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Sample records for post-acute care pac

  1. Cultural and semantic equivalence of the activity measure post-acute care (AM-PAC) after its translation into Mandarin Chinese.

    Science.gov (United States)

    Chang, Feng-Hang; Ni, Pengsheng; Chiou, Hung-Yi; Hou, Wen-Hsuan; Jette, Alan M

    2018-03-21

    The purpose of this study was to investigate the cultural and semantic equivalence of the Activity Measure Post-Acute Care (AM-PAC) outpatient short forms after they were translated from American English to Mandarin Chinese. This study was conducted with a composite sample of a group of 483 American adults (mean age 63.1 years, 42.4% males) and 553 Taiwanese adults (mean age 60.6 years, 47.2% males) who were undergoing home care or outpatient rehabilitation services. A confirmatory factor analysis tested the cultural equivalence of the AM-PAC dimensions between the US and Taiwanese samples. Semantic equivalence was tested through an item response theory-based differential item functioning (DFI) analysis. Results of the confirmatory factor analysis demonstrated good model-data fit of the AM-PAC in both the US and Taiwanese samples. Significant DFI was found for six Basic Mobility items, two Daily Activity items, and four Applied Cognition items. A DFI-adjusted conversion table was generated to transform the raw scores of the measure for comparisons between the two countries. This study provides evidence to support the conceptual equivalence of the AM-PAC when used in rehabilitation patients between American and Taiwanese cultural contexts. Some DFI items between the two groups were found, suggesting that some differences in semantic understanding of these items between cultures require cross-cultural adjustments. Implications for Rehabilitation Cultural equivalence needs to be tested before applying a clinical measure to another context. The findings of this study supported the three activity domains that the Activity Measure Post-Acute Care measures: Basic Mobility, Daily Activity, and Applied Cognition, which are all important rehabilitation outcomes that need to be assessed and monitored across rehabilitation settings. Differential item functioning was observed between the English and Chinese versions of the Activity Measure Post-Acute Care, indicating that

  2. 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

  3. Adaptation of the Activity Measure Post-Acute Care (AM-PAC) from English to Mandarin using the dual-panel translation approach

    DEFF Research Database (Denmark)

    Chang, Feng-Hang; Liou, Tsan-Hon; Brodersen, John

    2017-01-01

    translated using the dual-panel method. The translated AM-PAC was tested in 550 Chinese-speaking rehabilitation outpatients. Floor and ceiling effects were evaluated and internal consistency was assessed using Cronbach's alpha. Spearman correlation was used to assess the concurrent validity of the AM...

  4. Octogenarians' post-acute care use after cardiac valve surgery and recovery: clinical implications.

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    Edmiston, Elizabeth; Dolansky, Mary A; Zullo, Melissa; Forman, Daniel E

    2017-12-21

    Octogenarians receiving cardiac valve surgery is increasing and recovery is challenging. Post-acute care (PAC) services assist with recovery, yet services provided in facilities do not provide adequate cardiac-focused care or long-term self-management support. The purpose of the paper was to report post-acute care discharge rates in octogenarians and propose clinical implications to improve PAC services. Using a 2003 Medicare Part A database, we studied post-acute care service use in octogenarians after cardiac valve surgery. We propose expansion of the Geriatric Cardiac Care model to include broader clinical therapy dynamics. The sample (n = 10,062) included patients over 80 years discharged from acute care following valve surgery. Post-acute care services were used by 68% of octagarians following cardiac valve surgery (1% intermediate rehabilitation, 35% skilled nursing facility, 32% home health). The large percentage of octagarians using PAC point to the importance of integrating geriatric cardiac care into post-acute services to optimize recovery outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. [A Delphi Method Survey of the Core Competences of Post-Acute-Care Nurses in Caring for Acute Stroke Patients].

    Science.gov (United States)

    Chi, Shu-Ching; Yeh, Lily; Lu, Meei-Shiow; Lin, Pei-Yu

    2015-12-01

    Post-acute care (PAC) service is becoming increasingly important in Taiwan as a core focus of government policies that are designed to ensure continuity of care. In order to improve PAC nursing education and quality of care, the present study applies a modified Delphi method to identify the core competences of nurses who provide PAC services to acute stroke patients. We surveyed 18 experts in post-acute care and long-term care anonymously using a 29-question questionnaire in order to identify the essential professional skills that are required to perform PAC effectively. The results of this survey indicate that the core competences of PAC may be divided into two categories: Case Management and Care Management. Case Management includes Direct Care, Communication, Health Care Education, Nursing Consulting, and Family Assessment & Health Care. Care Management includes Interdisciplinary Teamwork, Patient Care Management, and Resource Integration. The importance and practicality of each item was evaluated using a 7-point Likert scale. The experts required 2 rounds to reach a consensus about the importance and 3 rounds to determine the practicality of PAC core competences. This process highlighted the differing points of view that are held by professionals in the realms of nursing, medicine, and national health policy. The PAC in-job training program in its current form inadequately cul-tivates core competence in Care Management. The results of the present study may be used to inform the development of PAC nurse orientation training programs and continuing education courses.

  6. Medicare Post-Acute Care Episodes and Payment Bundling

    Data.gov (United States)

    U.S. Department of Health & Human Services — Published in Volume 4, Issue 1, of Medicare and Medicaid Research Review, this paper provides an overview of results examining alternative Medicare post-acute care...

  7. Hospital to Post-Acute Care Facility Transfers: Identifying Targets for Information Exchange Quality Improvement.

    Science.gov (United States)

    Jones, Christine D; Cumbler, Ethan; Honigman, Benjamin; Burke, Robert E; Boxer, Rebecca S; Levy, Cari; Coleman, Eric A; Wald, Heidi L

    2017-01-01

    Information exchange is critical to high-quality care transitions from hospitals to post-acute care (PAC) facilities. We conducted a survey to evaluate the completeness and timeliness of information transfer and communication between a tertiary-care academic hospital and its related PAC facilities. This was a cross-sectional Web-based 36-question survey of 110 PAC clinicians and staff representing 31 PAC facilities conducted between October and December 2013. We received responses from 71 of 110 individuals representing 29 of 31 facilities (65% and 94% response rates). We collapsed 4-point Likert responses into dichotomous variables to reflect completeness (sufficient vs insufficient) and timeliness (timely vs not timely) for information transfer and communication. Among respondents, 32% reported insufficient information about discharge medical conditions and management plan, and 83% reported at least occasionally encountering problems directly related to inadequate information from the hospital. Hospital clinician contact information was the most common insufficient domain. With respect to timeliness, 86% of respondents desired receipt of a discharge summary on or before the day of discharge, but only 58% reported receiving the summary within this time frame. Through free-text responses, several participants expressed the need for paper prescriptions for controlled pain medications to be sent with patients at the time of transfer. Staff and clinicians at PAC facilities perceive substantial deficits in content and timeliness of information exchange between the hospital and facilities. Such deficits are particularly relevant in the context of the increasing prevalence of bundled payments for care across settings as well as forthcoming readmissions penalties for PAC facilities. Targets identified for quality improvement include structuring discharge summary information to include information identified as deficient by respondents, completion of discharge summaries

  8. Perspectives of Post-Acute Transition of Care for Cardiac Surgery Patients

    Directory of Open Access Journals (Sweden)

    Nicoleta Stoicea

    2017-11-01

    Full Text Available Post-acute care (PAC facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes, specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR services, caregiver burden, and the financial impact of care. The objective of this review is to examine existing models of cardiac transitional care, identify major challenges and social factors that affect PAC, and analyze the impact of current transitional care efforts and strategies implemented to improve health outcomes in this patient population. We intend to discuss successful methods to address the following aspects: hospital-PAC linkages, improved discharge planning, caregiver burden, and CR access and utilization through patient-centered programs. Regular home visits by healthcare providers result in decreased hospital readmission rates for patients utilizing home healthcare while improved hospital-PAC linkages reduced hospital readmissions by 25%. We conclude that widespread adoption of improvements in transitional care will play a key role in patient recovery and decrease hospital readmission, morbidity, and mortality.

  9. Why older adults may decline offers of post-acute care services: A qualitative descriptive study.

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    Sefcik, Justine S; Ritter, Ashley Z; Flores, Emilia J; Nock, Rebecca H; Chase, Jo-Ana D; Bradway, Christine; Potashnik, Sheryl; Bowles, Kathryn H

    The most common post-acute care (PAC) services available to patients after hospital discharge include home care, skilled nursing facilities, nursing homes, inpatient rehabilitation, and hospice. Patients who need PAC and receive services have better outcomes, however almost one-third of those offered services decline. Little research exists on PAC decision-making and why patients may decline services. This qualitative descriptive study explored the responses of thirty older adults to the question: "Can you, from the patient point of view, tell me why someone would not want post hospital care?" Three themes emerged. Participants may decline due to 1) previous negative experiences with PAC, or 2) a preference to be home. Some participants stated, "I'd be there" and would not decline services. Participants also discussed 3) why other patients might decline PAC which included patients' past experiences, lack of understanding/preconceived ideas, and preferences. Clinical implications include assessing patients' knowledge and experience before providing recommendations. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Rethinking transitions of care: An interprofessional transfer triage protocol in post-acute care.

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    Patel, Radha V; Wright, Lauri; Hay, Brittany

    2017-09-01

    Readmissions to hospitals from post-acute care (PAC) units within long-term care settings have been rapidly increasing over the past decade, and are drivers of increased healthcare costs. With an average of $11,000 per admission, there is a need for strategies to reduce 30-day preventable hospital readmission rates. In 2018, incentives and penalties will be instituted for long-term care facilities failing to meet all-cause, all-condition hospital readmission rate performance measures. An interprofessional team (IPT) developed and implemented a Transfer Triage Protocol used in conjunction with the INTERACT programme to enhance clinical decision-making and assess the potential to reduce the facility's 30-day preventable hospital readmission rates by 10% within 6 weeks of implementation. Results from quantitative analysis demonstrated an overall 35.2% reduction in the 30-day preventable hospital readmission rate. Qualitative analysis revealed the need for additional staff education, improved screening and communication upon admission and prior to hospital transfer, and the need for more IPT on-site availability. This pilot study demonstrates the benefits and implications for practice of an IPT to improve the quality of care within PAC and decrease 30-day preventable hospital readmissions.

  11. Medicare's post-acute care payment: a review of the issues and policy proposals.

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    Linehan, Kathryn

    2012-12-07

    Medicare spending on post-acute care provided by skilled nursing facility providers, home health providers, inpatient rehabilitation facility providers, and long-term care hospitals has grown rapidly in the past several years. The Medicare Payment Advisory Commission and others have noted several long-standing problems with the payment systems for post-acute care and have suggested refinements to Medicare's post-acute care payment systems that are intended to encourage the delivery of appropriate care in the right setting for a patient's condition. The Patient Protection and Affordable Care Act of 2010 contained several provisions that affect the Medicare program's post-acute care payment systems and also includes broader payment reforms, such as bundled payment models. This issue brief describes Medicare's payment systems for post-acute care providers, evidence of problems that have been identified with the payment systems, and policies that have been proposed or enacted to remedy those problems.

  12. The effect of integration of hospitals and post-acute care providers on Medicare payment and patient outcomes.

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    Konetzka, R Tamara; Stuart, Elizabeth A; Werner, Rachel M

    2018-02-07

    In this paper we examine empirically the effect of integration on Medicare payment and rehospitalization. We use 2005-2013 data on Medicare beneficiaries receiving post-acute care (PAC) in the U.S. to examine integration between hospitals and the two most common post-acute care settings: skilled nursing facilities (SNFs) and home health agencies (HHA), using two measures of integration-formal vertical integration and informal integration representing preferential relationships between providers without formal relationships. Our identification strategy is twofold. First, we use longitudinal models with a fixed effect for each hospital-PAC pair in a market to test how changes in integration impact patient outcomes. Second, we use an instrumental variable approach to account for patient selection into integrated providers. We find that vertical integration between hospitals and SNFs increases Medicare payments and reduces rehospitalization rates. However, vertical integration between hospitals and HHAs has little effect, nor does informal integration between hospitals and either PAC setting. Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.

  13. Post-acute care disparities in total joint arthroplasty.

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    Lan, Roy H; Kamath, Atul F

    2017-09-01

    Understanding the socioeconomic factors that influence hospitalization and post-discharge metrics after joint replacement is important for identifying key areas of improvement in the delivery of orthopaedic care. An institutional administrative data set of 2869 patients from an academic arthroplasty referral center was analyzed to quantify the relationship between socioeconomic factors and post-acute rehabilitation care received, length of stay, and cost of care. The study used International Classification of Disease, ninth edition coding in order to identify cohorts of patients who received joint arthroplasty of the knee and hip between January 2007 and May 2015. The study found that females (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.74-2.46), minorities (OR, 2.11; 95% CI, 1.78-2.51), and non-private insurance holders (OR, 1.56; 95% CI, 1.26-1.94) were more likely to be assigned to institutional care after discharge. The study also found that minorities (OR, 1.45; 95% CI, 1.24-1.70) and non-private insurance holders (OR, 1.43; 95% CI, 1.16-1.77) are more likely to exhibit longer length of stay. Mean charges were higher for males when compared to females ($80,010 vs $74,855; P total costs ($19,910 vs $18,613; P  = .001). Socioeconomic factors such as gender, race, and insurance status should be further explored with respect to healthcare policies seeking to influence quality of care and health outcomes.

  14. Bundling Post-Acute Care Services into MS-DRG Payments

    Data.gov (United States)

    U.S. Department of Health & Human Services — A bundled hospital payment system that encompasses both acute and post-acute care has been proposed as a means of creating financial incentives in the Medicare...

  15. Post-acute care and vertical integration after the Patient Protection and Affordable Care Act.

    Science.gov (United States)

    Shay, Patrick D; Mick, Stephen S

    2013-01-01

    The anticipated changes resulting from the passage of the Patient Protection and Affordable Care Act-including the proposed adoption of bundled payment systems and the promotion of accountable care organizations-have generated considerable controversy as U.S. healthcare industry observers debate whether such changes will motivate vertical integration activity. Using examples of accountable care organizations and bundled payment systems in the American post-acute healthcare sector, this article applies economic and sociological perspectives from organization theory to predict that as acute care organizations vary in the degree to which they experience environmental uncertainty, asset specificity, and network embeddedness, their motivation to integrate post-acute care services will also vary, resulting in a spectrum of integrative behavior.

  16. Effects of payment changes on trends in post-acute care.

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    Buntin, Melinda Beeuwkes; Colla, Carrie Hoverman; Escarce, José J

    2009-08-01

    To test how the implementation of new Medicare post-acute payment systems affected the use of inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and home health agencies. Medicare acute hospital, IRF, and SNF claims; provider of services file; enrollment file; and Area Resource File data. We used multinomial logit models to measure realized access to post-acute care and to predict how access to alternative sites of care changed in response to prospective payment systems. A file was constructed linking data for elderly Medicare patients discharged from acute care facilities between 1996 and 2003 with a diagnosis of hip fracture, stroke, or lower extremity joint replacement. Although the effects of the payment systems on the use of post-acute care varied, most reduced the use of the site of care they directly affected and boosted the use of alternative sites of care. Payment system changes do not appear to have differentially affected the severely ill. Payment system incentives play a significant role in determining where Medicare beneficiaries receive their post-acute care. Changing these incentives results in shifting of patients between post-acute sites.

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

    Science.gov (United States)

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

    2015-01-01

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

  18. Patient Hand Colonization With MDROs Is Associated with Environmental Contamination in Post-Acute Care.

    Science.gov (United States)

    Patel, Payal K; Mantey, Julia; Mody, Lona

    2017-09-01

    We assessed multidrug-resistant organism (MDRO) patient hand colonization in relation to the environment in post-acute care to determine risk factors for MDRO hand colonization. Patient hand colonization was significantly associated with environmental contamination. Risk factors for hand colonization included disability, urinary catheter, recent antibiotic use, and prolonged hospital stay. Infect Control Hosp Epidemiol 2017;38:1110-1113.

  19. Associations between preoperative physical therapy and post-acute care utilization patterns and cost in total joint replacement.

    Science.gov (United States)

    Snow, Richard; Granata, Jaymes; Ruhil, Anirudh V S; Vogel, Karen; McShane, Michael; Wasielewski, Ray

    2014-10-01

    Health-care costs following acute hospital care have been identified as a major contributor to regional variation in Medicare spending. This study investigated the associations of preoperative physical therapy and post-acute care resource use and its effect on the total cost of care during primary hip or knee arthroplasty. Historical claims data were analyzed using the Centers for Medicare & Medicaid Services Limited Data Set files for Diagnosis Related Group 470. Analysis included descriptive statistics of patient demographic characteristics, comorbidities, procedures, and post-acute care utilization patterns, which included skilled nursing facility, home health agency, or inpatient rehabilitation facility, during the ninety-day period after a surgical hospitalization. To evaluate the associations, we used bivariate and multivariate techniques focused on post-acute care use and total episode-of-care costs. The Limited Data Set provided 4733 index hip or knee replacement cases for analysis within the thirty-nine-county Medicare hospital referral cluster. Post-acute care utilization was a significant variable in the total cost of care for the ninety-day episode. Overall, 77.0% of patients used post-acute care services after surgery. Post-acute care utilization decreased if preoperative physical therapy was used, with only 54.2% of the preoperative physical therapy cohort using post-acute care services. However, 79.7% of the non-preoperative physical therapy cohort used post-acute care services. After adjusting for demographic characteristics and comorbidities, the use of preoperative physical therapy was associated with a significant 29% reduction in post-acute care use, including an $871 reduction of episode payment driven largely by a reduction in payments for skilled nursing facility ($1093), home health agency ($527), and inpatient rehabilitation ($172). The use of preoperative physical therapy was associated with a 29% decrease in the use of any post-acute care

  20. Evaluating the Quality of Patient Decision-Making Regarding Post-Acute Care.

    Science.gov (United States)

    Burke, Robert E; Jones, Jacqueline; Lawrence, Emily; Ladebue, Amy; Ayele, Roman; Leonard, Chelsea; Lippmann, Brandi; Matlock, Daniel D; Allyn, Rebecca; Cumbler, Ethan

    2018-05-01

    Despite a national focus on post-acute care brought about by recent payment reforms, relatively little is known about how hospitalized older adults and their caregivers decide whether to go to a skilled nursing facility (SNF) after hospitalization. We sought to understand to what extent hospitalized older adults and their caregivers are empowered to make a high-quality decision about utilizing an SNF for post-acute care and what contextual or process elements led to satisfaction with the outcome of their decision once in SNF. Qualitative inquiry using the Ottawa Decision Support Framework (ODSF), a conceptual framework that describes key components of high-quality decision-making. Thirty-two previously community-dwelling older adults (≥ 65 years old) and 22 caregivers interviewed at three different hospitals and three skilled nursing facilities. We used key components of the ODSF to identify elements of context and process that affected decision-making and to what extent the outcome was characteristic of a high-quality decision: informed, values based, and not associated with regret or blame. The most important contextual themes were the presence of active medical conditions in the hospital that made decision-making difficult, prior experiences with hospital readmission or SNF, relative level of caregiver support, and pressure to make a decision quickly for which participants felt unprepared. Patients described playing a passive role in the decision-making process and largely relying on recommendations from the medical team. Patients commonly expressed resignation and a perceived lack of choice or autonomy, leading to dissatisfaction with the outcome. Understanding and intervening to improve the quality of decision-making regarding post-acute care supports is essential for improving outcomes of hospitalized older adults. Our results suggest that simply providing information is not sufficient; rather, incorporating key contextual factors and improving the

  1. Post-Acute Care Facility as a Discharge Destination for Patients in Need of Palliative Care in Brazil.

    Science.gov (United States)

    Soares, Luiz Guilherme L; Japiassu, André M; Gomes, Lucia C; Pereira, Rogéria

    2018-02-01

    Patients with complex palliative care needs can experience delayed discharge, which causes an inappropriate occupancy of hospital beds. Post-acute care facilities (PACFs) have emerged as an alternative discharge destination for some of these patients. The aim of this study was to investigate the frequency of admissions and characteristics of palliative care patients discharged from hospitals to a PACF. We conducted a retrospective analysis of PACF admissions between 2014 and 2016 that were linked to hospital discharge reports and electronic health records, to gather information about hospital-to-PACF transitions. In total, 205 consecutive patients were discharged from 6 different hospitals to our PACF. Palliative care patients were involved in 32% (n = 67) of these discharges. The most common conditions were terminal cancer (n = 42, 63%), advanced dementia (n = 17, 25%), and stroke (n = 5, 8%). During acute hospital stays, patients with cancer had significant shorter lengths of stay (13 vs 99 days, P = .004), a lower use of intensive care services (2% vs 64%, P care. Further studies are necessary to understand the trajectory of posthospitalized patients with life-limiting illnesses and what factors influence their decision to choose a PACF as a discharge destination and place of death. We advocate that palliative care should be integrated into the portfolio of post-acute services.

  2. Building on a national health information technology strategic plan for long-term and post-acute care: comments by the Long Term Post Acute Care Health Information Technology Collaborative.

    Science.gov (United States)

    Alexander, Gregory L; Alwan, Majd; Batshon, Lynne; Bloom, Shawn M; Brennan, Richard D; Derr, John F; Dougherty, Michelle; Gruhn, Peter; Kirby, Annessa; Manard, Barbara; Raiford, Robin; Serio, Ingrid Johnson

    2011-07-01

    The LTPAC (Long Term Post Acute Care) Health Information Technology (HIT) Collaborative consists of an alliance of long-term services and post-acute care stakeholders. Members of the collaborative are actively promoting HIT innovations in long-term care settings because IT adoption for health care institutions in the United States has become a high priority. One method used to actively promote HIT is providing expert comments on important documents addressing HIT adoption. Recently, the Office of the National Coordinator for HIT released a draft of the Federal Health Information Technology Strategic Plan 2011-2015 for public comment. The following brief is intended to inform about recommendations and comments made by the Collaborative on the strategic plan. Copyright 2011, SLACK Incorporated.

  3. Nutritional variables predict chances of returning home and activities of daily living in post-acute geriatric care

    Science.gov (United States)

    Maeda, Keisuke; Koga, Takayuki; Akagi, Junji

    2018-01-01

    Background Little is known about the association between malnutrition and the chances of returning home from post-acute facilities in older adult patients. This study aimed to understand whether malnutrition and malnutrition-related factors would be determinants for returning home and activities of daily living (ADL) at discharge after post-acute care. Methods Patients aged ≥65 years living at home before the onset of an acute disease and admitted to a post-acute ward were enrolled (n=207) in this prospective observational study. Malnutrition was defined based on the criteria of the European Society for Clinical Nutrition and Metabolism. Nutritional parameters included the nutritional intake at the time of admission and oral conditions evaluated by the Oral Health Assessment Tool (OHAT). The Barthel Index was used to assess daily activities. A Cox regression analysis of the length of stay was performed. Multivariable linear regression analyses to determine associations between malnutrition, returning home, and ADL at discharge were performed, after adjusting the variables of acute care setting. Results The mean patient age was 84.7±6.7 years; 38% were men. European Society for Clinical Nutrition and Metabolism-defined malnutrition was observed in 129 (62.3%) patients, and 118 (57.0%) of all patients returned home. Multivariable regression analyses showed that malnutrition was a negative predictor of returning home (hazard ratio: 0.517 [0.351–0.761], p=0.001), and an increase in the nutritional intake (kcal/kg/d) was a positive predictor of the Barthel Index at discharge (coefficient: 0.34±0.15, p=0.021). The OHAT was not associated with returning home and ADL. Conclusion Malnutrition and nutritional intake are associated with returning home and ADL at discharge, respectively, after post-acute care. Further studies investigating the effects of a nutritional intervention for post-acute patients would be necessary. PMID:29416323

  4. Using denosumab to treat immobilization hypercalcemia in a post-acute care patient.

    Science.gov (United States)

    Booth, Katrina A; Hays, Clare I

    2014-10-01

    Hypercalcemia in adults has several less common causes. Management in patients with chronic kidney disease (CKD) is challenging because bisphosphonates are contraindicated. This case presents an uncommon cause of hypercalcemia in a subacute rehabilitation patient who was managed with denosumab. A 79-year-old female with CKD stage 4 was admitted to a skilled nursing facility with a limited-weight-bearing status after right-hip arthroplasty. Four weeks later, she developed hypercalcemia (11.5 mg/dL; normal, 7.9-9.9 mg/dL) with serum albumin of 2.5 g/dL (corrected calcium, 12.7 mg/dL). Despite iv fluids, hypercalcemia worsened (corrected serum calcium, 14.5 mg/dL), and she was rehospitalized. Additional studies eliminated common causes of hypercalcemia, leading to the diagnosis of immobilization hypercalcemia. Due to CKD, a bisphosphonate was not given. She received 10 doses of calcitonin s.c. with mild improvement in her calcium, and she returned to the skilled nursing facility. Because hypercalcemia worsened within days, denosumab 60 mg was administered s.c., and her serum calcium level normalized. Over the next several weeks, her surgical wound worsened. Hip x-ray showed osteolysis of her residual right femoral head. In retrospect, hip x-ray during her hospitalization for hypercalcemia showed osteolysis, likely from osteomyelitis. A contribution of osteomyelitis to hypercalcemia could not be excluded. Despite resolution of hypercalcemia, she succumbed to sepsis. Immobilization hypercalcemia is underappreciated in post-acute care older adults. In this patient with CKD, denosumab reversed her hypercalcemia; however, the case highlights potential risks and limitations with this therapy and emphasizes the need for further studies in medically complex older adults.

