, EJ, and Hewett, TE. Youth versus adult “weightlifting” injuries presenting to united states emergency rooms: accidental versus nonaccidental injury mechanisms. J Strength Cond Res 23(7): 2054–2060, 2009—Resistance training has previously been purported to be unsafe and ineffective in children. The purpose of this investigation was to evaluate resistance training-related injuries presenting to U.S. emergency rooms by age, type, and mechanism of injury. We hypothesized that older athletes would sustain greater percentages of joint sprains and muscle strains, whereas younger athletes would sustain a greater percentage of accidental injuries that would result in an increased percentage of fractures in youths. The U.S. Consumer Product Safety Commission (CPSC) National Electronic Injury Surveillance System was queried from 2002 to 2005 using the CPSC code for “Weightlifting.” Subjects between the ages of 8 and 30 were grouped by age categories 8 to 13 (elementary/middle school age), 14 to 18 (high school), 19 to 22 (college), and 23 to 30 (adult). Injuries were classified as “accidental” if caused by dropped weight or improper equipment use. Multiple logistic regression was used to compare accidental injuries between age groups. The sample consisted of 4, 111 patients. Accidental injuries decreased (p 14 to 18 > 19 to 22 years = 23 to 30 years. Conversely, sprain/strain injuries increased in each successive age group (p injuries (n = 2, 565) showed that the oldest categories (19–22 and 23–30 yr) demonstrated a greater percentage of sprains and strains relative to younger age categories (p injuries sustained in the 8 to 13 group were to the hand and foot and were most often related to “dropping” and “pinching” in the injury descriptions, and there was an increased percentage of fractures in the 8 to 13 group relative to all other groups (p injuries are the result of accidents that are potentially

Discovering Multimodal Behavior in Ms. Pac-Man through Evolution of Modular Neural Networks.

Science.gov (United States)

Schrum, Jacob; Miikkulainen, Risto

2016-03-12

Ms. Pac-Man is a challenging video game in which multiple modes of behavior are required: Ms. Pac-Man must escape ghosts when they are threats and catch them when they are edible, in addition to eating all pills in each level. Past approaches to learning behavior in Ms. Pac-Man have treated the game as a single task to be learned using monolithic policy representations. In contrast, this paper uses a framework called Modular Multi-objective NEAT (MM-NEAT) to evolve modular neural networks. Each module defines a separate behavior. The modules are used at different times according to a policy that can be human-designed (i.e. Multitask) or discovered automatically by evolution. The appropriate number of modules can be fixed or discovered using a genetic operator called Module Mutation. Several versions of Module Mutation are evaluated in this paper. Both fixed modular networks and Module Mutation networks outperform monolithic networks and Multitask networks. Interestingly, the best networks dedicate modules to critical behaviors (such as escaping when surrounded after luring ghosts near a power pill) that do not follow the customary division of the game into chasing edible and escaping threat ghosts. The results demonstrate that MM-NEAT can discover interesting and effective behavior for agents in challenging games.

HERSCHEL PACS OBSERVATIONS AND MODELING OF DEBRIS DISKS IN THE TUCANA-HOROLOGIUM ASSOCIATION

Energy Technology Data Exchange (ETDEWEB)

Donaldson, J. K. [Department of Astronomy, University of Maryland, College Park, MD 20742 (United States); Roberge, A. [Exoplanets and Stellar Astrophysics Laboratory, NASA Goddard Space Flight Center, Code 667, Greenbelt, MD 20771 (United States); Chen, C. H. [Space Telescope Science Institute, 3700 San Martin Dr., Baltimore, MD 21218 (United States); Augereau, J.-C.; Menard, F. [UJF - Grenoble 1/CNRS-INSU, Institut de Planetologie et d' Astrophysique de Grenoble (IPAG) UMR 5274, Grenoble, F-38041 (France); Dent, W. R. F. [ALMA, Avda Apoquindo 3846, Piso 19, Edificio Alsacia, Las Condes, Santiago (Chile); Eiroa, C.; Meeus, G. [Dpt. Fisica Teorica, Facultad de Ciencias, Universidad Autonoma de Madrid, Cantoblanco, 28049 Madrid (Spain); Krivov, A. V. [Astrophysikalishes Institut, Friedrich-Schiller-Universitaet Jena, Schillergaesschen 2-3, 07745 Jena (Germany); Mathews, G. S. [Institute for Astronomy (IfA), University of Hawaii, 2680 Woodlawn Dr., Honolulu, HI 96822 (United States); Riviere-Marichalar, P. [Centro de Astrobiologia Depto. Astrofisica (CSIC-INTA), POB 78, 28691 Villanueva de la Canada (Spain); Sandell, G., E-mail: jessd@astro.umd.edu [SOFIA-USRA, NASA Ames Research Center, Building N232, Rm. 146, Moffett Field, CA 94035 (United States)