  5. The relationship of post-acute home care use to Medicaid utilization and expenditures.

    Science.gov (United States)

    Payne, Susan M C; DiGiuseppe, David L; Tilahun, Negussie

    2002-06-01

    To describe the use of post-acute home care (PAHC) and total Medicaid expenditures among hospitalized nonelderly adult Medicaid eligibles and to test whether health services utilization rates or total Medicaid expenditures were lower among Medicaid eligibles who used PAHC compared to those who did not. 5,299 Medicaid patients aged 18-64 discharged in 1992-1996 from 29 hospitals in the Cleveland Health Quality Choice (CHQC) project. Linked Ohio Medicaid claims and CHQC medical record abstract data. One stay per patient was randomly selected. Observational study. To control for treatment selection bias, we developed a model predicting the probability (propensity) a patient would be referred to PAHC, as a proxy for the patient's need for PAHC. We matched 430 patients who used Medicaid-covered PAHC ("USE") to patients who did not ("NO USE") by their propensity scores. Study outcomes were inpatient re-admission rates and days of stay (DOS), nursing home admission rates and DOS, and mean total Medicaid expenditures 90 and 180 days after discharge. Of 3,788 medical patients, 12.1 percent were referred to PAHC; 64 percent of those referred used PAHC. Of 1,511 surgical patients, 10.9 percent were referred; 99 percent of those referred used PAHC. In 430 pairs of patients matched by propensity score, mean total Medicaid expenditures within 90 days after discharge were $7,649 in the USE group and $5,761 in the NO USE group. Total Medicaid expenditures were significantly higher in the USE group compared to the NO USE group for medical patients after 180 days (p analysis indicates the results may be influenced by unmeasured variables, most likely functional status and/or care-giver support. Thirty-six percent of the medical patients referred to PAHC did not receive Medicaid-covered services. This suggests potential underuse among medical patients. The high post-discharge expenditures suggest opportunities for reducing costs through coordinating utilization or diverting it to

  6. No Racial Difference in Rehabilitation Therapy Across All Post-Acute Care Settings in the Year Following a Stroke.

    Science.gov (United States)

    Skolarus, Lesli E; Feng, Chunyang; Burke, James F

    2017-12-01

    Black stroke survivors experience greater poststroke disability than whites. Differences in post-acute rehabilitation may contribute to this disparity. Therefore, we estimated racial differences in rehabilitation therapy utilization, intensity, and the number of post-acute care settings in the first year after a stroke. We used national Medicare data to study 186 168 elderly black and white patients hospitalized with a primary diagnosis of stroke in 2011. We tabulated the proportion of stroke survivors receiving physical, occupational, and speech and language therapy in each post-acute care setting (inpatient rehabilitation facility, skilled nursing facility, and home health agency), minutes of therapy, and number of transitions between settings. We then used generalized linear models to determine whether racial differences in minutes of physical therapy were influenced by demographics, comorbidities, thrombolysis, and markers of stroke severity. Black stroke patients were more likely to receive each type of therapy than white stroke patients. Compared with white stroke patients, black stroke patients received more minutes of physical therapy (897.8 versus 743.4; P rehabilitation therapy utilization or intensity after accounting for patient characteristics. It is unlikely that differences in rehabilitation utilization or intensity are important contributors to racial disparities in poststroke disability. © 2017 American Heart Association, Inc.

  7. 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.

  8. Investing in Post-Acute Care Transitions: Electronic Information Exchange Between Hospitals and Long-Term Care Facilities.

    Science.gov (United States)

    Cross, Dori A; Adler-Milstein, Julia

    2017-01-01

    Electronic health information exchange (HIE) is expected to help improve care transitions from hospitals to long-term care (LTC) facilities. We know little about the prevalence of hospital LTC HIE in the United States and what contextual factors may motivate or constrain this activity. Cross-sectional analysis of U.S. acute-care hospitals responding to the 2014 AHA IT Supplement survey and with available readmissions data (n = 1,991). We conducted multivariate logistic regression to explore the relationship between hospital LTC HIE and selected IT and policy characteristics. Over half of the hospitals in our study (57.2%) reported engaging in some form of HIE with LTC providers: 33.9% send-only, 0.5% receive-only, and 22.8% send and receive. Hospitals that engaged in some form of LTC HIE were more likely than those that did not engage to have attested to meaningful use (odds ratio [OR], 1.87; P = .01 for stage 1 and OR, 2.05; P investing in electronic information exchange with LTCs as part of a general strategy to adopt EHRs and engage in HIE, but also potentially to strengthen ties to LTC providers and to reduce readmissions. To achieve widespread connectivity, continued focus on adoption of related health IT infrastructure and greater emphasis on aligning incentives for hospital-LTC care transitions would be valuable. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  9. Prevalence of malnutrition and sarcopenia in a post-acute care geriatric unit: Applying the new ESPEN definition and EWGSOP criteria.

    Science.gov (United States)

    Sánchez-Rodríguez, Dolores; Marco, Ester; Ronquillo-Moreno, Natalia; Miralles, Ramón; Vázquez-Ibar, Olga; Escalada, Ferran; Muniesa, Josep M

    2017-10-01

    The European Society of Clinical Nutrition and Metabolism (ESPEN) consensus definition of malnutrition has been applied in hospitalized older diabetics and middle-aged patients, geriatric outpatients, and healthy elderly and young individuals. In a post-acute care setting, our aim was to assess malnutrition (ESPEN definition) and determine its relationship with sarcopenia in older in-patients deconditioned due to an acute process. Eighty-eight in-patients aged ≥70 years with body mass index (BMI) malnutrition risk using biochemical markers and Mini-Nutritional Assessment-Short Form (MNA-SF). The ESPEN definition was applied: 1) BMI Malnutrition prevalence was 4.5%, 7.9%, and 17% using ESPEN definitions 1, 2a, and 2b, respectively; 19.3% were malnourished. Prevalence of sarcopenia was 37.5%, of which 90.9% fulfilled ESPEN malnutrition criteria, a significant association (p = 0.02). No differences in biochemical markers were observed between patients with or without malnutrition or sarcopenia. ESPEN criteria constitute an appropriate tool to establish a malnutrition diagnosis in post-acute care. Sarcopenia, as defined by EWGSOP, was present in 37.5% of patients, of which 90.9% fulfilled ESPEN criteria; therefore, malnutrition was significantly related to sarcopenia. Additional work is needed to determine further implications of the ESPEN consensus definition. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  10. Impact of Anterior vs Posterior Approach for Total Hip Arthroplasty on Post-Acute Care Service Utilization.

    Science.gov (United States)

    L'Hommedieu, Coles E; Gera, James J; Rupp, Gerald; Salin, Jeffery W; Cox, John S; Duwelius, Paul J

    2016-09-01

    Controversy exists as to which surgical approach is best for total hip arthroplasty (THA). Previous studies suggested that the tissue-sparing anterior approach should result in a more rapid recovery requiring fewer postacute services, ultimately decreasing overall episodic cost. The purpose of this cross-sectional study was to determine if any significant differences exist between the anterior vs posterior approaches on postacute care service utilization, readmissions, or episodic cost. Claims data from 26,773 Medicare fee-for-service beneficiaries receiving elective THAs (Medical Severity-Diagnosis Related Groups (MS-DRGs) 469/470) were analyzed. Claims data were collected from the 2-year period, January 2013 through December 2014. The posterior surgical approach was performed on 23,653 patients while 3120 patients received the anterior approach. Data analysis showed negligible effect sizes in postacute care service utilization, readmission rate, and cost between the surgical approaches for elective THA (MS-DRG 469 and 470). Average THA total episode cost was negligibly higher for procedures using the anterior approach compared to the posterior approach ($22,517 and $22,068, respectively). Statistically significant differences were observed in inpatient rehab and home health cost and service utilization. However, the effect sizes of these comparisons are negligible when accounting for the large sample size. All other comparisons showed minimal and statistically insignificant variation. The results indicate that surgical approach alone is not the primary driver of postacute care service utilization, quality outcomes, or cost. Other factors such as physician-led patient-focused care pathways, care coordination, rapid rehabilitation protocols, perioperative pain management protocols, and patient education are integral for effective patient care. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. 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

  12. Persistence of Klebsiella pneumoniae ST258 as the predominant clone of carbapenemase-producing Enterobacteriaceae in post-acute-care hospitals in Israel, 2008-13.

    Science.gov (United States)

    Adler, Amos; Hussein, Omar; Ben-David, Debby; Masarwa, Samira; Navon-Venezia, Shiri; Schwaber, Mitchell J; Carmeli, Yehuda

    2015-01-01

    To study the molecular characteristics of carbapenemase-producing Enterobacteriaceae (CPE) in post-acute-care hospitals (PACHs) in Israel and to analyse the temporal changes between 2008 and 2013. CPE isolates were obtained during two cross-sectional, point prevalence national surveys of PACHs in Israel performed in 2008 and 2013. Surveillance cultures were collected by streaking rectal swabs onto selective media. Isolates were identified to species level and tested for blaKPC, blaNDM and blaOXA-48 by PCR and by the Carba NP test. Molecular typing was done by PCR for the pilv-l gene, designed for the ST258 KPC-producing Klebsiella pneumoniae (KPC-KP) clone, BOX-PCR and MLST. The prevalence of CPE carriage in the first survey was 184/1147 (16%); all of the isolates were KPC-KP. The prevalence of CPE carriage in the second survey was 127/1287 (9.9%); of these isolates, 113 (89%) were KPC-KP, 9 (7%) were other KPC-producing species and 5 (4%) were NDM- and OXA-48-producing CPE (n = 1 and 4, respectively). The proportion of the KPC-KP population represented by the ST258 clone increased from 120/184 (65%) in 2008 to 91/113 (80%) in 2013. In 58% (71/122) of the KPC-CPE carriers identified in the 2013 survey, the source of acquisition was determined to be the PACH itself. All four OXA-48 CPE were acquired either directly or indirectly from patients arriving from the Palestinian Authority or Syria. Despite the decreased prevalence of CPE in Israeli PACHs, and the emergence of new types of CPE, the KPC-KP ST258 clone remains the predominant clone represented. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  13. Construct validity and inter-rater reliability of the Dutch activity measure for post-acute care "6-clicks" basic mobility form to assess the mobility of hospitalized patients.

    Science.gov (United States)

    Geelen, Sven Jacobus Gertruda; Valkenet, Karin; Veenhof, Cindy

    2018-05-12

    To evaluate the construct validity and the inter-rater reliability of the Dutch Activity Measure for Post-Acute Care "6-clicks" Basic Mobility short form measuring the patient's mobility in Dutch hospital care. First, the "6-clicks" was translated by using a forward-backward translation protocol. Next, 64 patients were assessed by the physiotherapist to determine the validity while being admitted to the Internal Medicine wards of a university medical center. Six hypotheses were tested regarding the construct "mobility" which showed that: Better "6-clicks" scores were related to less restrictive pre-admission living situations (p = 0.011), less restrictive discharge locations (p = 0.001), more independence in activities of daily living (p = 0.001) and less physiotherapy visits (p Dutch "6-clicks" shows a good construct validity and moderate-to-excellent inter-rater reliability when used to assess the mobility of hospitalized patients. Implications for Rehabilitation Even though various measurement tools have been developed, it appears the majority of physiotherapists working in a hospital currently do not use these tools as a standard part of their care. The Activity Measure for Post-Acute Care "6-clicks" Basic Mobility is the only tool which is designed to be short, easy to use within usual care and has been validated in the entire hospital population. This study shows that the Dutch version of the Activity Measure for Post-Acute Care "6-clicks" Basic Mobility form is a valid, easy to use, quick tool to assess the basic mobility of Dutch hospitalized patients.

  14. Post-acute referral patterns for hospitals and implications for bundled payment initiatives.

    Science.gov (United States)

    Lau, Christopher; Alpert, Abby; Huckfeldt, Peter; Hussey, Peter; Auerbach, David; Liu, Hangsheng; Sood, Neeraj; Mehrotra, Ateev

    2014-09-01

    Under new bundled payment models, hospitals are financially responsible for post-acute care delivered by providers such as skilled nursing facilities (SNFs) and home health agencies (HHAs). The hope is that hospitals will use post-acute care more prudently and better coordinate care with post-acute providers. However, little is known about existing patterns in hospitals׳ referrals to post-acute providers. Post-acute provider referrals were identified using SNF and HHA claims within 14 days following hospital discharge. Hospital post-acute care network size and concentration were estimated across hospital types and regions. The 2008 Medicare Provider Analysis and Review claims for acute hospitals and SNFs, and the 100% HHA Standard Analytic Files were used. The mean post-acute care network size for U.S. hospitals included 57.9 providers with 37.5 SNFs and 23.4 HHAs. The majority of these providers (65.7% of SNFs, 60.9% of HHAs) accounted for 1 percent or less of a hospital׳s referrals and classified as "low-volume". Other post-acute providers we classified as routine. The mean network size for routine providers was greater for larger hospitals, teaching hospitals and in regions with higher per capita post-acute care spending. The average hospital works with over 50 different post-acute providers. Moreover, the size of post-acute care networks varies considerably geographically and by hospital characteristics. These results provide context on the complex task hospitals will face in coordinating care with post-acute providers and cutting costs under new bundled payment models. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. 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

  16. Change in cognitive performance is associated with functional recovery during post-acute stroke rehabilitation: a multi-centric study from intermediate care geriatric rehabilitation units of Catalonia.

    Science.gov (United States)

    Pérez, Laura Mónica; Inzitari, Marco; Roqué, Marta; Duarte, Esther; Vallés, Elisabeth; Rodó, Montserrat; Gallofré, Miquel

    2015-10-01

    Recovery after a stroke is determined by a broad range of neurological, functional and psychosocial factors. Evidence regarding these factors is not well established, in particular influence of cognition changes during rehabilitation. We aimed to investigate whether selective characteristics, including cognitive performance and its change over time, modulate functional recovery with home discharge in stroke survivors admitted to post-acute rehabilitation units. We undertook a multicenter cohort study, including all patients discharged from acute wards to any geriatric rehabilitation unit in Catalonia-Spain during 2008. Patients were assessed for demographics, clinical and functional variables using Conjunt Mínim Bàsic de Dades dels Recursos Sociosanitaris (CMBD-RSS), which adapts the Minimum Data Set tool used in America's nursing homes. Baseline-to-discharge change in cognition was calculated on repeated assessments using the Cognitive Performance Scale (CPS, range 0-6, best-worst cognition). The multivariable effect of these factors was analyzed in relation to the outcome. 879 post-stroke patients were included (mean age 77.48 ± 10.18 years, 52.6% women). A worse initial CPS [OR (95% CI) = 0.851 (0.774-0.935)] and prevalent fecal incontinence [OR (95% CI) = 0.560 (0.454-0.691)] reduced the likelihood of returning home with functional improvement; whereas improvement of CPS, baseline to discharge, [OR (95% CI) = 1.348 (1.144-1.588)], more rehabilitation days within the first 2 weeks [OR (95% CI) = 1.011 (1.006-1.015)] and a longer hospital stay [OR (95% CI) = 1.011 (1.006-1.015)] were associated with the outcome. In our sample, different clinical characteristics, including cognitive function and its improvement over time, are associated with functional improvement in stroke patients undergoing rehabilitation. Our results might provide information to further studies aimed at exploring the influence of cognition changes during rehabilitation.

  17. Effects of simulation-based educational program in improving the nurses' self-efficacy in caring for patients' with COPD and CHF in a post-acute care (PACU) setting.

    Science.gov (United States)

    Genuino, Mary Jane

    2018-02-01

    The 2014 national percentage for 30-day readmissions among Medicare recipients from Post-Acute Care Unit (PACU) showed: Heart Failure (HF) with major complications and co-morbidities, an average of 24.09%, and Chronic Obstructive Pulmonary Disease (COPD) with complications and co-morbidities 23.12%. The percentage of readmissions for New Jersey among PACU showed: HF with major complications and co-morbidities, an average of 24.40% and COPD 26.35% (Avalere Health, 2014). For this study site, the hospital readmission rate was not specifically broken down according to condition/diagnosis. Overall, the hospital readmission rate was approximately 20%. A few percent lower than the national and state average, but still a considerable number. This study is significant in finding out whether a simulation based educational program will increase the nurses' self-efficacy in caring for these patients. The positive outcome of this study can provide a template for training PACU nurses to aid in decreasing hospital readmissions in this vulnerable population. The simulation-based educational program was approximately 5h in length, and it was divided into two parts, a presentation on HF and COPD, and the actual simulation scenario, using a low-fidelity manikin (LFM). There were approximately 20 Registered nurses as participants but 4 did not complete the post-simulation self-efficacy scale, and the 16 were included in the actual study. This study was able to define the effects of simulation-based educational program on the RNs self-efficacy in caring for COPD and HF patients. The participants' demographic information, i.e. age, educational attainment, years of experience, and previous work experience, did not show any differences in how much the nurses' self-efficacy improved. The post-simulation self-efficacy score of the participants showed approximately 5% increase compared to the pre-simulation score. The outcome of the study concluded the simulation-based educational program

  18. Patterns of post-acute health care utilization after a severe traumatic brain injury: Results from the PariS-TBI cohort.

    Science.gov (United States)

    Jourdan, Claire; Bayen, Eleonore; Darnoux, Emmanuelle; Ghout, Idir; Azerad, Sylvie; Ruet, Alexis; Vallat-Azouvi, Claire; Pradat-Diehl, Pascale; Aegerter, Philippe; Weiss, Jean-Jacques; Azouvi, Philippe

    2015-01-01

    To assess brain injury services utilization and their determinants using Andersen's model. Prospective follow-up of the PariS-TBI inception cohort. Out of 504 adults with severe traumatic brain injury (TBI), 245 survived and 147 received a 4-year outcome assessment (mean age 33 years, 80% men). Provision rates of medical, rehabilitation, social and re-entry services and their relations to patients' characteristics were assessed. Following acute care discharge, 78% of patients received physiotherapy, 61% speech/cognitive therapy, 50% occupational therapy, 41% psychological assistance, 63% specialized medical follow-up, 21% community re-entry assistance. Health-related need factors, in terms of TBI severity, were the main predictors of services. Provision of each therapy was significantly associated with corresponding speech, motor and psychological impairments. However, care provision did not depend on cognitive impairments and cognitive therapy was related to pre-disposing and geographical factors. Community re-entry assistance was provided to younger and more independent patients. These quantitative findings illustrate strengths and weaknesses of late brain injury care provision in urban France and highlight the need to improve treatment of cognitive impairments.

  19. Impact of Neuromuscular Electrical Stimulation (NMES) on 90-Day Episode Costs and Post-Acute Care Utilization in Total Knee Replacement Patients with Disuse Atrophy.

    Science.gov (United States)

    Pal, Sarmistha; Chughtai, Morad; Sultan, Assem A; Khlopas, Anton; Sodhi, Nipun; George, Nicole E; Etcheson, Jennifer I; Gwam, Chukwuweike U; Newman, Jared M; Samuel, Linsen T; Bhave, Anil; DaVanzo, Joan E; Mont, Michael A

    2017-12-22

    This study evaluated differences in: 1) total episode payments, 2) probability of hospital readmission, 3) probability of inpatient rehab facility (IRF) and utilization, and 4) probability of skilled nursing care facility (SNF) utilization in patients who had disuse atrophy and underwent a total knee arthroplasty (TKA) and either did, or did not, receive preoperative home-based neuromuscular electrical stimulation (NMES) therapy. We used the Medicare limited dataset for a 5% sample of beneficiaries from 2014 and 2015 to construct episodes-of-care for TKA (DRG-470) patients with disuse atrophy who underwent a TKA during the 30 days prior to hospital admission and 90 days post-discharge. Patients were stratified into those who either did or did not receive pre- and postoperative NMES therapy. An ordinary least square (OLS) model was used to estimate the impact of NMES on total episode. Linear probability models were used to estimate the impact of NMES on SNF or IRF utilization and readmission. A $3,274 reduction in episode payments for patients who used preoperative NMES versus those who did not (ptotal episode payments and SNF utilization for TKA patients with disuse atrophy who had NMES therapy was demonstrated.

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. Overview of PACS

    Science.gov (United States)

    Vanden Brink, John A.

    1995-08-01

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

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. How Does the PAC Respond to Changes in the Payment Rate

    Data.gov (United States)

    U.S. Department of Health & Human Services — How Does the Volume of Post-Acute Care Respond to Changes in the Payment Rate Measure the effect of changes from 1997 to 2001 in Medicares payment rates for skilled...

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. Second-generation PACS

    International Nuclear Information System (INIS)

    Mattheus, R.; Osteaux, M.; Spruiyt, D.

    1989-01-01

    Purpose: In recent years, a gradual shift toward digital techniques has occurred in the field of medical imaging. The authors discuss how, with their approach, digital image management can be used in daily clinical routine. Instead of a centralized approach, we have taken a decentralized, multivendor, phase-expandable approach. The IMAC (image management and communication) architecture is a reflection of the organization of the imaging department. A section defined for each group of examinations (CT, MR imaging, DSA, emergency), has its own (dedicated) PACS environment, connected to the total PACS. Network management for controlling the image flow is based on patient appointments, scheduling of rooms, and work

  15. 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.

  16. 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...

  17. 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.

  18. 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.

  19. 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)

  20. 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

  1. 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.

  2. Identification of ICF categories relevant for nursing in the situation of acute and early post-acute rehabilitation

    Science.gov (United States)

    Mueller, Martin; Boldt, Christine; Grill, Eva; Strobl, Ralf; Stucki, Gerold

    2008-01-01

    Background The recovery of patients after an acute episode of illness or injury depends both on adequate medical treatment and on the early identification of needs for rehabilitation care. The process of early beginning rehabilitation requires efficient communication both between health professionals and the patient in order to effectively address all rehabilitation goals. The currently used nursing taxonomies, however, are not intended for interdisciplinary use and thus may not contribute to efficient rehabilitation management and an optimal patient outcome. The ICF might be the missing link in this communication process. The objective of this study was to identify the categories of the International Classification of Functioning, Disability and Health (ICF) categories relevant for nursing care in the situation of acute and early post-acute rehabilitation. Methods First, in a consensus process, "Leistungserfassung in der Pflege" (LEP) nursing interventions relevant for the situation of acute and early post-acute rehabilitation were selected. Second, in an integrated two-step linking process, two nursing experts derived goals of LEP nursing interventions from their practical knowledge and selected corresponding ICF categories most relevant for patients in acute and post-acute rehabilitation (ICF Core Sets). Results Eighty-seven percent of ICF Core Set categories could be linked to goals of at least one nursing intervention variable of LEP. The ICF categories most frequently linked with LEP nursing interventions were respiration functions, experience of self and time functions and focusing attention. Thirteen percent of ICF Core Set categories could not be linked with LEP nursing interventions. The LEP nursing interventions which were linked with the highest number of different ICF-categories of all were "therapeutic intervention", "patient-nurse communication/information giving" and "mobilising". Conclusion The ICF Core Sets for the acute hospital and early post-acute

  3. Identification of ICF categories relevant for nursing in the situation of acute and early post-acute rehabilitation

    Directory of Open Access Journals (Sweden)

    Strobl Ralf

    2008-02-01

    Full Text Available Abstract Background The recovery of patients after an acute episode of illness or injury depends both on adequate medical treatment and on the early identification of needs for rehabilitation care. The process of early beginning rehabilitation requires efficient communication both between health professionals and the patient in order to effectively address all rehabilitation goals. The currently used nursing taxonomies, however, are not intended for interdisciplinary use and thus may not contribute to efficient rehabilitation management and an optimal patient outcome. The ICF might be the missing link in this communication process. The objective of this study was to identify the categories of the International Classification of Functioning, Disability and Health (ICF categories relevant for nursing care in the situation of acute and early post-acute rehabilitation. Methods First, in a consensus process, "Leistungserfassung in der Pflege" (LEP nursing interventions relevant for the situation of acute and early post-acute rehabilitation were selected. Second, in an integrated two-step linking process, two nursing experts derived goals of LEP nursing interventions from their practical knowledge and selected corresponding ICF categories most relevant for patients in acute and post-acute rehabilitation (ICF Core Sets. Results Eighty-seven percent of ICF Core Set categories could be linked to goals of at least one nursing intervention variable of LEP. The ICF categories most frequently linked with LEP nursing interventions were respiration functions, experience of self and time functions and focusing attention. Thirteen percent of ICF Core Set categories could not be linked with LEP nursing interventions. The LEP nursing interventions which were linked with the highest number of different ICF-categories of all were "therapeutic intervention", "patient-nurse communication/information giving" and "mobilising". Conclusion The ICF Core Sets for the acute

  4. 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.

  5. 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.

  6. 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.

  7. Ankle manual therapy for individuals with post-acute ankle sprains: description of a randomized, placebo-controlled clinical trial.

    Science.gov (United States)

    Davenport, Todd E; Kulig, Kornelia; Fisher, Beth E

    2010-10-19

    Ankle sprains are common within the general population and can result in prolonged disablement. Limited talocrural dorsiflexion range of motion (DF ROM) is a common consequence of ankle sprain. Limited talocrural DF ROM may contribute to persistent symptoms, disability, and an elevated risk for re-injury. As a result, many health care practitioners use hands-on passive procedures with the intention of improving talocrural joint DF ROM in individuals following ankle sprains. Dosage of passive hands-on procedures involves a continuum of treatment speeds. Recent evidence suggests both slow- and fast-speed treatments may be effective to address disablement following ankle sprains. However, these interventions have yet to be longitudinally compared against a placebo study condition. We developed a randomized, placebo-controlled clinical trial designed to test the hypotheses that hands-on treatment procedures administered to individuals following ankle sprains during the post-acute injury period can improve short-, intermediate-, and long-term disablement, as well as reduce the risk for re-injury. This study is designed to measure the clinical effects of hands-on passive stretching treatment procedures directed to the talocrural joint that vary in treatment speed during the post-acute injury period, compared to hands-on placebo control intervention. http://www.clinicaltrials.gov identifier NCT00888498.

  8. Ankle manual therapy for individuals with post-acute ankle sprains: description of a randomized, placebo-controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Fisher Beth E

    2010-10-01

    Full Text Available Abstract Background Ankle sprains are common within the general population and can result in prolonged disablement. Limited talocrural dorsiflexion range of motion (DF ROM is a common consequence of ankle sprain. Limited talocrural DF ROM may contribute to persistent symptoms, disability, and an elevated risk for re-injury. As a result, many health care practitioners use hands-on passive procedures with the intention of improving talocrural joint DF ROM in individuals following ankle sprains. Dosage of passive hands-on procedures involves a continuum of treatment speeds. Recent evidence suggests both slow- and fast-speed treatments may be effective to address disablement following ankle sprains. However, these interventions have yet to be longitudinally compared against a placebo study condition. Methods/Design We developed a randomized, placebo-controlled clinical trial designed to test the hypotheses that hands-on treatment procedures administered to individuals following ankle sprains during the post-acute injury period can improve short-, intermediate-, and long-term disablement, as well as reduce the risk for re-injury. Discussion This study is designed to measure the clinical effects of hands-on passive stretching treatment procedures directed to the talocrural joint that vary in treatment speed during the post-acute injury period, compared to hands-on placebo control intervention. Trial Registration http://www.clinicaltrials.gov identifier NCT00888498.

  9. 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...

  10. 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.

  11. 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.

  12. 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.

  13. Using the New Postacute Care Quality Measures to Demonstrate the Value of Occupational Therapy.

    Science.gov (United States)

    Sandhu, Sharmila; Furniss, Jeremy; Metzler, Christina

    As the health care system continues to evolve toward one based on quality not quantity, demonstrating the value of occupational therapy has never been more important. Providing high-quality services, achieving optimal outcomes, and identifying and promoting occupational therapy's distinct value are the responsibilities of all practitioners. In relation to the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, the Centers for Medicare and Medicaid Services (CMS) is implementing new functional items and related outcome performance measures across postacute care (PAC) settings. Practitioners can demonstrate the role and value of occupational therapy services through their participation in data collection and the interpretation of the resulting performance measures. In this column, we review the objectives of the IMPACT Act, introduce the new self-care and mobility items and outcome performance measures being implemented in PAC settings, and describe ways to use these new data to advocate for occupational therapy. We also discuss American Occupational Therapy Association initiatives to provide materials and guidance for occupational therapy practitioners to contribute to PAC data collection. Copyright © 2018 by the American Occupational Therapy Association, Inc.

  14. 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...

  15. Guideline recommendations for post-acute postoperative physiotherapy in total hip and knee arthroplasty: are they used in daily clinical practice?

    Science.gov (United States)

    Peter, W F; Nelissen, R G H H; Vlieland, T P M Vliet

    2014-09-01

    In a Dutch guideline on physiotherapy (PT) in hip and knee osteoarthritis, a number of recommendations on post-acute (i.e. after discharge from hospital) PT following total hip (THA) and total knee (TKA) arthroplasty were included. Little is known about the uptake of these recommendations in daily clinical practice. The aim of the present study was to determine the extent to which the guideline recommendations regarding post-acute PT after THA and TKA are followed in daily clinical practice. An online pilot survey on the delivery of post-acute, postoperative PT was sent to a random sample of 957 Dutch physiotherapists. The survey included questions on the application of recommended, neither recommended nor advised against, and advised against treatment modalities and various treatment modalities for which there were no formulated recommendations. A total of 219 physiotherapists completed the questionnaire, with a mean age of 40 years (standard deviation 12.6), 55% female and 95% working in primary care. The vast majority reported the use of the recommended exercise modalities (muscle strengthening exercises (96%), and functional exercises (99%). Continuous passive motion, which was neither recommended nor advised against, and electrical muscle stimulation, which was not recommended, were provided by 1%. Reported treatment modalities for which there were no formulated recommendations included patient education (99%), gait training (95%), active range of motion (ROM) exercises (93%), balance exercises (86%), passive ROM exercises (58%), aerobic exercises (50%), massage (18%) and cold therapy (11%). The vast majority of physiotherapists reported adhering to recommendations on post-acute postoperative PT in THA and TKA patients after discharge from hospital. Although yet to be confirmed in a larger nationwide survey, the relatively high frequency of use of many other treatment modalities, for which there were no formulated recommendations, suggests the need to extend

  16. Vendor neutral archive in PACS

    International Nuclear Information System (INIS)

    Agarwal, Tapesh Kumar; Sanjeev

    2012-01-01

    An archive is a location containing a collection of records, documents, or other materials of historical importance. An integral part of Picture Archiving and Communication System (PACS) is archiving. When a hospital needs to migrate a PACS vendor, the complete earlier data need to be migrated in the format of the newly procured PACS. It is both time and money consuming. To address this issue, the new concept of vendor neutral archive (VNA) has emerged. A VNA simply decouples the PACS and workstations at the archival layer. This is achieved by developing an application engine that receives, integrates, and transmits the data using the different syntax of a Digital Imaging and Communication in Medicine (DICOM) format. Transferring the data belonging to the old PACS to a new one is performed by a process called migration of data. In VNA, a number of different data migration techniques are available to facilitate transfer from the old PACS to the new one, the choice depending on the speed of migration and the importance of data. The techniques include simple DICOM migration, prefetch-based DICOM migration, medium migration, and the expensive non-DICOM migration. “Vendor neutral” may not be a suitable term, and “architecture neutral,” “PACS neutral,” “content neutral,” or “third-party neutral” are probably better and preferred terms. Notwithstanding this, the VNA acronym has come to stay in both the medical IT user terminology and in vendor nomenclature, and radiologists need to be aware of its impact in PACS across the globe

  17. 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.

  18. 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)

  19. Identification of relevant ICF categories by geriatric patients in an early post-acute rehabilitation facility.

    Science.gov (United States)

    Grill, Eva; Stucki, Gerold; Boldt, Christine; Joisten, Susanne; Swoboda, Walter

    To describe functioning and health of elderly patients in an early post-acute rehabilitation facility and to identify the most common problems using the International Classification of Functioning, Disability and Health (ICF). Cross-sectional survey in a convenience sample of elderly patients requiring rehabilitation in an early post-acute rehabilitation facility. The second-level categories of the ICF were used to collect information on patients' problems. For the ICF components Body Functions, Body Structures and Activities and Participation, absolute and relative frequencies of impairments/limitations in the study population were reported. For the component Environmental Factors absolute and relative frequencies of perceived barriers or facilitators were reported. The mean age in the sample was 79.9 years. Sixty-nine percent of the patients were female. In 150 patients, 82 ICF categories (34%) had a prevalence of 30% or above. The 82 categories included 22 categories (45%) of the component Body Functions, six categories (15%) of the component Body Structures, 25 categories (34%) of the component Activities and Participation and 29 (57%) categories of the component Environmental Factors. This study is a first step towards the development of ICF Core Sets for geriatric patients in early post-acute rehabilitation facilities.

  20. 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.

  1. PACS for the Developing World

    Directory of Open Access Journals (Sweden)

    Jeffrey B. Mendel

    2015-11-01

    Full Text Available Digital imaging is now firmly ensconced in the developed world. Its widespread adoption has enabled instant access to images, remote viewing, remote consultation, and the end of lost or misplaced film. Unfortunately, the current paradigm of Picture Archiving and Communication System (PACS, with advanced technology inseparable from high complexity, high purchase costs, and high maintenance costs, is not suited for the low-income developing world. Like the simple, easy to repair, 1950’s American cars still running on the streets of Havana, the developing world requires a PACS (DW-PACS that can perform basic functions and survive in a limited-resource environment. The purpose of this article is to more fully describe this concept and to present a blueprint for PACS tailored to the needs and resources of the developing world. This framework should assist both users looking for a vendor-supplied or open-source solutions and developers seeking to address the needs of this emerging market.

  2. 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.

  3. 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

  4. Urological diagnosis using clinical PACS

    Science.gov (United States)

    Mills, Stephen F.; Spetz, Kevin S.; Dwyer, Samuel J., III

    1995-05-01

    Urological diagnosis using fluoroscopy images has traditionally been performed using radiographic films. Images are generally acquired in conjunction with the application of a contrast agent, processed to create analog films, and inspected to ensure satisfactory image quality prior to being provided to a radiologist for reading. In the case of errors the entire process must be repeated. In addition, the radiologist must then often go to a particular reading room, possibly in a remote part of the healthcare facility, to read the images. The integration of digital fluoroscopy modalities with clinical PACS has the potential to significantly improve the urological diagnosis process by providing high-speed access to images at a variety of locations within a healthcare facility without costly film processing. The PACS additionally provides a cost-effective and reliable means of long-term storage and allows several medical users to simultaneously view the same images at different locations. The installation of a digital data interface between the existing clinically operational PACS at the University of Virginia Health Sciences Center and a digital urology fluoroscope is described. Preliminary user interviews that have been conducted to determine the clinical effectiveness of PACS workstations for urological diagnosis are discussed. The specific suitability of the workstation medium is discussed, as are overall advantages and disadvantages of the hardcopy and softcopy media in terms of efficiency, timeliness and cost. Throughput metrics and some specific parameters of gray-scale viewing stations and the expected system impacts resulting from the integration of a urology fluoroscope with PACS are also discussed.

  5. 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

  6. Cardiology-oriented PACS

    Science.gov (United States)

    Silva, Augusto F. d.; Costa, Carlos; Abrantes, Pedro; Gama, Vasco; Den Boer, Ad

    1998-07-01

    This paper describes an integrated system designed to provide efficient means for DICOM compliant cardiac imaging archival, transmission and visualization based on a communications backbone matching recent enabling telematic technologies like Asynchronous Transfer Mode (ATM) and switched Local Area Networks (LANs). Within a distributed client-server framework, the system was conceived on a modality based bottom-up approach, aiming ultrafast access to short term archives and seamless retrieval of cardiac video sequences throughout review stations located at the outpatient referral rooms, intensive and intermediate care units and operating theaters.

  7. 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.

  8. 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.

  9. 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.)

  10. 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

  11. Web based emergency room PACS

    International Nuclear Information System (INIS)

    Cha, Soon Joo; Cheon, Yong Kyung; Choi, Sung Woo Kim

    2005-01-01

    We wished to develop the web based Picture Archiving and Communication System in the emergency room for early decision making in emergency treatment planning at a full PACS Hospital. The program tools were Microsoft Visual Studio 6.0 - Visual C++ 6.0, and the Microsoft SQL 7.0 under the Microsoft Windows 2000 server operation system. The achievement of images was performed by an auto transport program installed in the ER and the radiology department. The average compression rates were 5:1 for CT and MR, and 20:1 for CR with JPEG 2000 lossy compression. All the images were stored on hard disk for 3 months. The patients' information was displayed for 2 weeks for reducing the security risk. For interdepartmental consultation, patient query by patient hospital number was available. Our Web based ER PACS could be useful system for early decision making for treatment planning in the emergency room because it reduces the risk factors for the security of the Web Paces by using a system independent from PACS in the hospital and minimizing the information patients

  12. Web based emergency room PACS

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Soon Joo; Cheon, Yong Kyung; Choi, Sung Woo Kim [Ilsan Paik Hospital, Inje University, Seoul (Korea, Republic of)] (and others)

    2005-07-15

    We wished to develop the web based Picture Archiving and Communication System in the emergency room for early decision making in emergency treatment planning at a full PACS Hospital. The program tools were Microsoft Visual Studio 6.0 - Visual C++ 6.0, and the Microsoft SQL 7.0 under the Microsoft Windows 2000 server operation system. The achievement of images was performed by an auto transport program installed in the ER and the radiology department. The average compression rates were 5:1 for CT and MR, and 20:1 for CR with JPEG 2000 lossy compression. All the images were stored on hard disk for 3 months. The patients' information was displayed for 2 weeks for reducing the security risk. For interdepartmental consultation, patient query by patient hospital number was available. Our Web based ER PACS could be useful system for early decision making for treatment planning in the emergency room because it reduces the risk factors for the security of the Web Paces by using a system independent from PACS in the hospital and minimizing the information patients.

  13. Place orientation and visual construction subdomains of the Mini Mental State Examination test as predictors of rehabilitation outcome of post-acute hip-fractured patients.

    Science.gov (United States)

    Hershkovitz, Avital; Kornyukov, Natalia; Brill, Shai

    2017-11-01

    The study aimed at assessing the relationship between various Mini Mental State Examination (MMSE) subdomains and rehabilitation achievements in post-acute hip-fractured patients. Six hundred and five hip-fractured patients admitted during 2010-2013 to a post-acute geriatric rehabilitation center were included in the study. Main outcome measures were the Functional Independence Measure (FIM) instrument, the motor FIM (mFIM), the Montebello Rehabilitation Factor Score (MRFS) on the mFIM and length of stay (LOS). A logistic regression analysis tested the predictive value of MMSE subdomains for achieving a satisfactory functional gain (mFIM MRFS >30%) on operated patients admitted from community. Of all the six MMSE subdomains, place orientation and visual construction demonstrated significant predictive values for rehabilitation outcome. Patients who did not err on place orientation and visual construction MMSE domains had better probabilities [(OR 1.28, 95%CI, 1.05-1.58; p = 0.017); (OR 2.15, 95%CI, 1.28-3.59; p = 0.004), respectively] of achieving better rehabilitation achievements. Similar results were obtained for cognitively impaired patient groups [(OR 1.40 95%CI, 1.11-1.77; p = 0.005); (OR 2.47, 95%CI, 1.15-5.30; p = 0.021), respectively]. For the cognitively intact patient group, the variables with significant predictive value were time orientation and visual construction MMSE subdomains [(OR 2.26, 95%CI, 1.18-4.33; p = 0.014); (OR 2.87, 95%CI, 1.16-7.09; p = 0.022), respectively]. Post-acute hip-fractured patients scoring normally on place orientation and visual construction MMSE subdomains have a better chance of achieving favorable rehabilitation outcome. Implications for Rehabilitation Post-acute hip-fractured patients have a better chance to achieve a favorable rehabilitation outcome when scoring normally on place orientation and visual construction MMSE subdomains. Patients having difficulties in orientation and visual

  14. Accelerometer-based wireless body area network to estimate intensity of therapy in post-acute rehabilitation

    Directory of Open Access Journals (Sweden)

    Hamel Mathieu

    2008-09-01

    Full Text Available Abstract Background It has been suggested that there is a dose-response relationship between the amount of therapy and functional recovery in post-acute rehabilitation care. To this day, only the total time of therapy has been investigated as a potential determinant of this dose-response relationship because of methodological and measurement challenges. The primary objective of this study was to compare time and motion measures during real life physical therapy with estimates of active time (i.e. the time during which a patient is active physically obtained with a wireless body area network (WBAN of 3D accelerometer modules positioned at the hip, wrist and ankle. The secondary objective was to assess the differences in estimates of active time when using a single accelerometer module positioned at the hip. Methods Five patients (77.4 ± 5.2 y with 4 different admission diagnoses (stroke, lower limb fracture, amputation and immobilization syndrome were recruited in a post-acute rehabilitation center and observed during their physical therapy sessions throughout their stay. Active time was recorded by a trained observer using a continuous time and motion analysis program running on a Tablet-PC. Two WBAN configurations were used: 1 three accelerometer modules located at the hip, wrist and ankle (M3 and 2 one accelerometer located at the hip (M1. Acceleration signals from the WBANs were synchronized with the observations. Estimates of active time were computed based on the temporal density of the acceleration signals. Results A total of 62 physical therapy sessions were observed. Strong associations were found between WBANs estimates of active time and time and motion measures of active time. For the combined sessions, the intraclass correlation coefficient (ICC was 0.93 (P ≤ 0.001 for M3 and 0.79 (P ≤ 0.001 for M1. The mean percentage of differences between observation measures and estimates from the WBAN of active time was -8.7% ± 2.0% using

  15. Nursing diagnoses and interventions for post-acute-phase battered women.

    Science.gov (United States)

    Carlson-Catalano, J

    1998-01-01

    To identify nursing diagnoses and interventions applicable for post-acute-phase battered women. Eight battered women were interviewed twice for 2 hours. Gordon's functional health patterns provided the framework for data collection. Fifty-three nursing diagnoses and 52 nursing interventions were indicated in the data; 24 nursing diagnoses and 26 nursing interventions were present in all participants' data. With the use of comprehensive interventions, nurses can make a major contribution to society by enabling battered women to move to a more protected lifestyle.

  16. The course and impact of family optimism in the post-acute period after acquired brain injury.

    Science.gov (United States)

    Riley, Gerard A; Hough, Andrea; Meader, Laura M; Brennan, Andrew J

    2015-01-01

    To investigate the course and impact of family optimism in the post-acute stage of acquired brain injury. At Time 1, 30 family relatives of in-patients in rehabilitation units and 30 relatives of patients recently discharged from such units completed questionnaires relating to their emotional health, engagement in the rehabilitation process and expectations about the future consequences and controllability of the injury. At Time 2 (12-18 months later), 23 of the original sample completed questionnaires about their emotional health and actual consequences and controllability of the injury. At Time 1, optimism about future consequences and controllability was associated with greater engagement in the rehabilitation process and better emotional health. The two groups did not differ on any of the measures, which did not support the expectation that the patient's discharge home would trigger a loss of optimism and emotional upset for the family. At Time 2, the actual consequences were worse than had been expected at Time 1 and greater disappointment was associated with a greater decline in emotional wellbeing. Family expectations about recovery are linked with important variables such as emotional wellbeing and engagement in the rehabilitation process and need careful management by clinicians.

  17. 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.

  18. 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.

  19. 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...

  20. 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

  1. 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.)

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.)

  8. Can FES-augmented active cycling training improve locomotion in post-acute elderly stroke patients?

    Directory of Open Access Journals (Sweden)

    Elisabetta Peri

    2016-06-01

    Full Text Available Recent studies advocated the use of active cycling coupled with functional electrical stimulation to induce neuroplasticity and enhance functional improvements in stroke adult patients. The aim of this work was to evaluate whether the benefits induced by such a treatment are superior to standard physiotherapy. A single-blinded randomized controlled trial has been performed on post-acute elderly stroke patients. Patients underwent FES-augmented cycling training combined with voluntary pedaling or standard physiotherapy. The intervention consisted of fifteen 30-minutes sessions carried out within 3 weeks. Patients were evaluated before and after training, through functional scales, gait analysis and a voluntary pedaling test. Results were compared with an age-matched healthy group. Sixteen patients completed the training. After treatment, a general improvement of all clinical scales was obtained for both groups. Only the mechanical efficiency highlighted a group effect in favor of the experimental group. Although a group effect was not found for any other cycling or gait parameters, the experimental group showed a higher percentage of change with respect to the control group (e.g. the gait velocity was improved of 35.4% and 25.4% respectively, and its variation over time was higher than minimal clinical difference for the experimental group only. This trend suggests that differences in terms of motor recovery between the two groups may be achieved increasing the training dose. In conclusion, this study, although preliminary, showed that FES-augmented active cycling training seems to be effective in improving cycling and walking ability in post-acute elderly stroke patients. A higher sample size is required to confirm results.

  9. 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

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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.)

  15. 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

  16. 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.))

  17. PAC spectroscopy of electronic ceramics

    International Nuclear Information System (INIS)

    Gardner, J.A.; Wang, R.; Schwenker, R.; Sommers, J.A.

    1991-01-01

    Dilute indium dopants in cerium oxides and YBa 2 Cu 3 O x have been studied by 111 In/Cd Perturbed Angular Correlation (PAC) spectroscopy. By controlling oxygen vacancy concentration in the cerium oxides through doping or high-temperature vacuum annealing, we have found that indium always forms a defect complex unless the sample is doped to reduce greatly the oxygen vacancy concentration. Three different vacancy-associated complexes are found with concentrations that depend on doping and oxygen stoichiometry. Another defect complex occurs in samples having negligible vacancy concentration. At low temperatures, evidence is found of interaction with an electronic hole trapped by 111 Cd after the radioactive decay of the 111 In parent. In YBa 2 Cu 3 O x the indium substitutes preferentially at the Y site but has measurable probability of substitution in at least one of the two copper sites. A symmetry change near 650 C is consistent with the well-documented orthorhombic/tetragonal transition for samples in air or oxygen. (author). 23 refs, 10 figs

  18. Dynamics of inflammatory markers in post-acute stroke patients undergoing rehabilitation.

    Science.gov (United States)

    Manolescu, Bogdan Nicolae; Berteanu, Mihai; Dumitru, Luminița; Dinu, Horațiu; Iliescu, Alina; Fărcășanu, Ileana Cornelia; Oprea, Eliza; Vlădoiu, Suzana; Popa, Oana; Ianăș, Olga

    2011-12-01

    Stroke is a pathological condition associated with an enhanced inflammatory response that has a multifactorial etiology. We evaluated the dynamic of plasma concentrations of IL-1α, IL-6, IL-8, TNF-α, soluble form of intercellular adhesion molecule 1, and lipoprotein (a) [Lp(a)] during the rehabilitation of post-acute stroke patients (n = 20), in parallel with control subjects (n = 24). Stroke patients had significantly increased concentrations of IL-6, TNF-α, and Lp(a) when compared to healthy controls. It was found that the changes in the IL-6, IL-8, and TNF-α concentrations associated with the pathological condition were statistically significant (χ2 = 4.81, p = 0.028, χ2 = 10.40, p = 0.005 and χ2 = 6.73, p = 0.034, respectively). The decrease of Lp(a) during the rehabilitation had statistical significance (p = 0.043), while the decrease of IL-1α had marginal significance (p = 0.071). IL-1α, TNF-α, and Lp(a) concentrations were significantly negatively correlated with the Barthel index values, suggesting that the decrease of these inflammatory markers was beneficial for patients' recovery.

  19. Neuro-Mechanics of Recumbent Leg Cycling in Post-Acute Stroke Patients.

    Science.gov (United States)

    Ambrosini, Emilia; De Marchis, Cristiano; Pedrocchi, Alessandra; Ferrigno, Giancarlo; Monticone, Marco; Schmid, Maurizio; D'Alessio, Tommaso; Conforto, Silvia; Ferrante, Simona

    2016-11-01

    Cycling training is strongly applied in post-stroke rehabilitation, but how its modular control is altered soon after stroke has been not analyzed yet. EMG signals from 9 leg muscles and pedal forces were measured bilaterally during recumbent pedaling in 16 post-acute stroke patients and 12 age-matched healthy controls. Patients were asked to walk over a GaitRite mat and standard gait parameters were computed. Four muscle synergies were extracted through nonnegative matrix factorization in healthy subjects and patients unaffected legs. Two to four synergies were identified in the affected sides and the number of synergies significantly correlated with the Motricity Index (Spearman's coefficient = 0.521). The reduced coordination complexity resulted in a reduced biomechanical performance, with the two-module sub-group showing the lowest work production and mechanical effectiveness in the affected side. These patients also exhibited locomotor impairments (reduced gait speed, asymmetrical stance time, prolonged double support time). Significant correlations were found between cycling-based metrics and gait parameters, suggesting that neuro-mechanical quantities of pedaling can inform on walking dysfunctions. Our findings support the use of pedaling as a rehabilitation method and an assessment tool after stroke, mainly in the early phase, when patients can be unable to perform a safe and active gait training.

  20. 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

  1. Bundled Payments for Care Improvement Chart Book

    Data.gov (United States)

    U.S. Department of Health & Human Services — The HHS Assistant Secretary for Policy and Evaluation (ASPE) has conducted several research projects in the area of Medicare acute and post acute care episodes. The...

  2. 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.

  3. Cognitive Training for Post-Acute Traumatic Brain Injury: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Harry Hallock

    2016-10-01

    Full Text Available Objective: To quantitatively aggregate effects of cognitive training (CT on cognitive and functional outcome measures in patients with traumatic brain injury (TBI more than 12-months post-injury.Design: We systematically searched six databases for non-randomized and randomized controlled trials (RCTs of CT in TBI patients at least 12-months post-injury reporting cognitive and/or functional outcomes. Main Measures: Efficacy was measured as standardized mean difference (Hedges’ g of post-training change. We investigated heterogeneity across studies using subgroup analyses and meta-regressions. Results: Fourteen studies encompassing 575 patients were included. The effect of CT on overall cognition was small and statistically significant (g=0.22, 95%CI 0.05 to 0.38; p=0.01, with low heterogeneity (I2=11.71% and no evidence of publication bias. A moderate effect size was found for overall functional outcomes (g=0.32, 95%CI 0.08 to 0.57, p=0.01 with low heterogeneity (I2=14.27% and possible publication bias. Statistically significant effects were also found only for executive function (g=0.20, 95%CI 0.02 to 0.39, p=0.03 and verbal memory (g=0.32, 95%CI 0.14 to 0.50, p<0.01. Conclusions: Despite limited studies in this field, this meta-analysis indicates that CT is modestly effective in improving cognitive and functional outcomes in patients with post-acute TBI and should therefore play a more significant role in TBI rehabilitation.

  4. Identification of relevant ICF categories by patients with neurological conditions in early post-acute rehabilitation facilities.