2012-07-10

We present Herschel PACS photometry of 17 B- to M-type stars in the 30 Myr old Tucana-Horologium Association. This work is part of the Herschel Open Time Key Programme 'Gas in Protoplanetary Systems'. 6 of the 17 targets were found to have infrared excesses significantly greater than the expected stellar IR fluxes, including a previously unknown disk around HD30051. These six debris disks were fitted with single-temperature blackbody models to estimate the temperatures and abundances of the dust in the systems. For the five stars that show excess emission in the Herschel PACS photometry and also have Spitzer IRS spectra, we fit the data with models of optically thin debris disks with realistic grain properties in order to better estimate the disk parameters. The model is determined by a set of six parameters: surface density index, grain size distribution index, minimum and maximum grain sizes, and the inner and outer radii of the disk. The best-fitting parameters give us constraints on the geometry of the dust in these systems, as well as lower limits to the total dust masses. The HD105 disk was further constrained by fitting marginally resolved PACS 70 {mu}m imaging.

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

Science.gov (United States)

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.

Gel-sphere-pac reactor fuel fabrication and its application to a variety of fuels

International Nuclear Information System (INIS)

Olsen, A.R.; Judkins, R.R.

1979-12-01

The gel-sphere-pac fuel fabrication option was evaluated for its possible application to commercial scale fuel fabrication for 19 fuel element designs that use oxide fuel in metal clad rods. The dry gel spheres are prepared at the reprocessing plant and are then calcined, sintered, inspected, and loaded into fuel rods and packed by low-energy vibration. A fuel smear density of 83 to 88% theoretical can be obtained. All fuel fabrication process steps were defined and evaluated from fuel receiving to finished fuel element shipping. The evaluation also covers the feasibility of the process, the current status of technology, estimates of the required time and cost to develop the technology to commercial status, and the safety and licensability of commercial scale plants. The primary evaluation was for a Light-Water Reactor fuel element containing (U,Pu)O 2 fuel. The other 18 fuel element types - 3 for Light-Water Reactors, 1 for a Heavy-Water Reactor, 1 for a Gas-Cooled Fast Reactor, 7 for Liquid-Metal-Cooled Fast Breeder Reactors, and 3 pairs for Light-Water Prebreeder and Breeder Reactors - were compared with the Light-Water Reactor. The gel-sphere-pac option was found applicable to 17 of the 19 element types; the characteristics of a commercial scale plant were defined for these for making cost estimates for such plants. The evaluation clearly shows the gel-sphere-pac process to be a viable fuel fabrication option. Estimates indicate a significant potential fabrication cost advantage for the gel-sphere-pac process if a remotely operated and remotely maintained fuel fabrication plant is required

PacIOOS Nearshore Sensor 03 (NS03): Hilton Hawaiian Pier, Oahu, Hawaii

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

PacIOOS Nearshore Sensor 01 (NS01): Waikiki Yacht Club, Oahu, Hawaii

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

PacIOOS Nearshore Sensor 02 (NS02): Hawaii Yacht Club, Oahu, Hawaii

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

PacIOOS Nearshore Sensor 12 (NS12): Kalama Beach Park, Maui, Hawaii

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The nearshore sensors are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed point...

Minimally Clinically Important Change in the Activity Measure for Post-Acute Care (AM-PAC), a Generic Patient-Reported Outcome Tool, in People With Low Back Pain.