    Science.gov (United States)

    Grill, Eva; Lipp, Berthold; Boldt, Christine; Stucki, Gerold; Koenig, Eberhard

    To describe functioning and health of patients with neurological conditions in early post-acute rehabilitation facilities and to identify the most common problems using the International Classification of Functioning, Disability and Health (ICF). Cross-sectional survey in a convenience sample of patients with neurological conditions requiring rehabilitation in early post-acute facilities. The second-level categories of the ICF were used to collect information on patients' problems. For the ICF components Body Functions, Body Structures and Activities and Participation absolute and relative frequencies of impairments/limitations in the study population were reported. For the component Environmental Factors absolute and relative frequencies of perceived barriers or facilitators were reported. The mean age in the sample was 56.6 years with a median age of 60 years. Forty percent of the patients were female. In 292 neurological patients 125 categories (51%) had a prevalence of 30% and above: 39 categories (49%) of Body Functions, 11 categories (28%) of Body Structures, 64 categories (88%) of Activities and Participation and 10 (20%) categories of Environmental Factors. This study is a first step towards the development of ICF Core Sets for of patients with neurological conditions in early post-acute rehabilitation facilities.

  5. Traumatic brain injury and post-acute decline: what role does environmental enrichment play? A scoping review

    Directory of Open Access Journals (Sweden)

    Diana eFrasca

    2013-04-01

    Full Text Available Objectives. While a number of studies provide evidence of neural and cognitive decline in traumatic brain injury (TBI survivors during the post-acute stages of injury, there is a dearth of research on the possible mechanisms underlying this decline. The purposes of this paper, therefore, are to (1 examine evidence that environmental enrichment (EE can influence long-term outcome following TBI, and (2 examine the nature of post-acute environments, whether they vary in degree of EE, and what impact these variations have on outcomes.Methods. We conducted a scoping review to identify studies on EE in animals and humans, and post-discharge experiences that relate to barriers to recovery.Results. Ninety-six articles that met inclusion criteria demonstrated the benefits of EE on brain and behaviour in healthy and brain-injured animals and humans. Nineteen papers on post-discharge experiences provided evidence that variables such as insurance coverage, financial and social support, home therapy, and transition from hospital to home, also play a vital role in regaining independence. Conclusion. There is evidence to suggest that lack of EE, whether from lack of resources or limited ability to engage in such environments, may play a role in post-recovery cognitive and neural decline. Maximizing EE in the post-acute stages of TBI may improve long-term outcomes for the individual, their family and society.

  6. 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

  7. 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.

  8. Quality assurance issues and PACS

    NARCIS (Netherlands)

    Banta, H.D.

    1992-01-01

    Quality assessment and assurance is a growing concern in all areas of health care. The concern is fueled by a body of evidence that indicates that quality of care is not optimal, and in many instances, is unacceptably low. Although different standards for quality have been proposed, health outcome

  9. 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

  10. [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.

  11. Communication of Unexpected and Significant Findings on Chest Radiographs With an Automated PACS Alert System.

    LENUS (Irish Health Repository)

    Hayes, Sara A

    2014-08-01

    An integral part of realizing the enormous potential of imaging in patient care is close communication between radiologists and referring physicians. One key element of this process is the communication of unexpected significant findings. The authors examined the performance of a PACS-based alert system in the appropriate communication of reports containing unexpected significant findings to referring physicians.

  12. 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

  13. 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.)

  14. 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.)

  15. 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

  16. 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...

  17. 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

  18. 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.

  19. 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

  20. 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...

  1. 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.

  2. 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

  3. 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.

  4. Medical imaging, PACS, and imaging informatics: retrospective.

    Science.gov (United States)

    Huang, H K

    2014-01-01

    Historical reviews of PACS (picture archiving and communication system) and imaging informatics development from different points of view have been published in the past (Huang in Euro J Radiol 78:163-176, 2011; Lemke in Euro J Radiol 78:177-183, 2011; Inamura and Jong in Euro J Radiol 78:184-189, 2011). This retrospective attempts to look at the topic from a different angle by identifying certain basic medical imaging inventions in the 1960s and 1970s which had conceptually defined basic components of PACS guiding its course of development in the 1980s and 1990s, as well as subsequent imaging informatics research in the 2000s. In medical imaging, the emphasis was on the innovations at Georgetown University in Washington, DC, in the 1960s and 1970s. During the 1980s and 1990s, research and training support from US government agencies and public and private medical imaging manufacturers became available for training of young talents in biomedical physics and for developing the key components required for PACS development. In the 2000s, computer hardware and software as well as communication networks advanced by leaps and bounds, opening the door for medical imaging informatics to flourish. Because many key components required for the PACS operation were developed by the UCLA PACS Team and its collaborative partners in the 1980s, this presentation is centered on that aspect. During this period, substantial collaborative research efforts by many individual teams in the US and in Japan were highlighted. Credits are due particularly to the Pattern Recognition Laboratory at Georgetown University, and the computed radiography (CR) development at the Fuji Electric Corp. in collaboration with Stanford University in the 1970s; the Image Processing Laboratory at UCLA in the 1980s-1990s; as well as the early PACS development at the Hokkaido University, Sapporo, Japan, in the late 1970s, and film scanner and digital radiography developed by Konishiroku Photo Ind. Co. Ltd

  5. 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 ...

  6. 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

  7. Thicker carotid intima-media thickness and increased plasma VEGF levels suffered by post-acute thrombotic stroke patients

    Directory of Open Access Journals (Sweden)

    Yueniwati Y

    2016-12-01

    Full Text Available Yuyun Yueniwati,1 Ni Komang Darmiastini,1 Eko Arisetijono2 1Radiology Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia; 2Neurology Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia Background and objectives: Atherosclerosis causes reduction of the oxygen supply to structures in the far arterial wall, provoking the release of factors that drive angiogenesis of vasa vasorum, including VEGF. Other studies have revealed the inflammatory response in atherosclerosis and the role of platelet factor 4 (PF4 as an anti-angiogenic chemokine through the inhibition of VEGF. This cross-sectional study aims at measuring the effect of atherosclerosis assessed through carotid intima-media thickness (CIMT against plasma VEGF levels in patients with post-acute thrombotic stroke. Materials and methods: CIMT was assessed sonographically using GE Logiq S6 with 13 MHz frequency linear probe. VEGF-A plasma levels were measured using enzyme-linked immunosorbent assay (ELISA method. Differences among variables were compared statistically. The data were analyzed using Pearson correlation. Results: A total of 25 patients with post-acute thrombotic stroke were identified in days 7 to 90. CIMT thickening was indicated in 88% of patients (1.202 ± 0.312 mm, while an increase in plasma VEGF was identified in all patients (178.28 ± 93.96 ng/mL. There was no significant correlation between CIMT and plasma VEGF levels in patients with post-acute thrombotic stroke (p=0.741. A significant correlation was recognized between CIMT and total cholesterol (p=0.029 and low-density lipoprotein (p=0.018. Conclusion: There were no significant correlations between CIMT and plasma VEGF levels in patients with post-acute thrombotic stroke. However, plasma VEGF increased in patients with thrombotic stroke. CIMT measurement is a promising noninvasive modality to assess the vascular condition of patients with stroke and diabetes, while plasma VEGF

  8. 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

  9. 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.

  10. 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.

  11. Oxygen uptake response to cycle ergometry in post-acute stroke patients with different severity of hemiparesis.

    Science.gov (United States)

    Chen, Chun-Kai; Weng, Ming-Cheng; Chen, Tien-Wen; Huang, Mao-Hsiung

    2013-11-01

    This study evaluated the impact of severity of hemiparesis on oxygen uptake (VO2) response in post-acute stroke patients. Sixty-four patients with a mean poststroke interval of 8.6 ± 3.8 days underwent a ramp cardiopulmonary exercise test on a cycling ergometer to volitional termination. Mean peak VO2 (VO2peak) and work efficiency (ΔVO2/ΔWR) were measured by open-circuit spirometry during standard upright ergometer cycling. Severity of the hemiparetic lower limb was assessed by Brunnstrom's motor recovery stages lower extremity (BMRSL). VO2peak was 10% lower in hemiparetic leg with BMRSL V than in that with BMRSL VI, 20% lower in BMRSL IV, and 50% lower in BMRSL III. ΔVO2/ΔWR was higher for the group with increased BMRSL. The relations were consistent after adjustment for age, sex, body mass index, stroke type, hemiparetic side, modified Ashworth Scale, time poststroke, comorbidities, and medications. Our findings revealed that O2peak is dependent on the severity of hemiparesis in leg, and along with ΔO2/ΔWR closely related to the severity of hemiparesis in post-acute stroke patients, regardless of the types and locations of lesion after stroke, as well as the differences in comorbidities and medications. Copyright © 2013. Published by Elsevier B.V.

  12. 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)

  13. 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.

  14. 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

  15. 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.

  16. 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

  17. The Association between Anticholinergic Drug Use and Rehabilitation Outcome in Post-Acute Hip Fractured Patients: A Retrospective Cohort Study.

    Science.gov (United States)

    Hershkovitz, Avital; Angel, Corina; Brill, Shai; Nissan, Ran

    2018-04-01

    Anticholinergic (AC) drugs are associated with significant impairment in cognitive and physical function which may affect rehabilitation in older people. We aimed to evaluate whether AC burden is associated with rehabilitation achievement in post-acute hip-fractured patients. A retrospective cohort study carried out in a post-acute geriatric rehabilitation center on 1019 hip-fractured patients admitted from January 2011 to October 2015. The Anticholinergic Cognitive Burden Scale (ACB) was used to quantify the AC burden. Main outcome measures included the Functional Independence Measure (FIM) instrument, motor FIM (mFIM), Montebello Rehabilitation Factor Score (MRFS) on the mFIM, and length of stay (LOS). The study population was divided into two groups: individuals with low admission AC burden (ACB ≤ 1) and those with high admission AC burden (ACB ≥ 2). The relationship between the admission AC burden and clinical, demographic and comorbidity variables was assessed using the Mann-Whitney and Chi square tests. A multiple linear regression model was used to estimate the association between admission AC burden and discharge FIM score after controlling for sociodemographic characteristics and chronic diseases. Patients with a high admission AC burden had a significantly higher rate of high education, a significantly lower rate reside at home, they waited a longer period of time from surgery to rehabilitation, were less independent pre-fracture, and presented with a higher rate of vascular disorders and depression compared with patients with a lower admission AC burden. These patients also exhibited a significantly lower FIM score on admission and at discharge, a lower FIM score change, and a lower achievement on the MRFS compared with patients with a lower admission AC burden. A multiple linear regression analysis showed that admission AC burden was significantly associated with the discharge FIM score after adjustment for confounding variables. High admission

  18. 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

  19. 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

  20. 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

  1. Assessing the Psychedelic “After-Glow” in Ayahuasca Users: Post-Acute Neurometabolic and Functional Connectivity Changes Are Associated with Enhanced Mindfulness Capacities

    Science.gov (United States)

    Sampedro, Frederic; de la Fuente Revenga, Mario; Valle, Marta; Roberto, Natalia; Domínguez-Clavé, Elisabet; Elices, Matilde; Luna, Luís Eduardo; Crippa, José Alexandre S; Hallak, Jaime E C; de Araujo, Draulio B; Friedlander, Pablo; Barker, Steven A; Álvarez, Enrique; Soler, Joaquim; Pascual, Juan C; Feilding, Amanda

    2017-01-01

    Abstract Background Ayahuasca is a plant tea containing the psychedelic 5-HT2A agonist N,N-dimethyltryptamine and harmala monoamine-oxidase inhibitors. Acute administration leads to neurophysiological modifications in brain regions of the default mode network, purportedly through a glutamatergic mechanism. Post-acutely, ayahuasca potentiates mindfulness capacities in volunteers and induces rapid and sustained antidepressant effects in treatment-resistant patients. However, the mechanisms underlying these fast and maintained effects are poorly understood. Here, we investigated in an open-label uncontrolled study in 16 healthy volunteers ayahuasca-induced post-acute neurometabolic and connectivity modifications and their association with mindfulness measures. Methods Using 1H-magnetic resonance spectroscopy and functional connectivity, we compared baseline and post-acute neurometabolites and seed-to-voxel connectivity in the posterior and anterior cingulate cortex after a single ayahuasca dose. Results Magnetic resonance spectroscopy showed post-acute reductions in glutamate+glutamine, creatine, and N-acetylaspartate+N-acetylaspartylglutamate in the posterior cingulate cortex. Connectivity was increased between the posterior cingulate cortex and the anterior cingulate cortex, and between the anterior cingulate cortex and limbic structures in the right medial temporal lobe. Glutamate+glutamine reductions correlated with increases in the “nonjudging” subscale of the Five Facets Mindfulness Questionnaire. Increased anterior cingulate cortex-medial temporal lobe connectivity correlated with increased scores on the self-compassion questionnaire. Post-acute neural changes predicted sustained elevations in nonjudging 2 months later. Conclusions These results support the involvement of glutamate neurotransmission in the effects of psychedelics in humans. They further suggest that neurometabolic changes in the posterior cingulate cortex, a key region within the default

  2. Assessing the Psychedelic "After-Glow" in Ayahuasca Users: Post-Acute Neurometabolic and Functional Connectivity Changes Are Associated with Enhanced Mindfulness Capacities.

    Science.gov (United States)

    Sampedro, Frederic; de la Fuente Revenga, Mario; Valle, Marta; Roberto, Natalia; Domínguez-Clavé, Elisabet; Elices, Matilde; Luna, Luís Eduardo; Crippa, José Alexandre S; Hallak, Jaime E C; de Araujo, Draulio B; Friedlander, Pablo; Barker, Steven A; Álvarez, Enrique; Soler, Joaquim; Pascual, Juan C; Feilding, Amanda; Riba, Jordi

    2017-09-01

    Ayahuasca is a plant tea containing the psychedelic 5-HT2A agonist N,N-dimethyltryptamine and harmala monoamine-oxidase inhibitors. Acute administration leads to neurophysiological modifications in brain regions of the default mode network, purportedly through a glutamatergic mechanism. Post-acutely, ayahuasca potentiates mindfulness capacities in volunteers and induces rapid and sustained antidepressant effects in treatment-resistant patients. However, the mechanisms underlying these fast and maintained effects are poorly understood. Here, we investigated in an open-label uncontrolled study in 16 healthy volunteers ayahuasca-induced post-acute neurometabolic and connectivity modifications and their association with mindfulness measures. Using 1H-magnetic resonance spectroscopy and functional connectivity, we compared baseline and post-acute neurometabolites and seed-to-voxel connectivity in the posterior and anterior cingulate cortex after a single ayahuasca dose. Magnetic resonance spectroscopy showed post-acute reductions in glutamate+glutamine, creatine, and N-acetylaspartate+N-acetylaspartylglutamate in the posterior cingulate cortex. Connectivity was increased between the posterior cingulate cortex and the anterior cingulate cortex, and between the anterior cingulate cortex and limbic structures in the right medial temporal lobe. Glutamate+glutamine reductions correlated with increases in the "nonjudging" subscale of the Five Facets Mindfulness Questionnaire. Increased anterior cingulate cortex-medial temporal lobe connectivity correlated with increased scores on the self-compassion questionnaire. Post-acute neural changes predicted sustained elevations in nonjudging 2 months later. These results support the involvement of glutamate neurotransmission in the effects of psychedelics in humans. They further suggest that neurometabolic changes in the posterior cingulate cortex, a key region within the default mode network, and increased connectivity between the

  3. 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.

  4. 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)

  5. 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

  6. 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.

  7. 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

  8. 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.

  9. [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.

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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-.

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

    Directory of Open Access Journals (Sweden)

    Fatemeh Bahador

    2017-10-01

    imaging department. The majority of users agreed with the PACS benefits. Adequate management measures must be taken to maximize the benefits derived from this system and the utilization of information in order to improve the quality of care. Adequate training and elimination of the deficiencies could affect the use of this system and improvement in the health care services.

  16. Perspectives of patients on factors relating to adherence to post-acute coronary syndrome medical regimens

    Directory of Open Access Journals (Sweden)

    Lambert-Kerzner A

    2015-07-01

    Full Text Available Anne Lambert-Kerzner,1,2 Edward P Havranek,2,3 Mary E Plomondon,1,2 Katherine M Fagan,1 Marina S McCreight,1 Kelty B Fehling,1 David J Williams,2 Alison B Hamilton,4 Karen Albright,2 Patrick J Blatchford,2 Renee Mihalko-Corbitt,5 Chris L Bryson,6 Hayden B Bosworth,7 Miriam A Kirshner,7 Eric J Del Giacco,5 P Michael Ho1,2 1Department of Cardiology, Veterans Health Administration (VA Eastern Colorado Health Care System, Denver, CO, 2School of Public Health or School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, 3Cardiology, Denver Health Medical Center, Denver, CO, 4Health Services Research, Veterans Health Administration (VA Greater Los Angeles Healthcare System, Los Angeles, CA, 5Internal Medicine, John L. McClellan Memorial Veterans Hospital, Little Rock, AR, 6Health Services Research, Veterans Health Administration (VA Puget Sound Health Care System, Seattle, WA, 7Health Services Research, Durham Veterans Affairs Medical Center, Durham, NC, USA Purpose: Poor adherence to cardioprotective medications after acute coronary syndrome (ACS hospitalization is associated with increased risk of rehospitalization and mortality. Clinical trials of multifaceted interventions have improved medication adherence with varying results. Patients’ perspectives on interventions could help researchers interpret inconsistent outcomes. Identifying factors that patients believe would improve adherence might inform the design of future interventions and make them more parsimonious and sustainable. The objective of this study was to obtain patients’ perspectives on adherence to medical regimens after experiencing an ACS event and their participation in a medication adherence randomized control trial following their hospitalization. Patients and methods: Sixty-four in-depth interviews were conducted with ACS patients who participated in an efficacious, multifaceted, medication adherence randomized control trial. Interview transcripts were

  17. 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

  18. 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.

  19. 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.

  20. Workflow optimization beyond RIS and PACS

    International Nuclear Information System (INIS)

    Treitl, M.; Wirth, S.; Lucke, A.; Nissen-Meyer, S.; Trumm, C.; Rieger, J.; Pfeifer, K.-J.; Reiser, M.; Villain, S.

    2005-01-01

    Technological progress and the rising cost pressure on the healthcare system have led to a drastic change in the work environment of radiologists today. The pervasive demand for workflow optimization and increased efficiency of its activities raises the question of whether by employment of electronic systems, such as RIS and PACS, the potentials of digital technology are sufficiently used to fulfil this demand. This report describes the tasks and structures in radiology departments, which so far are only insufficiently supported by commercially available electronic systems but are nevertheless substantial. We developed and employed a web-based, integrated workplace system, which simplifies many daily tasks of departmental organization and administration apart from well-established tasks of documentation. Furthermore, we analyzed the effects exerted on departmental workflow by employment of this system for 3 years. (orig.) [de

  1. Sacubitril and valsartan fixed combination to reduce heart failure events in post-acute myocardial infarction patients.

    Science.gov (United States)

    Zaid Iskandar, M; Lang, C C

    2017-10-01

    Heart failure is a term used to define a constellation of symptoms and signs that are commonly attributed to the inability of the heart to produce a cardiac output that meets the demands of the body. It remains a deadly disease, affecting between 1-2% of the population, and is more common in the elderly, with around 6-10% of patients over 65 suffering from the condition. Sacubitril/valsartan (LCZ-696) is a combined neprilysin inhibitor and angiotensin AT1 receptor blocker approved in recent years for the treatment of chronic heart failure with reduced ejection fraction. In an area where there have been limited pharmacological advances in the last 10 years, this drug was a game changer and a much welcomed addition to contemporary heart failure therapy. It is currently being studied in patients with heart failure with preserved ejection fraction and for the reduction of heart failure events post-acute myocardial infarction. Results from the ongoing PARADISE-MI study are awaited by the global cardiology community with great interest. Copyright 2017 Clarivate Analytics.

  2. tDCS combined with optokinetic drift reduces egocentric neglect in severely impaired post-acute patients.

    Science.gov (United States)

    Turgut, Nergiz; Miranda, Marcela; Kastrup, Andreas; Eling, Paul; Hildebrandt, Helmut

    2018-06-01

    Visuospatial neglect is a disabling syndrome resulting in impaired activities of daily living and in longer durations of inpatient rehabilitation. Effective interventions to remediate neglect are still needed. The combination of tDCS and an optokinetic task might qualify as a treatment method. A total of 32 post-acute patients with left (n = 20) or right-sided neglect were allotted to an intervention or a control group (both groups n = 16). The intervention group received eight sessions of 1.5-2.0 mA parietal transcranial direct current stimulation (tDCS) during the performance of an optokinetic task distributed over two weeks. Additionally they received standard therapy for five hours per day. The control group received only the standard therapy. Patients were examined twice before (with 3-4 days between examinations) and twice after treatment (5-6 days between examinations). Compared to the control group and controlling for spontaneous remission, the intervention group improved on spontaneous body orientation and the Clock Drawing Test. Intragroup comparisons showed broad improvements on egocentric but not on allocentric symptoms only for the intervention group. A short additional application of tDCS during an optokinetic task led to improvements of severe neglect compared to a standard neurological early rehabilitation treatment. Improvements seem to concern primarily egocentric rather than allocentric neglect.

  3. 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.

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

    Science.gov (United States)

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

    2000-05-01

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

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

    Science.gov (United States)

    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.

  6. Staged residential post-acute rehabilitation for adults following acquired brain injury: A comparison of functional gains rated on the UK Functional Assessment Measure (UK FIM+FAM) and the Mayo-Portland Adaptability Inventory (MPAI-4).

    Science.gov (United States)

    Jackson, Diana; Seaman, Karla; Sharp, Kristylee; Singer, Rachel; Wagland, Janet; Turner-Stokes, Lynne

    2017-01-01

    To compare the UK Functional Assessment Measure (UK FIM+FAM) and Mayo-Portland Adaptability Inventory (MPAI-4) as measures of functional change in patients with brain injury receiving a staged residential post-acute community-based rehabilitation programme. Longitudinal cohort study of consecutive admissions (N = 42) over 3 years. Patients were assessed at admission and discharge/annual review. We examined groups according to stage of independence on admission: Maximum support (stages 1 and 2: N = 17); moderate/maximum self-care/household support (stage 3: N = 15); minimal self-care and moderate household/community support (stages 4-6: N = 10). Median (IQR) age: 50 (37-56) years. Male:female ratio: (71%:29%). Aetiology: stroke (50%), traumatic (36%) and other brain injuries (14%). Both tools demonstrated significant gains in overall scores and all subscales (p MPAI-4 was more sensitive to changes in adjustment and participation for clients admitted in the later stages (4-6). The UK FIM+FAM and MPAI-4 provide complementary evaluation across functional tasks ranging from self-care to participation. This study supports their use for longitudinal outcome evaluation in community residential rehabilitation services that take patients at different stages of recovery.

  7. 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

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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,.

  13. The Behavioural Assessment of Self-Structuring (BASS): psychometric properties in a post-acute brain injury rehabilitation programme.

    Science.gov (United States)

    Jackson, Howard F; Tunstall, Victoria; Hague, Gemma; Daniels, Leanne; Crompton, Stacey; Taplin, Kimberly

    2014-01-01

    Jackson et al. (this edition) argue that structure is an important component in reducing the handicaps caused by cognitive impairments following acquired brain injury and that post-acute neuropsychological brain injury rehabilitation programmes should not only endeavour to provide structure but also aim to develop self-structuring. However, at present there is no standardized device for assessing self-structuring. To provide preliminary analysis of the psychometric properties of the Behavioural Assessment of Self-Structuring (BASS) staff rating scale (a 26 item informant five point rating scale based on the degree of support client requires to achieve self-structuring item). BASS data was utilised for clients attending residential rehabilitation. Reliability (inter-rarer and intra-rater), validity (construct, concurrent and discriminate) and sensitivity to change were investigated. Initial results indicate that the BASS has reasonably good reliability, good construct validity (via principal components analysis), good discriminant validity, and good concurrent validity correlating well with a number of other outcome measures (HoNOS; NPDS, Supervision Rating Scale, MPAI, FIM and FAM). The BASS did not correlate well with the NPCNA. Finally, the BASS was shown to demonstrate sensitivity to change. Although some caution is required in drawing firm conclusions at the present time and further exploration of the psychometric properties of the BASS is required, initial results are encouraging for the use of the BASS in assessing rehabilitation progress. These findings are discussed in terms of the value of the concept of self-structuring to the rehabilitation process for individuals with neuropsychological impairments consequent on acquired brain injury.

  14. Prevalence, Reasons for Use, and Risk Perception of Electronic Cigarettes Among Post-Acute Coronary Syndrome Smokers.

    Science.gov (United States)

    Busch, Andrew M; Leavens, Eleanor L; Wagener, Theodore L; Buckley, Maria L; Tooley, Erin M

    2016-01-01

    The use of electronic cigarettes (e-cigarettes) has risen dramatically in recent years. However, there are currently no published data on the use of e-cigarettes among cardiac patients. The current study reports on the prevalence, reasons for use, and perceived risks of e-cigarettes among patients with post-acute coronary syndrome (ACS). The relationship between e-cigarette use and post-ACS tobacco smoking cessation is also explored. Participants were drawn from a randomized trial of smoking cessation treatments following hospitalization for ACS. The current study focused on 49 participants who completed e-cigarette questions at 24 weeks post-ACS. Of the 49 of participants, 51.0% reported ever use of an e-cigarette and 26.5% reported using an e-cigarette at some time during the 24 weeks post-ACS. Ever use and post-ACS use were both significantly associated with lower rates of abstinence from tobacco cigarettes. Participants perceived e-cigarettes as less harmful to cardiac health than tobacco use and Chantix (varenicline), and similarly harmful as nicotine replacement therapy. Participant perceived likelihood of experiencing a heart attack in the next year was 34.6% if they were to regularly use only e-cigarettes, significantly lower than the perceived risk of recurrence if they were to regularly smoke only tobacco cigarettes (56.2%) and significantly higher than the perceived risk of recurrence if they were to use no nicotine (15.2%). A significant minority of patients are using e-cigarettes post-ACS. Providers should be prepared to discuss potential discrepancies between patient beliefs about the safety of e-cigarettes and the current state of the science.

  15. [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

  16. 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.

  17. 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)

  18. 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)

  19. PACS war room for global teleradiology

    Science.gov (United States)

    Chen, Doris T.; Ho, Bruce K. T.; Chao, Woodrew; Taira, Ricky K.; Kangarloo, Hooshang

    1995-05-01

    UCLA is beginning teleradiology projects in Latin America, Asian Pacific, and the U.S. The UCLA teleradiology system communicates with remote imaging centers through a T1 based WAN and satellite technology. A network management center, i.e., PACS war room, with graphical user interface allows the system manager to monitor and control different elements of the system through various levels of abstraction from one location. The network manager software can monitor the activities of both hardware and software devices in the remote imaging centers, LAN and WAN performance, telearchiving and teleaccess pattern. Telearchiving can be monitored by graphically indicating large image movements between jukeboxes and over LAN or WAN. Once the teleradiology system is configured, the image flow pattern in a teleradiology center is predictable. Manual intervention of these teleradiology system functions is easily done through menu control in the war room display. A centralized network management with the global view of a teleradiology system has been developed. It can give commands to the elements of the system to tune the system for efficient utilization of the system resources. These managerial functions scale with the teleradiology system which is expandable to include many more potential remote imaging centers.

  20. 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

  1. 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.)

  2. 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.

  3. Cardio-PACs: a new opportunity

    Science.gov (United States)

    Heupler, Frederick A., Jr.; Thomas, James D.; Blume, Hartwig R.; Cecil, Robert A.; Heisler, Mary

    2000-05-01

    It is now possible to replace film-based image management in the cardiac catheterization laboratory with a Cardiology Picture Archiving and Communication System (Cardio-PACS) based on digital imaging technology. The first step in the conversion process is installation of a digital image acquisition system that is capable of generating high-quality DICOM-compatible images. The next three steps, which are the subject of this presentation, involve image display, distribution, and storage. Clinical requirements and associated cost considerations for these three steps are listed below: Image display: (1) Image quality equal to film, with DICOM format, lossless compression, image processing, desktop PC-based with color monitor, and physician-friendly imaging software; (2) Performance specifications include: acquire 30 frames/sec; replay 15 frames/sec; access to file server 5 seconds, and to archive 5 minutes; (3) Compatibility of image file, transmission, and processing formats; (4) Image manipulation: brightness, contrast, gray scale, zoom, biplane display, and quantification; (5) User-friendly control of image review. Image distribution: (1) Standard IP-based network between cardiac catheterization laboratories, file server, long-term archive, review stations, and remote sites; (2) Non-proprietary formats; (3) Bidirectional distribution. Image storage: (1) CD-ROM vs disk vs tape; (2) Verification of data integrity; (3) User-designated storage capacity for catheterization laboratory, file server, long-term archive. Costs: (1) Image acquisition equipment, file server, long-term archive; (2) Network infrastructure; (3) Review stations and software; (4) Maintenance and administration; (5) Future upgrades and expansion; (6) Personnel.

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. Methodology Of PACS Effectiveness Evaluation As Part Of A Technology Assessment. The Dutch PACS Project Extrapolated.

    Science.gov (United States)

    Andriessen, J. H. T. H.; van der Horst-Bruinsma, I. E.; ter Haar Romeny, B. M.

    1989-05-01

    The present phase of the clinical evaluation within the Dutch PACS project mainly focuses on the development and evaluation of a PACSystem for a few departments in the Utrecht University hospital (UUH). A report on the first clinical experiences and a detailed cost/savings analysis of the PACSystem in the UUH are presented elsewhere. However, an assessment of the wider fmancial and organizational implications for hospitals and for the health sector is also needed. To this end a model for (financial) cost assessment of PACSystems is being developed by BAZIS. Learning from the actual pilot implementation in UUH we realized that general Technology Assessment (TA) also calls for an extra-polation of the medical and organizational effects. After a short excursion into the various approaches towards TA, this paper discusses the (inter) organizational dimensions relevant to the development of the necessary exttapolationmodels.

  10. 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.

  11. 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.

  12. 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

  13. 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...

  14. 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.)

  15. What is the Best Strategy to Minimize After-Care Costs for Total Joint Arthroplasty in a Bundled Payment Environment?

    Science.gov (United States)

    Slover, James D; Mullaly, Kathleen A; Payne, Ashley; Iorio, Richard; Bosco, Joseph

    2016-12-01

    The post-acute care strategies after lower extremity total joint arthroplasty including the use of post-acute rehabilitation centers and home therapy services are associated with different costs. Providers in bundled payment programs are incentivized to use the most cost-effective strategies. We used decision analysis to examine the impact of extending the inpatient hospital stay to avoid discharge of patients to a post-acute rehabilitation facility. The results of this decision analysis show that extended acute hospital care for up to 5.2 extra days to allow for home discharge, rather than discharge to a post-acute inpatient facility can be financially preferable, provided quality is not negatively impacted. The data demonstrate that because the cost of additional acute care hospital days is relatively small and because the cost of an extended post-acute inpatient rehabilitation facility is high, keeping patients in the acute facility for a few extra days and then discharging them directly to home may result in an overall lower cost than discharge after a shorter hospital stay to an expensive post-acute facility. However, this approach will have challenges, and future studies are needed to evaluate this change in strategy. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. 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

  17. 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

  18. 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

  19. 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...

  20. 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.

  1. 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.

  2. 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

  3. (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 ...

  4. 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.)

  5. 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),

  6. 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.

  7. 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.

  8. Care and feeding of a staff for filmless radiology

    OpenAIRE

    Mensch, Bonnie; Honea, Rosemary; Orand, Michael

    1999-01-01

    Texas Children’s Hospital, a definitive care pediatric hospital located in the Texas Medical Center, has been constructing a large-scale picture archival and communications system (PACS) including ultrasound (US), computed tomography (CT), magnetic resonance (MR), and computed radiography (CR). Developing staffing adequate to meet the demands of filmless radiology operations has been a continuous challenge. Overall guidance for the PACS effort is provided by a hospital-level PACS Committee, a...

  9. Postacute rehabilitation quality of care: toward a shared conceptual framework.

    Science.gov (United States)

    Jesus, Tiago Silva; Hoenig, Helen

    2015-05-01

    There is substantial interest in mechanisms for measuring, reporting, and improving the quality of health care, including postacute care (PAC) and rehabilitation. Unfortunately, current activities generally are either too narrow or too poorly specified to reflect PAC rehabilitation quality of care. In part, this is caused by a lack of a shared conceptual understanding of what construes quality of care in PAC rehabilitation. This article presents the PAC-rehab quality framework: an evidence-based conceptual framework articulating elements specifically pertaining to PAC rehabilitation quality of care. The widely recognized Donabedian structure, process, and outcomes (SPO) model furnished the underlying structure for the PAC-rehab quality framework, and the International Classification of Functioning, Disability and Health (ICF) framed the functional outcomes. A comprehensive literature review provided the evidence base to specify elements within the SPO model and ICF-derived framework. A set of macrolevel-outcomes (functional performance, quality of life of patient and caregivers, consumers' experience, place of discharge, health care utilization) were defined for PAC rehabilitation and then related to their (1) immediate and intermediate outcomes, (2) underpinning care processes, (3) supportive team functioning and improvement processes, and (4) underlying care structures. The role of environmental factors and centrality of patients in the framework are explicated as well. Finally, we discuss why outcomes may best measure and reflect the quality of PAC rehabilitation. The PAC-rehab quality framework provides a conceptually sound, evidence-based framework appropriate for quality of care activities across the PAC rehabilitation continuum. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  10. Changes in aspects of social functioning depend upon prior changes in neurodisability in people with acquired brain injury undergoing post-acute neurorehabilitation.

    Science.gov (United States)

    Fortune, Dónal G; Walsh, R Stephen; Waldron, Brian; McGrath, Caroline; Harte, Maurice; Casey, Sarah; McClean, Brian

    2015-01-01

    Post-acute community-based rehabilitation is effective in reducing disability. However, while social participation and quality of life are valued as distal outcomes of neurorehabilitation, it is often not possible to observe improvements on these outcomes within the limited time-frames used in most investigations of rehabilitation. The aim of the current study was to examine differences in the sequence of attainments for people with acquired brain injury (ABI) undergoing longer term post-acute neurorehabilitation. Participants with ABI who were referred to comprehensive home and community-based neurorehabilitation were assessed at induction to service, at 6 months and again at 1.5 years while still in service on the Mayo-Portland Adaptability Index (MPAI-4), Community Integration Questionnaire, Hospital Anxiety and Depression Scale, and World Health Organisation Quality of Life measure. At 6 months post-induction to service, significant differences were evident in MPAI abilities, adjustment, and total neurodisability; and in anxiety and depression. By contrast, there was no significant effect at 6 months on more socially oriented features of experience namely quality of life (QoL), Community Integration and Participation. Eighteen month follow-up showed continuation of the significant positive effects with the addition of QoL-related to physical health, Psychological health, Social aspects of QoL and Participation at this later time point. Regression analyses demonstrated that change in QoL and Participation were dependent upon prior changes in aspects of neurodisability. Age, severity or type of brain injury did not significantly affect outcome. Results suggest that different constructs may respond to neurorehabilitation at different time points in a dose effect manner, and that change in social aspects of experience may be dependent upon the specific nature of prior neurorehabilitation attainments.

  11. Changes in aspects of social functioning depend upon prior changes in neurodisability in people with acquired brain injury undergoing post-acute neurorehabilitation.

    Directory of Open Access Journals (Sweden)

    Donal Gerard Fortune

    2015-09-01

    Full Text Available Post-acute community-based rehabilitation is effective in reducing disability. However, while social participation and quality of life are valued as distal outcomes of neurorehabilitation, it is often not possible to observe improvements on these outcomes within the limited time-frames used in most investigations of rehabilitation. The aim of the current study was to examine differences in the sequence of attainments for people with Acquired Brain Injury (ABI undergoing longer term post-acute neurorehabilitation. Participants with ABI who were referred to comprehensive home and community-based neurorehabilitation were assessed at induction to service, at 6 months and again at 1.5 years while still in service on the Mayo-Portland Adaptability Index (MPAI-4, Community Integration Questionnaire (CIQ, Hospital Anxiety and Depression Scale (HADS and World Health Organisation Quality of Life measure (WHOQoL-Bref. At 6 month post-induction to service, significant differences were evident in MPAI abilities, adjustment, and total neurodisability; and in anxiety and depression. By contrast, there was no significant effect at 6 months on more socially oriented features of experience namely Quality of life (QoL, Community Integration and Participation. Eighteen month follow-up showed continuation of the significant positive effects with the addition of QoL-related to physical health, Psychological health, Social aspects of QoL and Participation at this later time point. Regression analyses demonstrated that change in QoL and Participation were dependent upon prior changes in aspects of neurodisability. Age, severity or type of brain injury did not significantly affect outcome. Results suggest that different constructs may respond to neurorehabilitation at different time points in a dose effect manner, and that change in social aspects of experience may be dependent upon the specific nature of prior neurorehabilitation attainments.

  12. 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

  13. 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

  14. 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.

  15. 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

  16. 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

  17. Learning in clinical practice: findings from CT, MRI and PACS

    OpenAIRE

    Sinozic, Tanja

    2014-01-01

    This thesis explores learning in clinical practice in the cases of CT, MRI and PACS in\\ud UK hospitals. It asks the questions of how and why certain evolutionary features of\\ud technology condition learning and change in medical contexts.\\ud Using an evolutionary perspective of cognitive and social aspects of technological\\ud change, this thesis explores the relationships between technology and organisational\\ud learning processes of intuition, interpretation, integration and institutionalisa...

  18. 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.

  19. Description and repair procedure for optical digitizers PAC-4

    International Nuclear Information System (INIS)

    Hayat, M.K.; Ahmad, M.S.; Beg, M.M.

    1982-06-01

    The optical digitizer type PAC-4 is an optical analogue-to-digital converter with parallel read out. The optical digitizer is intended for digital measurements of angular rotation of its shaft. In this application the control shaft of the digitizer is coupled to a wheel, which moves on the carriage of the respective spectrometer axes, and indicates its angular position. For accurate determination of the selected neutron energies, it is important to measure the diffraction angles very accurately. (orig./A.B.)

  20. 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++.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. Ankle manual therapy for individuals with post-acute ankle sprains: description of a randomized, placebo-controlled clinical trial

    OpenAIRE

    Fisher Beth E; Kulig Kornelia; Davenport Todd E

    2010-01-01

    Abstract Background Ankle sprains are common within the general population and can result in prolonged disablement. Limited talocrural dorsiflexion range of motion (DF ROM) is a common consequence of ankle sprain. Limited talocrural DF ROM may contribute to persistent symptoms, disability, and an elevated risk for re-injury. As a result, many health care practitioners use hands-on passive procedures with the intention of improving talocrural joint DF ROM in individuals following ankle sprains...

  8. Eplerenone survival benefits in heart failure patients post-myocardial infarction are independent from its diuretic and potassium-sparing effects. Insights from an EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study) substudy

    DEFF Research Database (Denmark)

    Rossignol, Patrick; Ménard, Joël; Fay, Renaud

    2011-01-01

    The purpose of this study was to determine whether a diuretic effect may be detectable in patients treated with eplerenone, a mineralocorticoid receptor antagonist, as compared with placebo during the first month of EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy...

  9. Eplerenone survival benefits in heart failure patients post-myocardial infarction are independent from its diuretic and potassium-sparing effects. Insights from an EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study) substudy

    DEFF Research Database (Denmark)

    Rossignol, Patrick; Ménard, Joël; Fay, Renaud

    2011-01-01

    The purpose of this study was to determine whether a diuretic effect may be detectable in patients treated with eplerenone, a mineralocorticoid receptor antagonist, as compared with placebo during the first month of EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and S...

  10. 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.

  11. 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.)

  12. 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

  13. 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.

  14. 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.

  15. Ethernet image communication performance in a multimodal PACS network

    International Nuclear Information System (INIS)

    Lou, S.L.; Valentino, D.J.; Chan, K.K.; Huang, H.K.

    1989-01-01

    The authors have evaluated the performance of an Ethernet network in a multimodal picture archiving and communications system (PACS) environment. The study included measurements between Sun workstations and PC- AT computers running communication software at the TCP level. First they initiated image transfers between two workstations, a server and a client. Next, they successively added clients to transfer images to the server and they measured degradation in network performance. Finally, they initiated image transfers between pairs of workstations and again measured performance degradation. The results of the authors' experiments indicate that Ethernet is suitable for image communication only in limited network situations. They discuss how to maximize network performance given these constraints

  16. Pac-Rim LNG project : final project report specifications

    International Nuclear Information System (INIS)

    1996-01-01

    PAC-RIM LNG Inc. has submitted a proposal to the British Columbia Environmental Assessment Office, to develop a liquefied natural gas project which would purchase pipeline quality natural gas from sources in northeast British Columbia and Alberta and transport it via a dedicated pipeline system to a LNG processing plant on tidewater on the Pacific coast. The project would include storage and processing facilities and a marine loading terminal. This document sets out the final project report specifications prepared by the Project Committee on the basis of input received from the public, First Nations and federal, provincial and local governments

  17. PACS/information systems interoperability using Enterprise Communication Framework.

    Science.gov (United States)

    alSafadi, Y; Lord, W P; Mankovich, N J

    1998-06-01

    Interoperability among healthcare applications goes beyond connectivity to allow components to exchange structured information and work together in a predictable, coordinated fashion. To facilitate building an interoperability infrastructure, an Enterprise Communication Framework (ECF) was developed by the members of the Andover Working Group for Healthcare Interoperability (AWG-OHI). The ECF consists of four models: 1) Use Case Model, 2) Domain Information Model (DIM), 3) Interaction Model, and 4) Message Model. To realize this framework, a software component called the Enterprise Communicator (EC) is used. In this paper, we will demonstrate the use of the framework in interoperating a picture archiving and communication system (PACS) with a radiology information system (RIS).

  18. Ceramic sphere-pac breeder design for fusion blankets

    International Nuclear Information System (INIS)

    Gierszewski, P.J.; Sullivan, J.D.

    1991-01-01

    Randomly packed beds of ceramic spheres are a practical approach to surrounding fusion plasmas with tritium-breeding material. This paper examines the general properties of sphere-pac beds for application in fusion breeder blankets. The design considerations and models are reviewed for packing, tritium breeding and recovery, thermal conductivity, purge-gas pressure drop, mechanical behavior and fabrication. The design correlations are compared against available fusion ceramic data. Specific conclusions are that ternary (three-size) beds are not attractive for fusion blankets, and that the fusion spheres should be as large as possible subject primarily to packing constraints. (orig.)

  19. Impurity cluster interaction in fcc metals studied by PAC

    International Nuclear Information System (INIS)

    Deicher, M.; Echt, O.; Recknagel, E.; Wichert, T.

    1981-01-01

    A defect configuration of high thermal stability has been observed by PAC in Au, showing the same properties as previously published configuration in Cu and Ni. We prove that these configurations cannot consist of any small defect complex with well-defined size; especially the observed influence of the damaging conditions on the thermal stability of the defects in Au and Cu would contradict such an assumption. It is shown that probe atoms trapped at large clusters of variable size can nevertheless experience a unique electric field gradient, and that in our case intrinsic stacking faults, formed by vacancies, can account for all the measured properties. (orig.)

  20. Automating PACS Quality Control with the Vanderbilt Image Processing Enterprise Resource.

    Science.gov (United States)

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

    2012-02-12

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

  1. Talking PACS: Part 2 - why should we change to PACS? | Schulze ...

    African Journals Online (AJOL)

    This article is a critical evaluation of the workflow within a film- and paper-based imaging department. It also illustrates how all the factors culminate to produce poor patient care and decreased productivity. Practical examples are provided within the Tygerberg Hospital scenario. The effect of international trends on the ...

  2. SIAM (Suicide intervention assisted by messages): the development of a post-acute crisis text messaging outreach for suicide prevention.

    Science.gov (United States)

    Berrouiguet, Sofian; Alavi, Zarrin; Vaiva, Guillaume; Courtet, Philippe; Baca-García, Enrique; Vidailhet, Pierre; Gravey, Michel; Guillodo, Elise; Brandt, Sara; Walter, Michel

    2014-11-18

    Suicidal behaviour and deliberate self-harm are common among adults. Research indicates that maintaining contact either via letter or postcard with at-risk adults following discharge from care services can reduce reattempt risk. Feasibility trials demonstrated that intervention through text message was also effective in preventing suicide repetition amongst suicide attempters. The aim of the current study is to investigate the effect of text message intervention versus traditional treatment on reducing the risk of suicide attempt repetition among adults after self-harm. The study will be a 2-year multicentric randomized controlled trial conducted by the Brest University Hospital, France. Participants will be adults discharged after self-harm, from emergency services or after a short hospitalization. Participants will be recruited over a 12-month period. The intervention is comprised of an SMS that will be sent at h48, D7, D15 and monthly. The text message enquires about the patients' well-being and includes information regarding individual sources of help and evidence-based self help strategies. Participants will be assessed at the baseline, month 6 and 13. As primary endpoint, we will assess the number of patients who reattempt suicide in each group at 6 months. As secondary endpoints, we will assess the number of patients who reattempt suicide at 13 month, the number of suicide attempts in the intervention and control groups at 6 and 13 month, the number of death by suicide in the intervention and control groups at month 6 and 13. In both groups, suicidal ideations, will be assessed at the baseline, month 6 and 13. Medical costs and satisfaction will be assessed at month 13. This paper describes the design and deployment of a trial SIAM; an easily reproducible intervention that aims to reduce suicide risk in adults after self-harm. It utilizes several characteristics of interventions that have shown a significant reduction in the number of suicide reattempts. We

  3. 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

  4. 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

  5. Combined PACS and intranet information system in a University Hospital

    International Nuclear Information System (INIS)

    Heiss, D.; Pfluger, T.; Pfeifer, K.J.; Hahn, K.; Koenig, A.; Endres, S.

    2000-01-01

    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.) [de

  6. 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.

  7. 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...

  8. 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 ...

  9. 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

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

    Science.gov (United States)

    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.

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. Teleradiology and PACS - strategy of the Innsbruck University Hospital

    International Nuclear Information System (INIS)

    Vogl, R.

    2005-01-01

    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.) [de

  16. Benefits of cloud computing for PACS and archiving.

    Science.gov (United States)

    Koch, Patrick

    2012-01-01

    The goal of cloud-based services is to provide easy, scalable access to computing resources and IT services. The healthcare industry requires a private cloud that adheres to government mandates designed to ensure privacy and security of patient data while enabling access by authorized users. Cloud-based computing in the imaging market has evolved from a service that provided cost effective disaster recovery for archived data to fully featured PACS and vendor neutral archiving services that can address the needs of healthcare providers of all sizes. Healthcare providers worldwide are now using the cloud to distribute images to remote radiologists while supporting advanced reading tools, deliver radiology reports and imaging studies to referring physicians, and provide redundant data storage. Vendor managed cloud services eliminate large capital investments in equipment and maintenance, as well as staffing for the data center--creating a reduction in total cost of ownership for the healthcare provider.

  17. Report on the 2005 Particle Accelerator Conference (PAC05)

    International Nuclear Information System (INIS)

    Kathy F. Rosenbalm

    2005-01-01

    The 21st Particle Accelerator Conference, PAC05, took place at the Knoxville Convention Center (KCC) from Monday through Friday, May 16-20, 2005. Sponsored by the American Physical Society (APS), the Institute of Electrics and Electronics Engineers (IEEE) with its subdivision of Nuclear and Plasma Sciences Society (NPSS), the conference was hosted by the Oak Ridge National Laboratory (ORNL) Spallation Neutron Source (SNS) Project and Thomas Jefferson National Accelerator Facility (JLab). The conference was chaired by Norbert Holtkamp, and the Local Organizing Committee was made up of staff from the ORNL SNS Project under the chairmanship of Stuart Henderson. The conference welcomed over 1400 delegates from the United States, Europe, Asia, the Middle East, South America and from as far away as Australia. Almost 1400 papers where processed during the conference and will be published on the Joint Accelerator Conferences Website (JACoW) page

  18. PAC study of ionic motion in silver compound superionic conductors

    International Nuclear Information System (INIS)

    Mekata, M.; Seguchi, Y.

    1983-01-01

    Ionic motion in superionic conductors, Ag 2 S, Ag 2 Se and Ag 3 SI was investigated by γ-γ PAC on 111 Cd. Diffusion constant measurements showed that probe ions migrate almost as fast as Ag + ions above 500 K in Ag 2 S and Ag 2 Se and above 700 K in Ag 3 SI. Multivalent impurities were found to be unstable in AgI and Ag 2 Te. The correlation time of ionic motion was deduced from the observed relaxation rate together with the diffusion constants. The correlation time and its activation energy increase in order of Ag 2 S, Ag 2 Se and Ag 3 SI. The flight distance of Ag + ions remains almost constant in the measured temperature range. (Auth.)

  19. Proceedings of the 22nd Particle Accelerator Conference (PAC'07)

    International Nuclear Information System (INIS)

    2007-01-01

    The twenty-second Particle Accelerator Conference, PAC'07, took place at the Albuquerque Convention Centre in Albuquerque, the largest city in New Mexico, from Monday to Friday, 2007 June 25 to 29. It was attended by over 1350 delegates from 25 different countries (63% North America, 24% Europe, 11% Asia and 2% Other), and was held under the auspices of the two professional societies that oversee and make holding this series of conferences possible, the Division of Physics of Beams within APS, and the Nuclear and Plasma Sciences Society within IEEE. As host of the conference, Los Alamos National Laboratory (LANL) is especially thanked for their many contributions and assistance both prior to and during the conference. The Convention Center was an ideal location for information sharing and discussions between the interdisciplinary aspects of the accelerator community, as well as for related meetings and ad-hoc 'rump' sessions.

  20. 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

  1. 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.

  2. 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

  3. 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

  4. 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.)

  5. 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

  6. 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)

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

    Science.gov (United States)

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

    2006-01-01

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

  8. ChroPac-Trial: Duodenum-preserving pancreatic head resection versus pancreatoduodenectomy for chronic pancreatitis. Trial protocol of a randomised controlled multicentre trial

    Directory of Open Access Journals (Sweden)

    Schlitt Hans

    2010-04-01

    Full Text Available Abstract Background A recently published systematic review indicated superiority of duodenum-preserving techniques when compared with pancreatoduodenectomy, for the treatment of patients with chronic pancreatitis in the head of the gland. A multicentre randomised trial to confirm these results is needed. Methods/Design ChroPac aims to investigate differences in quality of life, mortality and morbidity during 24 months after surgery (duodenum-preserving pancreatic head resection versus pancreatoduodenectomy in patients with chronic pancreatitis of the pancreatic head. ChroPac is a randomised, controlled, observer and patient blinded multicentre surgical trial with two parallel comparison groups. The primary outcome measure will be the average quality of life during 24 months after surgery. Statistical analysis is based on the intention-to-treat population. Analysis of covariance will be applied for the intervention group comparison adjusting for age, centre and quality of life before surgery. Level of significance is set at 5% (two-sided and sample size (n = 100 per group is determined to assure a power of 90%. Discussion The ChroPac trial will explore important outcomes from different perspectives (e.g. surgeon, patient, health care system. Its pragmatic approach promises high external validity allowing a comprehensive evaluation of the surgical strategy for treatment of patients with chronic pancreatitis. Trial registration Controlled-trials.com ISRCTN38973832

  9. 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.