Science.gov (United States)

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

Use of the emergency room in Elliot Lake, a rural community of Northern Ontario, Canada.

Science.gov (United States)

Harris, L; Bombin, M; Chi, F; DeBortoli, T; Long, J

2004-01-01

There is ample documentation that use of hospital emergency facilities for reasons other than urgencies/emergencies results in clogged services in many urban centers. However, little has been published about similar misuse of emergency rooms/departments in rural and remote areas, where the situation is usually compounded by a scarcity of healthcare professionals. In Canada there is a shortage of physicians in rural and remote areas as a consequence of misdistribution (most physicians staying in southern urban centers after residence), and there is a chronic misuse of facilities meant for urgencies/emergencies to cope with primary healthcare needs. We address the problem in Elliot Lake, a rural Northern Ontario community of 12,000 people. The economy of Elliot Lake was based on uranium mining until the mid-1990s, when it drastically changed to become a center for affordable retirement and recreational tourism. As a consequence, at the present time the proportion of seniors in Elliot Lake doubles the Canadian average. Our objectives are to elucidate the demographics of emergency room (ER) clients and the effect of the elderly population; the nature of ER use; the perceived level of urgency of clients versus health professionals; and possible alternatives offered to non-urgent/emergency visits. This is the first study of the kind in Northern Ontario, a region the size of France. The study, conducted in July 2001, used a prospective survey, completed by patients and attending clinicians at the time of a patient's presentation to the ER of St Joseph's General Hospital. This hospital is staffed by family physicians, a nurse practitioner, and registered nurses (RNs). The catchment area population (town plus surrounding areas) of the hospital is approximately 18,000 people. ER clients were interviewed verbally, and the attending health professionals responded to written questionnaires. Demographics were recorded (age, sex, employment and marital status), as was each client

Intraoperative and recovery room outcome | Edomwonyi | East ...

African Journals Online (AJOL)

Objectives: To identify and quantitate anaesthesia related complications in the intraoperative period and in the post anaesthesia recovery room. Design: A prospective study. Setting: University of Benin Teaching Hospital; a University - affiliated tertiary centre. Subjects: Patients scheduled for elective and emergency surgery ...

A comparison of the time required by radiologists for the preparation of clinico-radiological meetings when film and PACS are used

International Nuclear Information System (INIS)

Weatherburn, G.; Bryan, S.; Cousins, C.

2000-01-01

The hypothesis was that when a hospital-wide Picture Archive and Communications System (PACS) is used, preparation for clinico-radiological meetings is faster, and more images are available, than when a conventional film system is used. This paper reports a study which compared the preparation time by radiologists when film was used with the time for the same activity when a hospital-wide PACS was used at Hammersmith Hospital for the preparation of the respiratory medicine and hepato-biliary meetings. It was found that when PACS was used the time per patient to prepare for the respiratory medicine session was reduced by 11.1 min and that similarly, 16 min per patient was saved in the preparation of the hepato-biliary sessions. The number of images which were unavailable for the session was reduced when PACS was in operation, but this reduction was not shown to be statistically significant. The introduction of PACS at Hammersmith Hospital has significantly reduced the time spent by radiologists in preparing for the two clinico-radiological sessions studied and, if this is extended to the other numerous sessions held each week, contributes to a considerable saving of staff time within the radiology department. (orig.)

PacIOOS Water Quality Buoy AW (WQB-AW): Ala Wai, Oahu, Hawaii

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The water quality buoys are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed points....

PacIOOS Water Quality Buoy KN (WQB-KN): Kilo Nalu, Oahu, Hawaii

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The water quality buoys are part of the Pacific Islands Ocean Observing System (PacIOOS) and are designed to measure a variety of ocean parameters at fixed points....