  10. 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...

  11. 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...

  12. 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

  13. 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....

  14. 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....

  15. 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....

  16. 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...

  17. 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....

  18. PacIOOS Water Quality Buoy 04 (WQB-04): Hilo Bay, Big Island, 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....

  19. 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...

  20. 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...

  1. 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...

  2. 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....

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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...

  9. 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....

  10. 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....

  11. 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....

  12. 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....

  13. 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....

  14. 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...

  15. PacIOOS Water Quality Buoy 03 (WQB-03): Kiholo Bay, Big Island, 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....

  16. 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....

  17. 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...

  18. 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....

  19. 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....

  20. 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....

  1. 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

  2. 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 ...

  3. 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)

  4. 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

  5. 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

  6. 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

  7. Java-based PACS and reporting system for nuclear medicine

    Science.gov (United States)

    Slomka, Piotr J.; Elliott, Edward; Driedger, Albert A.

    2000-05-01

    In medical imaging practice, images and reports often need be reviewed and edited from many locations. We have designed and implemented a Java-based Remote Viewing and Reporting System (JaRRViS) for a nuclear medicine department, which is deployed as a web service, at the fraction of the cost dedicated PACS systems. The system can be extended to other imaging modalities. JaRRViS interfaces to the clinical patient databases of imaging workstations. Specialized nuclear medicine applets support interactive displays of data such as 3-D gated SPECT with all the necessary options such as cine, filtering, dynamic lookup tables, and reorientation. The reporting module is implemented as a separate applet using Java Foundation Classes (JFC) Swing Editor Kit and allows composition of multimedia reports after selection and annotation of appropriate images. The reports are stored on the server in the HTML format. JaRRViS uses Java Servlets for the preparation and storage of final reports. The http links to the reports or to the patient's raw images with applets can be obtained from JaRRViS by any Hospital Information System (HIS) via standard queries. Such links can be sent via e-mail or included as text fields in any HIS database, providing direct access to the patient reports and images via standard web browsers.

  8. PAC++: Object-oriented platform for accelerator codes

    International Nuclear Information System (INIS)

    Malitsky, N.; Reshetov, A.; Bourianoff, G.

    1994-06-01

    Software packages in accelerator physics have relatively long life cycles. They had been developed and used for a wide range of accelerators in the past as well as for the current projects. For example, the basic algorithms written in the first accelerator Program TRANSPORT are actual for design of most magnet systems. Most of these packages had been implemented on Fortran. But this language is rather inconvenient as a basic language for large integrated projects that possibly could include real-time data acquisition, data base access, graphic riser interface modules (GUI), arid other features. Some later accelerator programs had been based on object-oriented tools (primarily, C++ language). These range from systems for advanced theoretical studies to control system software. For the new generations of accelerators it would be desirable to have an integrated platform in which all simulation and control tasks will be considered with one point of view. In this report the basic principles of an object-oriented platform for accelerator research software (PAC++) are suggested and analyzed. Primary objectives of this work are to enable efficient self-explaining realization of the accelerator concepts and to provide an integrated environment for the updating and the developing of the code

  9. Mandatory bundled payment getting into formation for value-based care.

    Science.gov (United States)

    Fink, John

    2015-10-01

    Succeeding under Medicare's enterprise Comprehensive Care for Joint Replacement Model will require collaboration among caregivers and financial arrangements to align incentives Priorities for most organization's transition to becoming a value-based hospitals will be care redesign, supply-purchasing strategy, and post-acute care provider partnering. Pursuing value for your joint replacement program will chart a path for other service lines and lead your organization's transition to becoming a value-based enterprise.

  10. 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.)

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. Context indexing of digital cardiac ultrasound records in PACS

    Science.gov (United States)

    Lobodzinski, S. Suave; Meszaros, Georg N.

    1998-07-01

    Recent wide adoption of the DICOM 3.0 standard by ultrasound equipment vendors created a need for practical clinical implementations of cardiac imaging study visualization, management and archiving, DICOM 3.0 defines only a logical and physical format for exchanging image data (still images, video, patient and study demographics). All DICOM compliant imaging studies must presently be archived on a 650 Mb recordable compact disk. This is a severe limitation for ultrasound applications where studies of 3 to 10 minutes long are a common practice. In addition, DICOM digital echocardiography objects require physiological signal indexing, content segmentation and characterization. Since DICOM 3.0 is an interchange standard only, it does not define how to database composite video objects. The goal of this research was therefore to address the issues of efficient storage, retrieval and management of DICOM compliant cardiac video studies in a distributed PACS environment. Our Web based implementation has the advantage of accommodating both DICOM defined entity-relation modules (equipment data, patient data, video format, etc.) in standard relational database tables and digital indexed video with its attributes in an object relational database. Object relational data model facilitates content indexing of full motion cardiac imaging studies through bi-directional hyperlink generation that tie searchable video attributes and related objects to individual video frames in the temporal domain. Benefits realized from use of bi-directionally hyperlinked data models in an object relational database include: (1) real time video indexing during image acquisition, (2) random access and frame accurate instant playback of previously recorded full motion imaging data, and (3) time savings from faster and more accurate access to data through multiple navigation mechanisms such as multidimensional queries on an index, queries on a hyperlink attribute, free search and browsing.

  16. 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.)

  17. [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.

  18. 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...

  19. 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....

  20. 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.

  1. 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.

  2. 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

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. Strategic Review Process for an Accountable Care Organization and Emerging Accountable Care Best Practices.

    Science.gov (United States)

    Conway, Sarah J; Himmelrich, Sarah; Feeser, Scott A; Flynn, John A; Kravet, Steven J; Bailey, Jennifer; Hebert, Lindsay C; Donovan, Susan H; Kachur, Sarah G; Brown, Patricia M C; Baumgartner, William A; Berkowitz, Scott A

    2018-02-02

    Accountable Care Organizations (ACOs), like other care entities, must be strategic about which initiatives they support in the quest for higher value. This article reviews the current strategic planning process for the Johns Hopkins Medicine Alliance for Patients (JMAP), a Medicare Shared Savings Program Track 1 ACO. It reviews the 3 focus areas for the 2017 strategic review process - (1) optimizing care coordination for complex, at-risk patients, (2) post-acute care, and (3) specialty care integration - reviewing cost savings and quality improvement opportunities, associated best practices from the literature, and opportunities to leverage and advance existing ACO and health system efforts in each area. It then reviews the ultimate selection of priorities for the coming year and early thoughts on implementation. After the robust review process, key stakeholders voted to select interventions targeted at care coordination, post-acute care, and specialty integration including Part B drug and imaging costs. The interventions selected incorporate a mixture of enhancing current ACO initiatives, working collaboratively and synergistically on other health system initiatives, and taking on new projects deemed targeted, cost-effective, and manageable in scope. The annual strategic review has been an essential and iterative process based on performance data and informed by the collective experience of other organizations. The process allows for an evidence-based strategic plan for the ACO in pursuit of the best care for patients.

  12. 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...

  13. 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...

  14. 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

  15. 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

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

    Science.gov (United States)

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

    2015-10-01

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

  17. [Impact of the positive appraisal of care on quality of life, purpose in life, and will to continue care among Japanese family caregivers of older adults: analysis by kinship type].

    Science.gov (United States)

    Yamamoto-Mitani, Noriko; Ishigaki, Kazuko; Kuniyoshi, Midori; Kawahara-Maekawa, Noriko; Hasegawa, Kiyomi; Hayashi, Kunihiko; Sugishita, Chieko

    2002-07-01

    The impact of positive appraisal of care (PAC) on the caregiver's quality of life (QL), sense of purpose in life (sense of ikigai) and will to continue care was examined. Data were collected from 322 Japanese family caregivers of older adults who were using visiting nursing services through 21 facilities in the Tokyo metropolitan area, and the prefectures of Shizuoka, Mie and Okinawa. The data were grouped by kinship type (husband or son, wife, daughter or daughter-in-law) and analyzed separately. From the multiple regression and logistic regression analyses, the following results were derived: 1) The PAC was not related to the physical QL regardless of the relationship type; 2) The relationship depended upon the relationship type: only the PAC was related to the mental QL among husband and son caregivers, both the PAC and the negative appraisal of care (NAC) were important among wives, only the NAC among daughters, and none of them among daughters-in-law; 3) Both the PAC and NAC were related to the sense of ikigai in all caregiver types except among husband and son caregivers, which showed no relationship between the NAC and sense of ikigai; 4) Both the PAC and NAC were related to will to continue care among son and husband caregivers, whereas only the PAC was among wives and daughters-in-law. Only the NAC was related among daughters. However, the difference across kinship type seems minimal for will to continue care. Understanding the PAC among family caregivers may be important in order to better assist them to improve their mental QL or sense of ikigai as well as to predict their continuation of caregiving at home. The impact of PAC varies depending on the kinship type, and it should be assessed separately with reference to this pariable to develop plans for appropriate assistance.

  18. The bizzare phenomenon of smokers' paradox in the immediate outcome post acute myocardial infarction: an insight into the Malaysian National Cardiovascular Database-Acute Coronary Syndrome (NCVD-ACS) registry year 2006-2013.

    Science.gov (United States)

    Venkatason, Padmaa; Salleh, Norsabihin Mohd; Zubairi, Yong; Hafidz, Imran; Ahmad, Wan Azman Wan; Han, Sim Kui; Zuhdi, Ahmad Syadi Mahmood

    2016-01-01

    'Smoker's paradox' is a controversial phenomenon of an unexpected favourable outcome of smokers post acute myocardial infarction. There are conflicting evidences from the literature so far. We investigate for the existence of this phenomenon in our post acute myocardial infarction patients. We analysed 12,442 active smokers and 10,666 never-smokers diagnosed with STEMI and NSTEMI from the Malaysian National Cardiovascular Database-Acute Coronary Syndrome (NCVD-ACS) year 2006-2013 from 18 hospitals across Malaysia. Comparisons in the baseline characteristics, clinical presentation, in-hospital treatment and short term clinical outcome were made between the two groups. To compare the clinical outcome, an extensive multivariate adjustment was made to estimate the allcause mortality risk ratios for both groups. The active smokers were younger (smokers 53.7 years vs non-smokers 62.3 years P smokers and intravenous thrombolysis was the main reperfusion therapy in both groups. Smokers had a higher rate of in-hsopital coronary revascularisation in NSTEMI group (21.6 % smokers vs 16.7 % non-smokers P non-smokers in the STEMI group. Multivariate adjusted mortality risk ratios showed significantly lower mortality risks of smokers at both in-hospital (RR 0.510 [95 % CI 0.442-0.613]) and 30-day post discharge (RR 0.534 [95 % CI 0.437-0.621]). Smoking seems to be associated with a favourable outcome post myocardial infarction. The phenomenon of 'smoker's paradox' is in fact a reality in our patients population. The definitive explanation for this unexpected protective effect of smoking remains unclear.

  19. Defects in copper studied by PAC between 10 K and 800 K

    International Nuclear Information System (INIS)

    Deicher, M.; Gruebel, G.; Minde, R.; Recknagel, E.; Wichert, Th.

    1982-01-01

    The perturbed angular correlation technique (PAC) is used to clarify the defect situation in copper between stage I and V. The experimental results obtained for selfinterstitials, vacancies and defect clusters under different damaging conditions are shown. Their microscopic interpretation within the scope of the results of complementary experimental methods is discussed. (author)

  20. 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.

  1. Application of gel microsphere processes to preparation of Sphere-Pac nuclear fuel

    International Nuclear Information System (INIS)

    Haas, P.A.; Notz, K.J.; Spence, R.D.

    1978-01-01

    Sphere-Pac fabrication of nuclear fuels using two or more sizes of oxide or carbide spheres is ideally suited to nonproliferation-fuel cycles and remote refabrication. The sizes and compositions of spheres necessary for such fuel cycles have not been commonly prepared; therefore, modifications of sol-gel processes to meet these requirements are being developed and demonstrated

  2. Clinical delineation of the PACS1-related syndrome--Report on 19 patients

    NARCIS (Netherlands)

    Schuurs-Hoeijmakers, J.H.M.; Landsverk, M.L.; Foulds, N.; Kukolich, M.K.; Gavrilova, R.H.; Greville-Heygate, S.; Hanson-Kahn, A.; Bernstein, J.A.; Glass, J.; Chitayat, D.; Burrow, T.A.; Husami, A.; Collins, K.; Wusik, K.; Aa, N. van der; Kooy, F.; Brown, K.T.; Gadzicki, D.; Kini, U.; Alvarez, S.; Fernandez-Jaen, A.; McGehee, F.; Selby, K.; Tarailo-Graovac, M.; Allen, M.; Karnebeek, C.D. van; Stavropoulos, D.J.; Marshall, C.R.; Merico, D.; Gregor, A.; Zweier, C.; Hopkin, R.J.; Chu, Y.W.; Chung, B.H.; Vries, B. de; Devriendt, K.; Hurles, M.E.; Brunner, H.G.

    2016-01-01

    We report on 19 individuals with a recurrent de novo c.607C>T mutation in PACS1. This specific mutation gives rise to a recognizable intellectual disability syndrome. There is a distinctive facial appearance (19/19), characterized by full and arched eyebrows, hypertelorism with downslanting

  3. 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

  4. 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.

  5. 76 FR 80971 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC)

    Science.gov (United States)

    2011-12-27

    ..., Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC) AGENCY: National Archives and Records... made for the committee meeting of the State, Local, Tribal, and Private Sector Policy Advisory..., Local, Tribal, and Private Sector Entities. DATES: The meeting will be held on January 18, 2012, 10 a.m...

  6. 77 FR 41204 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC)

    Science.gov (United States)

    2012-07-12

    ..., Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC) AGENCY: Information Security Oversight..., announcement is made for the committee meeting of the State, Local, Tribal, and Private Sector Policy Advisory..., Local, Tribal, and Private Sector Entities. DATES: The meeting will be held on July 25, 2012, 10:00 a.m...

  7. 78 FR 75376 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTP-PAC)

    Science.gov (United States)

    2013-12-11

    ...] State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTP-PAC) AGENCY: National Archives... (NARA) announces a meeting of the State, Local, Tribal, and Private Sector Policy Advisory Committee... Information Program for State, Local, Tribal, and Private Sector Entities. The meeting will be open to the...

  8. 76 FR 41826 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC)

    Science.gov (United States)

    2011-07-15

    ... NATIONAL ARCHIVES AND RECORDS ADMINISTRATION Information Security Oversight Office State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC) AGENCY: National Archives and Records... Information Program for State, Local, Tribal, and Private Sector Entities. DATES: The meeting will be held on...

  9. 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.

  10. 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.

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

    Science.gov (United States)

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

    2002-01-01

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

  12. 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...

  13. Haematobia irritans dataset of raw sequence reads from Illumina and Pac Bio sequencing of genomic DNA

    Science.gov (United States)

    The genome of the horn fly, Haematobia irritans, was sequenced using Illumina- and Pac Bio-based protocols. Following quality filtering, the raw reads have been deposited at NCBI under the BioProject and BioSample accession numbers PRJNA30967 and SAMN07830356, respectively. The Illumina reads are un...

  14. From international charity to value chain coordinator : The case of the Pueblos en Accion Comunitaria (PAC)

    NARCIS (Netherlands)

    G.M. Gómez (Georgina)

    2011-01-01

    markdownabstractThis article describes the activities of The association Pueblos en Acción Comunitaria (PAC) as a model of value chain organization with an entrepreneurial vision and Christian inspiration and enquires in what ways it represents a new model to promote local development and poverty

  15. 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)

  16. TNOs are Cool: Thermophysical modeling of a sample of 20 classical KBOs using Herschel/PACS

    NARCIS (Netherlands)

    Vilenius, E.; Müller, T.; Pal, A.; Santos-Sanz, P.; Rengel, M.; Hartogh, P.; Protopapa, S.; Mueller, M.; Mommert, M.; Stansberry, J.; Lellouch, E.; Böhnhardt, H.; Ortiz, J. L.; Thirouin, A.; Henry, F.; Delsanti, A.; Fornasier, S.; Hestroffer, D.; Dotto, E.

    2011-01-01

    We determine the sizes and albedos of 20 classical Kuiper belt objects. Our observations with the PACS instrument on-board Herschel Space Observatory cover the wavelength range where the thermal emission from trans-Neptunian objects has its maximum. We use a consistent method for data reduction and

  17. Ceramic Membrane combined with Powdered Activated Carbon (PAC) or Coagulation for Treatment of Impaired Quality Waters

    KAUST Repository

    Hamad, Juma Z.

    2013-01-01

    and adsorption can remove some organic matter but with a low removal of the biopolymers component which is responsible for fouling. Powdered activated carbon (PAC) accompanied with a LPM maintains good removal of TOrCs. However, enhanced removal of TOr

  18. 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.

  19. 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.

  20. Genome sequencing of Deutsch strain of cattle ticks, Rhipicephalus microplus: Raw Pac Bio reads.

    Science.gov (United States)

    Pac Bio RS II whole genome shotgun sequencing technology was used to sequence the genome of the cattle tick, Rhipicephalus microplus. The DNA was derived from 14 day old eggs from the Deutsch Texas outbreak strain reared at the USDA-ARS Cattle Fever Tick Research Laboratory, Edinburg, TX. Each corre...

  1. 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.

  2. 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)

  3. 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.

  4. 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)

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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.

  10. 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...

  11. 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...

  12. Uptake of postabortion care services and acceptance of postabortion contraception in Puntland, Somalia.

    Science.gov (United States)

    Chukwumalu, Kingsley; Gallagher, Meghan C; Baunach, Sabine; Cannon, Amy

    2017-11-01

    Unsafe abortion is responsible for at least 9% of all maternal deaths worldwide; however, in humanitarian emergencies where health systems are weak and reproductive health services are often unavailable or disrupted, this figure is higher. In Puntland, Somalia, Save the Children International (SCI) implemented postabortion care (PAC) services to address the issue of high maternal morbidity and mortality due to unsafe abortion. Abortion is explicitly permitted by Somali law to save the life of a woman, but remains a sensitive topic due to religious and social conservatism that exists in the region. Using a multipronged approach focusing on capacity building, assurance of supplies and infrastructure, and community collaboration and mobilisation, the demand for PAC services increased as did the proportion of women who adopted a method of family planning post-abortion. From January 2013 to December 2015, a total of 1111 clients received PAC services at the four SCI-supported health facilities. The number of PAC clients increased from a monthly average of 20 in 2013 to 38 in 2015. During the same period, 98% (1090) of PAC clients were counselled for postabortion contraception, of which 955 (88%) accepted a contraceptive method before leaving the facility, with 30% opting for long-acting reversible contraception. These results show that comprehensive PAC services can be implemented in politically unstable, culturally conservative settings where abortion and modern contraception are sensitive and stigmatised matters among communities, health workers, and policy makers. However, like all humanitarian settings, large unmet needs exist for PAC services in Somalia.

  13. Population aging and its impacts: strategies of the health-care system in Taipei.

    Science.gov (United States)

    Lin, Ming-Hsien; Chou, Ming-Yueh; Liang, Chih-Kuang; Peng, Li-Ning; Chen, Liang-Kung

    2010-11-01

    Taiwan is one of the fastest aging countries in the world. As such, the government has developed various strategies to promote an age-friendly health-care system. Health services are supported by National Health Insurance (NHI), which insures over 97% of citizens and over 99% of health-care institutes. The current health-care system has difficulties in caring for older patients with multiple comorbidities, complex care needs, functional impairments, and post-acute care needs. Taipei, an international metropolis with a well-preserved tradition of filial piety in Chinese societies, has developed various strategies to overcome the aforementioned barriers to an age-friendly health-care system. These include an emphasis on general medical care and a holistic approach in all specialties, development of a geriatrics specialty training program, development of post-acute services, and strengthening of linkages between health and social care services. Despite achievements thus far, challenges still include creating a more extensive integration between medical specialties, promotion of an interdisciplinary care model across specialties and health-care settings, and integration of health and social care services. The experiences of Taipei in developing an age-friendly health-care service system may be a culturally appropriate model for other Chinese and Asian communities. Copyright © 2010 Elsevier B.V. All rights reserved.

  14. [The Development of Long-Term Care Policies and the Impact on Nursing].

    Science.gov (United States)

    Wu, Shiao-Chi; Tsai, Yin-Yin; Yeh, Shin-Ting

    2015-10-01

    The government must reform and enhance current medical and long-term care services in order to respond effectively to societal ageing and labor shortage trends and to ensure sustainable operations. The post-acute care system should be reoriented on the home and community instead of the hospital. The Long Term Care Service Act integrates long-term care services that were previously dispersed amongst different departments, sets up a long-term care development fund, and improves the quality and allocation of long-term care services. Moreover, the Long Term Care Insurance Act will implement a bundle payment system to assist disabled families. The integration of automation and information technology will make long-term care more efficient. Although nurses are more skilled at elderly care and counseling than other community care professionals, nurses generally lack training in business management. Home and community-based services thus require better-trained manpower, opportunities to set care agents, and opportunities to offer flexible caring jobs. Therefore, nurses should strengthen their capabilities in post-acute care, business management, cooperation, and coordination.

  15. "Right tool," wrong "job": Manual vacuum aspiration, post-abortion care and transnational population politics in Senegal.

    Science.gov (United States)

    Suh, Siri

    2015-06-01

    The "rightness" of a technology for completing a particular task is negotiated by medical professionals, patients, state institutions, manufacturing companies, and non-governmental organizations. This paper shows how certain technologies may challenge the meaning of the "job" they are designed to accomplish. Manual vacuum aspiration (MVA) is a syringe device for uterine evacuation that can be used to treat complications of incomplete abortion, known as post-abortion care (PAC), or to terminate pregnancy. I explore how negotiations over the rightness of MVA as well as PAC unfold at the intersection of national and global reproductive politics during the daily treatment of abortion complications at three hospitals in Senegal, where PAC is permitted but induced abortion is legally prohibited. Although state health authorities have championed MVA as the "preferred" PAC technology, the primary donor for PAC, the United States Agency for International Development, does not support the purchase of abortifacient technologies. I conducted an ethnography of Senegal's PAC program between 2010 and 2011. Data collection methods included interviews with 49 health professionals, observation of PAC treatment and review of abortion records at three hospitals, and a review of transnational literature on MVA and PAC. While MVA was the most frequently employed form of uterine evacuation in hospitals, concerns about off-label MVA practices contributed to the persistence of less effective methods such as dilation and curettage (D&C) and digital curettage. Anxieties about MVA's capacity to induce abortion have constrained its integration into routine obstetric care. This capacity also raises questions about what the "job," PAC, represents in Senegalese hospitals. The prioritization of MVA's security over women's access to the preferred technology reinforces gendered inequalities in health care. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. New Methods for Landslide Identification and Mapping Using SAR Polarimetry Obtained During the PacRim 2000 Mission in Taiwan

    National Research Council Canada - National Science Library

    Czuchlewski, Kristina R; Weissel, Jeffrey K; Lee, Jong-Sen

    2005-01-01

    We reanalyze PacRim 2000 L-band AIRSAR polarimetry collected over the western foothills of central Taiwan a year after the September 20, 1999 ChiChi earthquake, which produced more than 10,000 landslide...

  17. The Radar Correlation and Interpolation (C&I) Algorithms Deployed in the ASR-9 Processor Augmentation Card (9PAC)

    National Research Council Canada - National Science Library

    Elkin, G

    2001-01-01

    .... The increased processing speed and memory size of the 9PAC hardware made it possible for new surveillance algorithms to be developed in software in order to provide improved primary radar and beacon...

  18. 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.

  19. 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...

  20. Investigation on network utilization efficiency and image transmission time for the PACS network

    International Nuclear Information System (INIS)

    Tawara, K.; Nishihara, E.; Komatsu, K.I.

    1987-01-01

    The authors investigated the following features of a PACS network: (1) network utilization efficiency and (2) image transmission time. They changed the following parameters, which the two items shown above depend on: (1) transfer rate between imaging equipment and network (10 kB/econd-8 MB/second), (2) network transmission speed (100 kB/second-50 MB/second), (3) packet length (10 kB-4 MB), and (4) message length (image data) (64 kB-4 MB). As a result, a conventional-type network cannot meet a need for PACS. To solve this problem, the authors propose a multiplexed network that consists of the high-speed network for image transmission and the conventional speed of control network for commands and shorter messages. If the packet length of the image network is designed to be variable, they can choose an optimum packet length for image transmission

  1. 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

  2. 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...

  3. 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)

  4. Phase quantification of mullite-zirconia and zircon commercial powders using PAC and XRD techniques

    Energy Technology Data Exchange (ETDEWEB)

    Rendtorff, Nicolas M.; Conconi, Maria S.; Aglietti, Esteban F. [Centro de Tecnologia de Recursos Minerales y Ceramica (CETMIC: CONICET-CIC) (Argentina); Chain, Cecilia Y.; Pasquevich, Alberto F. [Universidad Nacional de La Plata, Departamento de Fisica, IFLP, Facultad de Ciencias Exactas (Argentina); Rivas, Patricia C. [CONICET (Argentina); Martinez, Jorge A., E-mail: toto@fisica.unlp.edu.ar; Caracoche, Maria C. [Universidad Nacional de La Plata, Departamento de Fisica, IFLP, Facultad de Ciencias Exactas (Argentina)

    2010-06-15

    The short range technique of the Perturbed Angular Correlation (PAC) and x-ray diffraction (Rietveld) methods have been employed to determine the phase content in commercial mullite-zirconia and zircon raw materials that are ordinarily used to produce ceramic materials. The PAC technique, which probes zirconium-containing compounds at nanoscopic level, showed that zircon contains crystalline ZrSiO{sub 4} and an important amount of a structurally distorted zircon, which is also observed accompanying monoclinic zirconia in mullite-zirconia. This particular zircon phase was not detected by the long range x-ray diffraction-Rietveld technique. After an annealing treatment, important changes in crystalline contents of the powders allow confirming, by the x-ray diffraction-Rietveld method, the preexistence of this particular zircon phase. This fact must be taken into account when preparing multicomposites based on the present raw materials.