Guidelines for control room design reviews

International Nuclear Information System (INIS)

1981-09-01

whether the control room provides the system status information, control capabilities, feedback, and analytic aids necessary for control room operators to accomplish their functions effectively. To identify characteristics of the existing control room instrumentation, controls, other equipment, and physical arrangements that may detract from operator performance. o analyze and evaluate the problems that could arise from discrepancies of the above kinds, and to analyze means of correcting those discrepancies which could lead to substantial problems. To define and put into effect a plan of action that applies human factors principles to improve control room design and enhance operator effectiveness. Particular emphasis should be placed on improvements affecting control room design and operator performance under abnormal or emergency conditions. To integrate the control room design review with other areas of human factors inquiry identified in the NRC Task Action Plan

Experimental Study of RailPAc Plasma Actuator for High-Authority Aerodynamic Flow Control in One Atmosphere

Science.gov (United States)

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

2014-10-01

Dielectric barrier discharge (DBD) actuators, a type of electrohydrodynamic (EHD) plasma actuator, have generated considerable interest in recent years. However, theoretical performance limitations hinder their application for high speed flows. Magnetohydrodynamic (MHD) plasma actuators with higher control authority circumvent these limitations, offering an excellent alternative. The rail plasma actuator (RailPAc) is an MHD actuator which uses Lorentz force to impart momentum to the surrounding air. RailPAc functions by generating a fast propagating arc column between two rail electrodes that accelerate the arc through J × B forces in a self-induced B-field. The arc column drags the surrounding air to induce aerodynamic flow motion. Our study of the RailPAc will include a description of the transient arc discharge structure through high-speed imaging and a description of the arc composition and temperature through time-resolved emission spectroscopy. Time-resolved force measurements quantify momentum transfer from the arc to the surrounding air and provides a direct measure of the actuator control authority.

Light hadron spectrum from quenched lattice QCD. Results from the CP-PACS

International Nuclear Information System (INIS)

Yoshie, Tomoteru

2001-01-01

Deriving the light hadron spectrum from first principles of QCD has been a fundamental issue in elementary particle physics since the mid-1970s, when QCD was established. With this goal in mind, we have carried out large-scale simulations of lattice QCD on the CP-PACS computer. In this article, we present results for the light hadron spectrum derived in the quenched approximation to lattice QCD. We find that although the global structure of the observed spectrum is reproduced, the quenched spectrum systematically deviates from experiment when examined with an accuracy at better than a 10% level. Results for light quark masses are also reported. Another simulation of full QCD done recently (also on the CP-PACS computer) shows indications that the discrepancy observed in quenched QCD is significantly reduced by the introduction of two flavors of light dynamical quarks. (author)

Effect of PACS/CR on cost of care and length of stay in a medical intensive care unit

Science.gov (United States)

Langlotz, Curtis P.; Kundel, Harold L.; Brikman, Inna; Pratt, Hugh M.; Redfern, Regina O.; Horii, Steven C.; Schwartz, J. Sanford

1996-05-01

Our purpose was to determine the economic effects associated with the introduction of PACS and computed radiology (CR) in a medical intensive care unit (MICU). Clinical and financial data were collected over a period of 6 months, both before and after the introduction of PACS/CR in our medical intensive care unit. Administrative claims data resulting from the MICU stay of each patient enrolled in our study were transferred online to our research database from the administrative databases of our hospital and its affiliated clinical practices. These data included all charge entries, sociodemographic data, admissions/discharge/transfer chronologies, ICD9 diagnostic and procedure codes, and diagnostic related groups. APACHE III scores and other case mix adjusters were computed from the diagnostic codes, and from the contemporaneous medical record. Departmental charge to cost ratios and the Medicare Resource-Based Relative Value Scale fee schedule were used to estimate costs from hospital and professional charges. Data were analyzed using both the patient and the exam as the unit of analysis. Univariate analyses by patient show that patients enrolled during the PACS periods were similar to those enrolled during the Film periods in age, sex, APACHE III score, and other measures of case mix. No significant differences in unadjusted median length of stay between the two Film and two PACS periods were detected. Likewise, no significant differences in unadjusted total hospital and professional costs were found between the Film and PACS periods. In our univariate analyses by exam, we focused on the subgroup of exams that had triggered primary clinical actions in any period. Those action-triggering exams were divided into two groups according to whether the referring clinician elected to obtain imaging results from the workstation or from the usual channels. Patients whose imaging results were obtain from the workstation had significantly lower professional costs in the 7 days

A simulator-based nuclear reactor emergency response training exercise.

Science.gov (United States)