  5. 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.)

  6. EXP-PAC: providing comparative analysis and storage of next generation gene expression data.

    Science.gov (United States)

    Church, Philip C; Goscinski, Andrzej; Lefèvre, Christophe

    2012-07-01

    Microarrays and more recently RNA sequencing has led to an increase in available gene expression data. How to manage and store this data is becoming a key issue. In response we have developed EXP-PAC, a web based software package for storage, management and analysis of gene expression and sequence data. Unique to this package is SQL based querying of gene expression data sets, distributed normalization of raw gene expression data and analysis of gene expression data across experiments and species. This package has been populated with lactation data in the international milk genomic consortium web portal (http://milkgenomics.org/). Source code is also available which can be hosted on a Windows, Linux or Mac APACHE server connected to a private or public network (http://mamsap.it.deakin.edu.au/~pcc/Release/EXP_PAC.html). Copyright © 2012 Elsevier Inc. All rights reserved.

  7. 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.

  8. Optimizing physicians' instruction of PACS through e-learning: cognitive load theory applied.

    Science.gov (United States)

    Devolder, P; Pynoo, B; Voet, T; Adang, L; Vercruysse, J; Duyck, P

    2009-03-01

    This article outlines the strategy used by our hospital to maximize the knowledge transfer to referring physicians on using a picture archiving and communication system (PACS). We developed an e-learning platform underpinned by the cognitive load theory (CLT) so that in depth knowledge of PACS' abilities becomes attainable regardless of the user's prior experience with computers. The application of the techniques proposed by CLT optimizes the learning of the new actions necessary to obtain and manipulate radiological images. The application of cognitive load reducing techniques is explained with several examples. We discuss the need to safeguard the physicians' main mental processes to keep the patient's interests in focus. A holistic adoption of CLT techniques both in teaching and in configuration of information systems could be adopted to attain this goal. An overview of the advantages of this instruction method is given both on the individual and organizational level.

  9. 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

  10. Measuring viability of pacs during reform period in Maharashtra: A case study

    OpenAIRE

    Shah, Deepak

    2007-01-01

    The study showed a reduction in the operational efficiency of the selected PACS during the post-economic reform period as against the pre-economic reform period. The operational efficiency was measured in respect of various liquidity ratio, profitability ratios and financial leverage ratios. Not only the selected societies showed a decline in their current ratio, rate of return on assets, return on owner’s equity and Marginal Efficiency of Capital (MEC) but also showed higher dependency on le...

  11. Gel-sphere-pac fuel for thermal reactors: assessment of fabrication technology and irradiation performance

    Energy Technology Data Exchange (ETDEWEB)

    Beatty, R.L. Norman, R.E.; Notz, K.J. (comps.)

    1979-11-01

    Recent interest in proliferation-resistant fuel cycles for light-water reactors has focused attention on spiked plutonium and /sup 233/U-Th fuels, requiring remote refabrication. The gel-sphere-pac process for fabricating metal-clad fuel elements has drawn special attention because it involves fewer steps. Gel-sphere-pac fabrication technology involves two major areas: the preparation of fuel spheres of high density and loading these spheres into rods in an efficiently packed geometry. Gel sphere preparation involves three major steps: preparation of a sol or of a special solution (broth), gelation of droplets of sol or broth to give semirigid spheres of controlled size, and drying and sintering these spheres to a high density. Gelation may be accomplished by water extraction (suitable only for sols) or ammonia gelation (suitable for both sols and broths but used almost exclusively with broths). Ammonia gelation can be accomplished either externally, via ammonia gas and ammonium hydroxide, or internally via an added ammonia generator such as hexamethylenetetramine. Sphere-pac fuel rod fabrication involves controlled blending and metering of three sizes of spheres into the rod and packing by low- to medium-energy vibration to achieve about 88% smear density; these sizes have diametral ratios of about 40:10:1 and are blended in size fraction amounts of about 60% coarse, 18% medium, and 22% fine. Irradiation test results indicate that sphere-pac fuel performs at least as well as pellet fuel, and may in fact offer an advantage in significantly reducing mechanical and chemical interaction between the fuel and cladding. The normal feed for gel sphere preparation, heavy metal nitrate solution, is the usual product of fuel reprocessing, so that fabrication of gel spheres performs all the functions performed by both conversion and pellet fabrication in the case of pellet technology.

  12. Modeling and simulation of control system for electron beam machine (EBM) using programmable automation controller (PAC)

    International Nuclear Information System (INIS)

    Leo Kwee Wah; Lojius Lombigit; Abu Bakar Mhd Ghazali; Muhamad Zahidee Taat; Ayub Mohamed; Chong Foh Yoong

    2006-01-01

    An EBM electronic model is designed to simulate the control system of the Nissin EBM, which is located at Block 43, MINT complex of Jalan Dengkil with maximum output of 3 MeV, 30 mA using a Programmable Automation Controllers (PAC). This model operates likes a real EBM system where all the start-up, interlocking and stopping procedures are fully followed. It also involves formulating the mathematical models to relate certain output with the input parameters using data from actual operation on EB machine. The simulation involves a set of PAC system consisting of the digital and analogue input/output modules. The program code is written using Labview software (real-time version) on a PC and then downloaded into the PAC stand-alone memory. All the 23 interlocking signals required by the EB machine are manually controlled by mechanical switches and represented by LEDs. The EB parameters are manually controlled by potentiometers and displayed on analogue and digital meters. All these signals are then interfaced to the PC via a wifi wireless communication built-in at the PAC controller. The program is developed in accordance to the specifications and requirement of the original real EB system and displays them on the panel of the model and also on the PC monitor. All possible chances from human errors, hardware and software malfunctions, including the worst-case conditions will be tested, evaluated and modified. We hope that the performance of our model complies the requirements of operating the EB machine. It also hopes that this electronic model can replace the original PC interfacing being utilized in the Nissin EBM in the near future. The system can also be used to study the fault tolerance analysis and automatic re-configuration for advanced control of the EB system. (Author)

  13. Elecciones: entre gamonalismo y civismo. El caso de Tumaco en la costa Pacífica

    OpenAIRE

    Helfrich, Linda

    2017-01-01

    Este artículo nace de un estudio de caso sobre las elecciones, el sistema de partidos y la cultura política en el municipio de Tumaco, en la costa Pacífica nariñense 1 En él se analizan las elecciones populares de alcaldes y las reformas en el marco de la nueva Constitución  de  1991.

  14. 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

  15. 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

  16. Elecciones: entre gamonalismo y civismo. El caso de Tumaco en la costa Pacífica

    Directory of Open Access Journals (Sweden)

    Linda Helfrich-Bernal

    2000-01-01

    Full Text Available Este artículo nace de un estudio de caso sobre las elecciones, el sistema de partidos y la cultura política en el municipio de Tumaco en la Costa Pacífica nariñense. En él se analizan las elecciónes populares de alcaldes y las reformas en el marco de la nueva Constitución de 1991.

  17. Gel-sphere-pac fuel for thermal reactors: assessment of fabrication technology and irradiation performance

    International Nuclear Information System (INIS)

    Beatty, R.L.; Norman, R.E.; Notz, K.J.

    1979-11-01

    Recent interest in proliferation-resistant fuel cycles for light-water reactors has focused attention on spiked plutonium and 233 U-Th fuels, requiring remote refabrication. The gel-sphere-pac process for fabricating metal-clad fuel elements has drawn special attention because it involves fewer steps. Gel-sphere-pac fabrication technology involves two major areas: the preparation of fuel spheres of high density and loading these spheres into rods in an efficiently packed geometry. Gel sphere preparation involves three major steps: preparation of a sol or of a special solution (broth), gelation of droplets of sol or broth to give semirigid spheres of controlled size, and drying and sintering these spheres to a high density. Gelation may be accomplished by water extraction (suitable only for sols) or ammonia gelation (suitable for both sols and broths but used almost exclusively with broths). Ammonia gelation can be accomplished either externally, via ammonia gas and ammonium hydroxide, or internally via an added ammonia generator such as hexamethylenetetramine. Sphere-pac fuel rod fabrication involves controlled blending and metering of three sizes of spheres into the rod and packing by low- to medium-energy vibration to achieve about 88% smear density; these sizes have diametral ratios of about 40:10:1 and are blended in size fraction amounts of about 60% coarse, 18% medium, and 22% fine. Irradiation test results indicate that sphere-pac fuel performs at least as well as pellet fuel, and may in fact offer an advantage in significantly reducing mechanical and chemical interaction between the fuel and cladding. The normal feed for gel sphere preparation, heavy metal nitrate solution, is the usual product of fuel reprocessing, so that fabrication of gel spheres performs all the functions performed by both conversion and pellet fabrication in the case of pellet technology

  18. Alternative Splicing of the Pituitary Adenylate Cyclase-Activating Polypeptide Receptor PAC1: Mechanisms of Fine Tuning of Brain Activity

    Directory of Open Access Journals (Sweden)

    Janna eBlechman

    2013-05-01

    Full Text Available Alternative splicing of the precursor mRNA encoding for the neuropeptide receptor PAC1/ADCYAP1R1 generates multiple protein products that exhibit pleiotropic activities. Recent studies in mammals and zebrafish have implicated some of these splice isoforms in control of both cellular and body homeostasis. Here, we review the regulation of PAC1 splice variants and their underlying signal transduction and physiological processes in the nervous system.

  19. 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

  20. 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.

  1. 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.

  2. 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.

  3. 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)

  4. 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)

  5. Effective Reuse of Electroplating Rinse Wastewater by Combining PAC with H2O2/UV Process.

    Science.gov (United States)

    Yen, Hsing Yuan; Kang, Shyh-Fang; Lin, Chen Pei

    2015-04-01

    This study evaluated the performance of treating electroplating rinse wastewater by powder activated carbon (PAC) adsorption, H2O2/UV oxidation, and their combination to remove organic compounds and heavy metals. The results showed that neither the process of PAC adsorption nor H2O2/UV oxidation could reduce COD to 100 mg/L, as enforced by the Taiwan Environmental Protection Agency. On the other hand, the water sample treated by the combined approach of using PAC (5 g/L) pre-adsorption and H2O2/UV post-oxidation (UV of 64 W, H2O2 of 100 mg/L, oxidation time of 90 min), COD and DOC were reduced to 8.2 mg/L and 3.8 mg/L, respectively. Also, the combined approach reduced heavy metals to meet the effluent standards and to satisfy the in-house water reuse criteria for the electroplating factory. The reaction constant analysis indicated that the reaction proceeded much more rapidly for the combined process. Hence, it is a more efficient, economic and environmentally friendly process.

  6. 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)

  7. 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.

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

    Science.gov (United States)

    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.

  9. Integrating CAD modules in a PACS environment using a wide computing infrastructure.

    Science.gov (United States)

    Suárez-Cuenca, Jorge J; Tilve, Amara; López, Ricardo; Ferro, Gonzalo; Quiles, Javier; Souto, Miguel

    2017-04-01

    The aim of this paper is to describe a project designed to achieve a total integration of different CAD algorithms into the PACS environment by using a wide computing infrastructure. The aim is to build a system for the entire region of Galicia, Spain, to make CAD accessible to multiple hospitals by employing different PACSs and clinical workstations. The new CAD model seeks to connect different devices (CAD systems, acquisition modalities, workstations and PACS) by means of networking based on a platform that will offer different CAD services. This paper describes some aspects related to the health services of the region where the project was developed, CAD algorithms that were either employed or selected for inclusion in the project, and several technical aspects and results. We have built a standard-based platform with which users can request a CAD service and receive the results in their local PACS. The process runs through a web interface that allows sending data to the different CAD services. A DICOM SR object is received with the results of the algorithms stored inside the original study in the proper folder with the original images. As a result, a homogeneous service to the different hospitals of the region will be offered. End users will benefit from a homogeneous workflow and a standardised integration model to request and obtain results from CAD systems in any modality, not dependant on commercial integration models. This new solution will foster the deployment of these technologies in the entire region of Galicia.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. From acute care to home care: the evolution of hospital responsibility and rationale for increased vertical integration.

    Science.gov (United States)

    Dilwali, Prashant K

    2013-01-01

    The responsibility of hospitals is changing. Those activities that were once confined within the walls of the medical facility have largely shifted outside them, yet the requirements for hospitals have only grown in scope. With the passage of the Patient Protection and Affordable Care Act (ACA) and the development of accountable care organizations, financial incentives are focused on care coordination, and a hospital's responsibility now includes postdischarge outcomes. As a result, hospitals need to adjust their business model to accommodate their increased need to impact post-acute care settings. A home care service line can fulfill this role for hospitals, serving as an effective conduit to the postdischarge realm-serving as both a potential profit center and a risk mitigation offering. An alliance between home care agencies and hospitals can help improve clinical outcomes, provide the necessary care for communities, and establish a potentially profitable product line.

  16. 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.)

  17. 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.

  18. “Right tool,” wrong “job”: Manual vacuum aspiration, post-abortion care and transnational population politics in Senegal

    Science.gov (United States)

    Suh, Siri

    2015-01-01

    The “rightness” of a technology for completing a particular task is negotiated by medical professionals, patients, state institutions, manufacturing companies, and non-governmental organizations. This paper shows how certain technologies may challenge the meaning of the “job” they are designed to accomplish. Manual vacuum aspiration (MVA) is a syringe device for uterine evacuation that can be used to treat complications of incomplete abortion, known as post-abortion care (PAC), or to terminate pregnancy. I explore how negotiations over the rightness of MVA as well as PAC unfold at the intersection of national and global reproductive politics during the daily treatment of abortion complications at three hospitals in Senegal, where PAC is permitted but induced abortion is legally prohibited. Although state health authorities have championed MVA as the “preferred” PAC technology, the primary donor for PAC, the United States Agency for International Development, does not support the purchase of abortifacient technologies. I conducted an ethnography of Senegal's PAC program between 2010 and 2011. Data collection methods included interviews with 49 health professionals, observation of PAC treatment and review of abortion records at three hospitals, and a review of transnational literature on MVA and PAC. While MVA was the most frequently employed form of uterine evacuation in hospitals, concerns about off-label MVA practices contributed to the persistence of less effective methods such as dilation and curettage (D&C) and digital curettage. Anxieties about MVA's capacity to induce abortion have constrained its integration into routine obstetric care. This capacity also raises questions about what the “job,” PAC, represents in Senegalese hospitals. The prioritization of MVA's security over women's access to the preferred technology reinforces gendered inequalities in health care. PMID:25948127

  19. 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.

  20. Observations of oral hygiene care interventions provided by nurses to hospitalized older people.

    Science.gov (United States)

    Coker, Esther; Ploeg, Jenny; Kaasalainen, Sharon; Carter, Nancy

    Dependent older hospitalized patients rely on nurses to assist them with the removal of plaque from their teeth, dentures, and oral cavities. Oral care interventions by 25 nurses on post-acute units, where patients have longer hospital stays, were observed during evening care. In addition to efforts to engage patients in oral care, nurses provided the following interventions: (a) supporting the care of persons with dentures; (b) supporting the care of natural teeth; (c) cleansing the tongue and oral cavity; and (d) moisturizing lips and oral tissues. Patients' oral hygiene care was supported in just over one-third of encounters. Denture care was inconsistently performed, and was infrequently followed by care of the oral cavity. Nurses did not encourage adequate self-care of natural teeth by patients, and infrequently moisturized tissues. Evidence-based oral hygiene care standards are required to assist nurses to support patients in achieving optimal oral hygiene outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Adsorption of selected emerging contaminants onto PAC and GAC: Equilibrium isotherms, kinetics, and effect of the water matrix.

    Science.gov (United States)

    Real, Francisco J; Benitez, F Javier; Acero, Juan L; Casas, Francisco

    2017-07-03

    The removal of three emerging contaminants (ECs) (amitriptyline hydrochloride (AH), methyl salicylate (MS) and 2-phenoxyethanol (PE)) dissolved in several water matrices by means of their adsorption onto powdered activated carbon (PAC) and granular activated carbon (GAC) has been investigated. When dissolved in ultrapure water, adsorption of the ECs followed the trend of AH > MS > PE, with a positive effect of the adsorbent dose. According to the analysis of the adsorption isotherms and adsorption kinetics, PAC showed strongly higher adsorption efficiency in both capacity and velocity of the adsorption, in agreement with its higher mesoporosity. Equilibrium isotherm data were fitted by Langmuir and Freundlich models. Pseudo-second order kinetics modeled very successfully the adsorption process. Finally, the effect of the presence of dissolved organic matter (DOM) in the water matrices (ultrapure water, surface water and two effluents from wastewater treatment plants) on the adsorption of the selected ECs onto PAC was established, as well as its performance on the removal of water quality parameters. Results show a negative effect of the DOM content on the adsorption efficiency. Over 50% of organic matter was removed with high PAC doses, revealing that adsorption onto PAC is an effective technology to remove both micro-pollutants and DOM from water matrices.

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

    Directory of Open Access Journals (Sweden)

    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

  3. Oportunidades y amenazas para Colombia de pertenecer a la Alianza del Pacífico

    OpenAIRE

    Piedrahita Valencia, Paula Andrea

    2015-01-01

    Por medio de este proyecto se analizaron las asimetrías presentes en las economías de los cuatro países miembros de la Alianza del Pacífico y cómo Colombia puede enfrentar estos y retos y convertirlos en oportunidades de acuerdo a la experiencia en diferentes áreas de sus países aliados. De acuerdo a las bases de datos de los países firmantes se encontró que la balanza comercial entre Colombia y México presenta un déficit y está en constante crecimiento, pudiendo ser contrarrestada con fut...

  4. Fully automated processing of fMRI data in SPM: from MRI scanner to PACS.

    Science.gov (United States)

    Maldjian, Joseph A; Baer, Aaron H; Kraft, Robert A; Laurienti, Paul J; Burdette, Jonathan H

    2009-01-01

    Here we describe the Wake Forest University Pipeline, a fully automated method for the processing of fMRI data using SPM. The method includes fully automated data transfer and archiving from the point of acquisition, real-time batch script generation, distributed grid processing, interface to SPM in MATLAB, error recovery and data provenance, DICOM conversion and PACS insertion. It has been used for automated processing of fMRI experiments, as well as for the clinical implementation of fMRI and spin-tag perfusion imaging. The pipeline requires no manual intervention, and can be extended to any studies requiring offline processing.

  5. 73Se, an unusual PAC probe applied to the study of semiconductors

    International Nuclear Information System (INIS)

    Vianden, R.

    1990-01-01

    The isotope 73 Se was produced by an (α,3n) reaction from 72 Ge in order to study the applicability of this probe to PAC defect studies in semiconductors. Measurements before and after annealing recoil implanted samples showed that the quadrupole interaction of the 66 keV state in the daughter isotope 73 As with the lattice damage created by the implantation is comparable to that found for 111 In in Ge. This indicates that 73 Se can be a suitable probe for defect studies in semiconductors with nuclear methods. (orig.)

  6. Mixed U/Pu oxide fabrication facility for gel-sphere-pac fuel

    International Nuclear Information System (INIS)

    1978-09-01

    This paper describes a conceptual plant which uses the gel-sphere-pac process to fabricate mixed oxide (MOX) fuel and covers (1) fabrication of co-processed MOX fuel and (2) fabrication of co-processed spiked MOX fuel, using 60 Co. The report describes: the fuel fabrication process and plant layout, including scrap and waste processing; and maintenance safety and ventilation measures. A description of the conversion of U and Pu nitrate using a gel sphere process is given in Appendix A

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

    Science.gov (United States)

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

    2015-01-01

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

  8. 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.

  9. A Brucella spp. Isolate from a Pac-Man Frog (Ceratophrys ornata) Reveals Characteristics Departing from Classical Brucellae.

    Science.gov (United States)

    Soler-Lloréns, Pedro F; Quance, Chris R; Lawhon, Sara D; Stuber, Tod P; Edwards, John F; Ficht, Thomas A; Robbe-Austerman, Suelee; O'Callaghan, David; Keriel, Anne

    2016-01-01

    Brucella are highly infectious bacterial pathogens responsible for brucellosis, a frequent worldwide zoonosis. The Brucella genus has recently expanded from 6 to 11 species, all of which were associated with mammals; The natural host range recently expanded to amphibians after some reports of atypical strains from frogs. Here we describe the first in depth phenotypic and genetic characterization of a Brucella strains isolated from a frog. Strain B13-0095 was isolated from a Pac-Man frog ( Ceratophyrus ornate ) at a veterinary hospital in Texas and was initially misidentified as Ochrobactrum anthropi . We found that B13-0095 belongs to a group of early-diverging brucellae that includes Brucella inopinata strain BO1 and the B. inopinata -like strain BO2, with traits that depart significantly from those of the "classical" Brucella spp. Analysis of B13-0095 genome sequence revealed several specific features that suggest that this isolate represents an intermediate between a soil associated ancestor and the host adapted "classical" species. Like strain BO2, B13-0095 does not possess the genes required to produce the perosamine based LPS found in classical Brucella , but has a set of genes that could encode a rhamnose based O-antigen. Despite this, B13-0095 has a very fast intracellular replication rate in both epithelial cells and macrophages. Finally, another major finding in this study is the bacterial motility observed for strains B13-0095, BO1, and BO2, which is remarkable for this bacterial genus. This study thus highlights several novel characteristics in strains belonging to an emerging group within the Brucella genus. Accurate identification tools for such atypical Brucella isolates and careful evaluation of their zoonotic potential, are urgently required.

  10. Activity-based funding of hospitals and its impact on mortality, readmission, discharge destination, severity of illness, and volume of care: a systematic review and meta-analysis.

    Science.gov (United States)

    Palmer, Karen S; Agoritsas, Thomas; Martin, Danielle; Scott, Taryn; Mulla, Sohail M; Miller, Ashley P; Agarwal, Arnav; Bresnahan, Andrew; Hazzan, Afeez Abiola; Jeffery, Rebecca A; Merglen, Arnaud; Negm, Ahmed; Siemieniuk, Reed A; Bhatnagar, Neera; Dhalla, Irfan A; Lavis, John N; You, John J; Duckett, Stephen J; Guyatt, Gordon H

    2014-01-01

    Activity-based funding (ABF) of hospitals is a policy intervention intended to re-shape incentives across health systems through the use of diagnosis-related groups. Many countries are adopting or actively promoting ABF. We assessed the effect of ABF on key measures potentially affecting patients and health care systems: mortality (acute and post-acute care); readmission rates; discharge rate to post-acute care following hospitalization; severity of illness; volume of care. We undertook a systematic review and meta-analysis of the worldwide evidence produced since 1980. We included all studies reporting original quantitative data comparing the impact of ABF versus alternative funding systems in acute care settings, regardless of language. We searched 9 electronic databases (OVID MEDLINE, EMBASE, OVID Healthstar, CINAHL, Cochrane CENTRAL, Health Technology Assessment, NHS Economic Evaluation Database, Cochrane Database of Systematic Reviews, and Business Source), hand-searched reference lists, and consulted with experts. Paired reviewers independently screened for eligibility, abstracted data, and assessed study credibility according to a pre-defined scoring system, resolving conflicts by discussion or adjudication. Of 16,565 unique citations, 50 US studies and 15 studies from 9 other countries proved eligible (i.e. Australia, Austria, England, Germany, Israel, Italy, Scotland, Sweden, Switzerland). We found consistent and robust differences between ABF and no-ABF in discharge to post-acute care, showing a 24% increase with ABF (pooled relative risk  = 1.24, 95% CI 1.18-1.31). Results also suggested a possible increase in readmission with ABF, and an apparent increase in severity of illness, perhaps reflecting differences in diagnostic coding. Although we found no consistent, systematic differences in mortality rates and volume of care, results varied widely across studies, some suggesting appreciable benefits from ABF, and others suggesting deleterious

  11. Activity-based funding of hospitals and its impact on mortality, readmission, discharge destination, severity of illness, and volume of care: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Karen S Palmer

    Full Text Available Activity-based funding (ABF of hospitals is a policy intervention intended to re-shape incentives across health systems through the use of diagnosis-related groups. Many countries are adopting or actively promoting ABF. We assessed the effect of ABF on key measures potentially affecting patients and health care systems: mortality (acute and post-acute care; readmission rates; discharge rate to post-acute care following hospitalization; severity of illness; volume of care.We undertook a systematic review and meta-analysis of the worldwide evidence produced since 1980. We included all studies reporting original quantitative data comparing the impact of ABF versus alternative funding systems in acute care settings, regardless of language. We searched 9 electronic databases (OVID MEDLINE, EMBASE, OVID Healthstar, CINAHL, Cochrane CENTRAL, Health Technology Assessment, NHS Economic Evaluation Database, Cochrane Database of Systematic Reviews, and Business Source, hand-searched reference lists, and consulted with experts. Paired reviewers independently screened for eligibility, abstracted data, and assessed study credibility according to a pre-defined scoring system, resolving conflicts by discussion or adjudication.Of 16,565 unique citations, 50 US studies and 15 studies from 9 other countries proved eligible (i.e. Australia, Austria, England, Germany, Israel, Italy, Scotland, Sweden, Switzerland. We found consistent and robust differences between ABF and no-ABF in discharge to post-acute care, showing a 24% increase with ABF (pooled relative risk  = 1.24, 95% CI 1.18-1.31. Results also suggested a possible increase in readmission with ABF, and an apparent increase in severity of illness, perhaps reflecting differences in diagnostic coding. Although we found no consistent, systematic differences in mortality rates and volume of care, results varied widely across studies, some suggesting appreciable benefits from ABF, and others suggesting

  12. Definition and specification for PACS. A checklist based on the standard ''IEEE Recommended Practice for Software Requirements Specifications''

    International Nuclear Information System (INIS)

    Koenig, H.; Klose, K.J.

    1999-01-01

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

  13. 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.

  14. PAC study in the HfO2-SiO2 system

    International Nuclear Information System (INIS)

    Chain, C.Y.; Damonte, L.C.; Ferrari, S.; Munoz, E.; Torres, C. Rodriguez; Pasquevich, A.F.

    2010-01-01

    A high-k HfO 2 /SiO 2 gate stack is taking the place of SiO 2 as a gate dielectric in field effect transistors. This fact makes the study of the solid-state reaction between these oxides very important. Nanostructure characterization of a high-energy ball milled and post-annealed equimolar HfO 2 and amorphous SiO 2 powder mixture has been carried out by perturbed angular correlations (PAC) technique. The study was complemented with X-ray diffraction and positron annihilation lifetime spectroscopy (PALS). The experimental results revealed that the ball milling of equimolar mixtures increases the defects concentration in hafnium oxide. No solid-state reaction occurred even after 8 h of milling. The formation of HfSiO 4 (hafnon) was observed in the milled blends annealed at high temperatures.The PAC results of the milled samples are compared with those obtained for pure m-ZrO 2 subjected to high-energy ball milling and with reported microstructure data for the system ZrO 2 -SiO 2 .

  15. Criminalidad organizada transnacional en Asia-Pacífico: repercusiones para la seguridad regional e internacional

    Directory of Open Access Journals (Sweden)

    Daniel Sansó-Rubert Pascual

    2011-05-01

    Full Text Available Asia-Pacífico es un área de creciente importancia estratégica en clave de seguridad, caracterizada por la multiplicidad de actores con objetivos divergentes y por la naturaleza multiforme de los desafíos presentes. De entre todos ellos destaca una amenaza común e insidiosa: la criminalidad organizada transnacional. Un recorrido geográfico por Asia-Pacífico permite identificar una fecunda variedad de mercados criminales y una riqueza tipológica criminal amplia, hasta el punto de resultar fútil el tratar de establecer una estructura tipo reflejo de la realidad imperante. Las manifestaciones asiáticas del crimen organizado no configuran un fenómeno monolítico; más bien, presentan un panorama poliédrico, complejo y multidimensional, con importantes manifestaciones regionales y creciente proyección internacional. En conjunto, la criminalidad organizada en la región representa uno de los grandes desafíos actuales en términos de proliferación y exportación de crimen organizado. Inercia que se mantiene a comienzos del recientemente inaugurado siglo XXI.

  16. Research on a Valuation Standard and the Actual Condition About Security Management in PACS

    International Nuclear Information System (INIS)

    Jeong, Jae Ho; Son, Gi Gyeong; Kang, Hee Doo; Dong, Kyung Rae; Kweon, Dae Cheol; Kim, Hyun Soo

    2008-01-01

    This study is to prepare an evaluation standard about personal information protection and security management of a medical institution and to build up a grade standard of evaluation in PACS environment. We built up evaluation index based on 10 detailed items in four big categories (political security, technical security, data management security and physical security) by referring to ISO17799 (BS 7799), HIPPA (Health Insurance and Portability and Accountability Act of 1996) and domestic medical law. We have investigated at the thirty places where medical facility with the extracted security criteria and security evaluation index. Average score of physical security list, one of the big categories, was 18.5/20 (93%) at all medical institutions. Political security score was 18.5/30 (62%), data management security score was 12/20 (60%) and technical security score was 17.5/30 (58%). Therefore, security evaluation score was average 67 in 30 general hospitals, which was 4th level. The results showed that it is necessary to establish evaluation and management standard about personal information protection and security consciousness which are weak in PACS environment.

  17. Time analysis for optimization of radiology workflow in conventional radiology during RIS-PACS-integration

    Science.gov (United States)

    Falkensammer, Peter; Soegner, Peter I.; zur Nedden, Dieter

    2002-05-01

    The integration of RIS-PACS systems in radiology units are intended to reduce time consumption in radiology workflow and thus to increase radiologist productivity. Along with the RIS-PACS integration at the University Hospital Innsbruck we analyzed workflow from patient admission to release of final reports before implementation. The follow up study after six months of the implementation is currently in work. In this study we compared chest to skeletal x-ray examinations in 969 patients before the implementation. Drawing the admission-to-release-of-final-report period showed a two-peak diagram with the first peak corresponding to a release of final results on the same day and the second peak to a release on the following day. In the chest x-ray group, 57% were released the same day (mean value 4:02 hours) and 43% the next day (mean value 21:47 hours). Looking at the skeletal x-rays 40% were released the same day (mean value 3:58 hours) and 60% were released the next day (mean value 21:05 hours). Summarizing the results we should say, that the average chest x-ray requires less time than an skeletal x-ray, due to the fact that a greater percentage of reports is released the same day. The most important result is, that the most time consuming workstep is the exchange of data media between radiologist and secretary with at least 5 hours.

  18. Asia- Pacífico en la Estrategia de Seguridad Nacional 2013

    Directory of Open Access Journals (Sweden)

    Gracia Abad

    2014-05-01

    Full Text Available A pesar de que la Estrategia de Seguridad Nacional incluye Asia-Pacífico entre los entornos estratégicos considerados como prioritarios para España, un análisis más pausado del documento revela que, en realidad, la importancia que se otorga a la región no es demasiado elevada. Tal aproximación es sorprendente si tenemos en cuenta no sólo el creciente papel de Asia-Pacífico en los asuntos internacionales, sino la cada vez mayor atención a la región de otros actores, entre los que cabe mencionar a los Estados Unidos, pero también a algunos los principales miembros de la Unión Europea. Esa baja prioridad asignada a la región, unida a una definición excesivamente vaga tanto de los posibles desafíos para nuestra seguridad provenientes de esa región, como de las acciones que se podrían poner en marcha para atenderlos, hacen que el documento diste de lo que sería necesario en lo que respecta a este ámbito geográfico.

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

    Science.gov (United States)

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

    2012-01-01

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

  20. Study of molybdenum oxide by means of Perturbed Angular Correlations (PAC) and Mössbauer spectroscopy

    CERN Multimedia

    Among transition-metal oxides, the molybdenum oxide compounds are particularly attractive due to the structural (2D) anisotropy and to the ability of the molybdenum ion to change its oxidation state. These properties make it suitable for applications on, e.g., chemical sensors, solar cells, catalytic and optoelectronic devices. At ISOLDE we aim studying the incorporation of selected dopants by ion implantation, using the nuclear techniques of Perturbed Angular Correlations (PAC) and Mössbauer spectroscopy (MS). Both techniques make use of highly diluted radioactive probe nuclei, which interact – as atomic-sized tips – with the host atoms and defects. The objectives of this project are to study at the atomic scale the probe’s local environment, its electronic configuration and polarization, the probe’s lattice sites, point defects and its recombination dynamics. In the case of e-$\\gamma$ PAC, the electron mobility on the host can be further studied, e.g., as a function of temperature.

  1. [A combined PACS and Internet information system in a university medical center].

    Science.gov (United States)

    Heiss, D; König, A; Endres, S; Pfluger, T; Pfeifer, K J; Hahn, K

    2000-06-01

    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. 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 Internet 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. 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. The advantages of digitalization were, besides reduction of film cost, especially optimizations of work flow with access to digital images from everywhere at any time.

  2. Himage PACS: a new approach to storage, integration, and distribution of cardiologic images

    Science.gov (United States)

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

    2004-04-01

    This paper presents a Cardiology oriented information system that provides permanent availability of all clinical history, including alphanumeric and image data, with time and cost-effective transmission (reduced download time), without loss of image diagnosis quality and based on a Web Multimedia Integrated Access Interface. This implies the integration of HIS and PACS in a unique access interface, providing on-line and fast access to authorized healthcare professionals. The benefits obtained from the HIS-PACS integration and from the availability of all historical patient data are unquestionable to practitioners but also to the patients. Moreover, the system includes a telematic platform capable of establishing cooperative telemedicine sessions where our most impressive utilization is a transcontinental work platform for cardiovascular ultrasound. The key point of our approach starts with the construction of a DICOM private transfer syntax that is prepared to support any video encoder installed on a Windows-based station. With this structure it is possible to select the best encoder to a specific modality and work scenario. Good trade-off between compression ratio and diagnostic quality, low network traffic load, backup facilities and data portability are other achievements of this system.

  3. THE EXTRAORDINARY FAR-INFRARED VARIATION OF A PROTOSTAR: HERSCHEL/PACS OBSERVATIONS OF LRLL54361

    Energy Technology Data Exchange (ETDEWEB)

    Balog, Zoltan; Detre, Örs H.; Bouwmann, Jeroen; Nielbock, Markus; Klaas, Ulrich; Krause, Oliver; Henning, Thomas [Max Planck Institute for Astronomy Königstuhl 17, Heidelberg D-69117 (Germany); Muzerolle, James [Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21218 (United States); Flaherty, Kevin [Astronomy Department, Wesleyan University, Middletown, CT 06459 (United States); Furlan, Elise [Natinal Optical Astronomy Observatory, 950 N. Cherry Avenue, Tucson, AZ 85719 (United States); Gutermuth, Rob [Department of Astronomy, University of Massachusetts, Amherst, MA 01003 (United States); Juhasz, Attila [Leiden Observatory, Leiden University, Niels Bohrweg 2, NL-2333-CA Leiden (Netherlands); Bally, John [CASA, University of Colorado, CB 389, Boulder, CO 80309 (United States); Marton, Gabor, E-mail: balog@mpia.de [Konkoly Observatory, Research Center for Astronomy and Earth Sciences, Hungarian Academy of Sciences, Konkoly Thege 15-17, 1121 Budapest (Hungary)

    2014-07-10

    We report Herschel/Photodetector Array Camera and Spectrometer (PACS) photometric observations at 70 μm and 160 μm of LRLL54361—a suspected binary protostar that exhibits periodic (P = 25.34 days) flux variations at shorter wavelengths (3.6 μm and 4.5 μm) thought to be due to pulsed accretion caused by binary motion. The PACS observations show unprecedented flux variation at these far-infrared wavelengths that are well correlated with the variations at shorter wavelengths. At 70 μm the object increases its flux by a factor of six while at 160 μm the change is about a factor of two, consistent with the wavelength dependence seen in the far-infrared spectra. The source is marginally resolved at 70 μm with varying FWHM. Deconvolved images of the sources show elongations exactly matching the outflow cavities traced by the scattered light observations. The spatial variations are anti-correlated with the flux variation, indicating that a light echo is responsible for the changes in FWHM. The observed far-infrared flux variability indicates that the disk and envelope of this source is periodically heated by the accretion pulses of the central source, and suggests that such long wavelength variability in general may provide a reasonable proxy for accretion variations in protostars.

  4. CALIPSO: an interactive image analysis software package for desktop PACS workstations

    Science.gov (United States)

    Ratib, Osman M.; Huang, H. K.

    1990-07-01

    The purpose of this project is to develop a low cost workstation for quantitative analysis of multimodality images using a Macintosh II personal computer. In the current configuration the Macintosh operates as a stand alone workstation where images are imported either from a central PACS server through a standard Ethernet network or recorded through video digitizer board. The CALIPSO software developed contains a large variety ofbasic image display and manipulation tools. We focused our effort however on the design and implementation ofquantitative analysis methods that can be applied to images from different imaging modalities. Analysis modules currently implemented include geometric and densitometric volumes and ejection fraction calculation from radionuclide and cine-angiograms Fourier analysis ofcardiac wall motion vascular stenosis measurement color coded parametric display of regional flow distribution from dynamic coronary angiograms automatic analysis ofmyocardial distribution ofradiolabelled tracers from tomoscintigraphic images. Several of these analysis tools were selected because they use similar color coded andparametric display methods to communicate quantitative data extracted from the images. 1. Rationale and objectives of the project Developments of Picture Archiving and Communication Systems (PACS) in clinical environment allow physicians and radiologists to assess radiographic images directly through imaging workstations (''). This convenient access to the images is often limited by the number of workstations available due in part to their high cost. There is also an increasing need for quantitative analysis ofthe images. During thepast decade

  5. Clinical results of HIS, RIS, PACS integration using data integration CASE tools

    Science.gov (United States)

    Taira, Ricky K.; Chan, Hing-Ming; Breant, Claudine M.; Huang, Lu J.; Valentino, Daniel J.

    1995-05-01

    Current infrastructure research in PACS is dominated by the development of communication networks (local area networks, teleradiology, ATM networks, etc.), multimedia display workstations, and hierarchical image storage architectures. However, limited work has been performed on developing flexible, expansible, and intelligent information processing architectures for the vast decentralized image and text data repositories prevalent in healthcare environments. Patient information is often distributed among multiple data management systems. Current large-scale efforts to integrate medical information and knowledge sources have been costly with limited retrieval functionality. Software integration strategies to unify distributed data and knowledge sources is still lacking commercially. Systems heterogeneity (i.e., differences in hardware platforms, communication protocols, database management software, nomenclature, etc.) is at the heart of the problem and is unlikely to be standardized in the near future. In this paper, we demonstrate the use of newly available CASE (computer- aided software engineering) tools to rapidly integrate HIS, RIS, and PACS information systems. The advantages of these tools include fast development time (low-level code is generated from graphical specifications), and easy system maintenance (excellent documentation, easy to perform changes, and centralized code repository in an object-oriented database). The CASE tools are used to develop and manage the `middle-ware' in our client- mediator-serve architecture for systems integration. Our architecture is scalable and can accommodate heterogeneous database and communication protocols.

  6. C4. Pneumonia adquirida na comunidade (PAC: estudo retrospectivo num hospital central

    Directory of Open Access Journals (Sweden)

    A. Oliveira

    2003-11-01

    Full Text Available A PAC é uma importante causa de morbilidade e mortalidade nos doentes hospitalizados. O objectivo deste estudo foi analisar a etiologia, factores de risco, tratamento e mortalidade da PAC no internamento. Procedemos a um estudo retrospectivo de 246 doentes, admitidos no nosso Departamento com o diagnóstico de PAC num período de 24 meses. A média etária foi de 58,9 anos e 61% eram do sexo masculino. Em 48,6% existiam comorbilidades. Na radiografia torácica havia envolvimento multilobar em 17,1%, padrão alveolar em 66,7% e derrame pleural em 18,3%.Os agentes etiológicos foram pesquisados em 195 doentes (75,9% e foram positivos em 57 (29,2%: 11% das hemoculturas (19/173; 30% dos exames culturais de expectoração (48/160 e 10.4% das serologias e antigenúria para Legionella (7/67 foram positivos. Nos doentes com etiologia bacteriana o agente etiológico mais frequente foi S. pneumoniae (47%, seguindo-se os Gram-negativos (26% e H. Influenza (18%.A amoxicilina/clavulanato (82,9% e macrólidos (68,1% foram os antibióticos mais usados. Houve associação de antibióticos em 61,6% dos doentes. A duração média do tratamento foi de 12 dias. Em 93% dos doentes assistiu-se a evolução favorável. A mortalidade foi de 5,1%.Concluimos que o S. pneumoniae continua a ser o agente etiológico mais frequente de PAC. A escolha terapêutica esteve de acordo com as guidelines internacionais e o regime terapêutico mostrou-se adequado tendo a maioria das PAC evolução favorável com baixa mortalidade. : CAP is an important cause of morbidity and mortality in hospitalized patients. The aim of this study was to analyze etiology, risk factors, treatment and mortality of CAP. We conducted a retrospective analysis of clinical data from 246 patients admitted to our Department with CAP diagnosis throughout an 24 month period.The patients were in average age 58,9 years old and 61% were male. In 48,6% significant co-morbidities were found. On chest X-ray there

  7. Propuesta para la resolución pacífica de conflictos en Educación Infantil

    OpenAIRE

    Manso Antona, Ángela

    2017-01-01

    Durante la etapa educativa de Infantil, los conflictos constituyen un tema que está muy presente y en muy pocas ocasiones se presta atención a los mismos y mucho menos se educa sobre ellos, es decir, no se ofrecen las herramientas y los recursos necesarios para que se resuelvan de forma pacífica. La escuela es uno de los principales agentes de aprendizaje de las habilidades necesarias para la resolución pacífica de los conflictos, y es necesario que desde el aula se aborde el aprendizaje d...

  8. 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

  9. 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.

  10. Evaluation of patient and proxy responses on the activity measure for postacute care.

    Science.gov (United States)

    Jette, Alan M; Ni, Pengsheng; Rasch, Elizabeth K; Appelman, Jed; Sandel, M Elizabeth; Terdiman, Joseph; Chan, Leighton

    2012-03-01

    Our objective was to examine the agreement between adult patients with stroke and family member or clinician proxies in activity measure for postacute care (AM-PAC) summary scores for daily activity, basic mobility, and applied cognitive function. This study involved 67 patients with stroke admitted to a hospital within the Kaiser Permanente of Northern California system and were participants in a parent study on stroke outcomes. Each participant and proxy respondent completed the AM-PAC by personal or telephone interview at the point of hospital discharge or during ≥1 transitions to different postacute care settings. The results suggest that for patients with a stroke proxy, AM-PAC data are robust for family or clinician proxy assessment of basic mobility function and clinician proxy assessment of daily activity function, but less robust for family proxy assessment of daily activity function and for all proxy groups' assessments of applied cognitive function. The pattern of disagreement between patient and proxy was, on average, relatively small and random. There was little evidence of systematic bias between proxy and patient reports of their functional status. The degree of concordance between patient and proxy was similar for those with moderate to severe strokes compared with mild strokes. Patient and proxy ratings on the AM-PAC achieved adequate agreement for use in stroke research when using proxy respondents could reduce sample selection bias. The AM-PAC data can be implemented across institutional as well as community care settings while achieving precision and reducing respondent burden.

  11. 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

  12. Day Care Centers for Seniors in Singapore: Looking Back and Looking Ahead.

    Science.gov (United States)

    Liu, Germaine; Yap, Philip; Wong, Gabriel H Z; Wei, Heng Xiao; Hua, Ee Chye

    2015-07-01

    The burden of care for frail elderly persons on families and the society is ever real as our population ages. Given the dual-income nature of many working families, day care centers offer a strong alternative to nursing homes for families wishing to provide custodial care and meaningful engagement for seniors while continuing to uphold their filial duties. Recognizing this, several initiatives, such as SPICE (Singapore Programme for Integrated Care for the Elderly) and Weekend Respite Care, have been launched to enhance the services of Singapore's day care centers. This article traces the evolution of this process, distills current challenges, and offers policy recommendations to improve Singapore's day care services for seniors. Copyright © 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  13. 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

  14. 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.

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

    Science.gov (United States)

    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.

  16. Vaimupuudega koolieelikute (re)habilitatsioonivajaduse määratlemine S/P = PAC formulariga / Kristel Voll

    Index Scriptorium Estoniae

    Voll, Kristel

    2000-01-01

    Artikli autor uuris, kas ja kuidas on võimalik Eestis rakendada PAC (Progress Assessment Chart) formularide spetsiaalselt raskema vaimupuudega astme jaoks loodud varinti S/P=PACd mõõduka, raske ja sügava vaimupuudega koolieelikute sotsiaalsete oskuste taseme määramiseks

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

    Science.gov (United States)

    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/

  18. 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

  19. 78 FR 41959 - State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC); Notice of Meeting

    Science.gov (United States)

    2013-07-12

    ...] State, Local, Tribal, and Private Sector Policy Advisory Committee (SLTPS-PAC); Notice of Meeting AGENCY... Classified National Security Information Program for State, Local, Tribal, and Private Sector Entities. FOR..., announcement is made for the following committee meeting. Name of Committee: State, Local, Tribal, and Private...

  20. PACS and SPIRE photometer maps of M33 : First results of the HERschel M33 Extended Survey (HERM33ES)

    NARCIS (Netherlands)

    Kramer, C.; Buchbender, C.; Xilouris, E. M.; Boquien, M.; Braine, J.; Calzetti, D.; Lord, S.; Mookerjea, B.; Quintana-Lacaci, G.; Relano, M.; Stacey, G.; Tabatabaei, F. S.; Verley, S.; Aalto, S.; Akras, S.; Albrecht, M.; Anderl, S.; Beck, R.; Bertoldi, F.; Combes, F.; Dumke, M.; Garcia-Burillo, S.; Gonzalez, M.; Gratier, P.; Guesten, R.; Henkel, C.; Israel, F. P.; Koribalski, B.; Lundgren, A.; Martin-Pintado, J.; Roellig, M.; Rosolowsky, E.; Schuster, K. F.; Sheth, K.; Sievers, A.; Stutzki, J.; Tilanus, R.P.J.; van der Tak, F.; Wiedner, M. C.; van der Werf, Paul P.

    Context. Within the framework of the HERM33ES key program, we are studying the star forming interstellar medium in the nearby, metal-poor spiral galaxy M33, exploiting the high resolution and sensitivity of Herschel. Aims. We use PACS and SPIRE maps at 100, 160, 250, 350, and 500 mu m wavelength, to

  1. 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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

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

  4. Mixed phase in cubic and hexagonal HoMn2111Cd PAC and 119Sn, 57Fe Moessbauer studies

    International Nuclear Information System (INIS)

    Cottenier, S.; Meersschaut, J.; Demuynck, S.; Swinnen, B.; Rots, M.

    1998-01-01

    Hyperfine parameters on 57 Fe, 119 Sn and 111 Cd substituted into the Mn sublattice were measured by Moessbauer and PAC spectroscopies. From these results it is tentatively concluded that C15 and C14 HoMn 2 are mixed-phase compounds. In C14 HoMn 2 there is no (or small) moment on the 2a site. (orig.)

  5. 76 FR 336 - Intent To Prepare a Supplemental Environmental Impact Statement (SEIS) for PacRim Coal's Proposed...

    Science.gov (United States)

    2011-01-04

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

  6. Why Hospitals and Payers are Recommending Home Care Upon Discharge Instead of SNF or Traditional Home Health Services--Alternative Payment Model Hospital Incentives Aligning with Patient Choice.

    Science.gov (United States)

    Luke, Josh

    2016-01-01

    Seniors and other hospital patients in the United States have traditionally had the option of being discharged to a skilled nursing facility (convalescent home) for post-acute services, or home with nursing and therapy services provided in the home setting. Traditionally, these home based services have been referred to as "home health." As more Americans have retired, home health services have expanded and are readily accessible. This growth put tremendous stress on the Medicare fund which pays for senior care services. However, "Home Care," which traditionally has been viewed as non-medical home based services, has also become a booming industry for the cost conscious in recent years as more Americans reach retirement age. With the passing of the Affordable Care Act in 2010, providers and payers are now finding themselves responsible for post-acute care and continuous patient health, so cost efficient solutions for post-acute care are thriving. For the first time in history, American hospitals and Insurers are recognizing Home Care as an effective model that achieves the Triple Aim of Health Care reform. Home Care, which is no longer completely non-medical services, has proven to be an integral part of the care continuum for seniors in recent years and is now becoming a viable solution for keeping patients well, while still honoring their desire to age and heal at home. This paper analyzes the benefits and risks of home care and provides a clear understanding as to why American hospitals are emphasizing SNF Avoidance and skipping home health, opting instead to refer patients directly to home care as the preferred discharge solution in a value based model.

  7. Moluscos marinos de la Isla de Gorgona (Costa del Pacífico colombiano)

    OpenAIRE

    Cosel, R.v.

    1984-01-01

    Se listan 319 especies de moluscos marinos ya recolectados por varias personas y expediciones científicas en la Isla Gorgona (Litoral Pacífico de Colombia, provincia zoogeográfica panameña). 209 especies (65.5%) se encuentran desde México hasta el Ecuador o Perú, 21 especies (6.6%) desde Centroamérica hasta el Ecuador o Perú y 4 especies (1.3%) desde Gorgona (límite norte) hasta el Ecuador o Perú. Para 42 especies (13.2%), Gorgona forma el límite sur de distribución, otras 14 e...

  8. Towards a semantic PACS: Using Semantic Web technology to represent imaging data.

    Science.gov (United States)

    Van Soest, Johan; Lustberg, Tim; Grittner, Detlef; Marshall, M Scott; Persoon, Lucas; Nijsten, Bas; Feltens, Peter; Dekker, Andre

    2014-01-01

    The DICOM standard is ubiquitous within medicine. However, improved DICOM semantics would significantly enhance search operations. Furthermore, databases of current PACS systems are not flexible enough for the demands within image analysis research. In this paper, we investigated if we can use Semantic Web technology, to store and represent metadata of DICOM image files, as well as linking additional computational results to image metadata. Therefore, we developed a proof of concept containing two applications: one to store commonly used DICOM metadata in an RDF repository, and one to calculate imaging biomarkers based on DICOM images, and store the biomarker values in an RDF repository. This enabled us to search for all patients with a gross tumor volume calculated to be larger than 50 cc. We have shown that we can successfully store the DICOM metadata in an RDF repository and are refining our proof of concept with regards to volume naming, value representation, and the applications themselves.

  9. Reconstructing the CT number array from gray-level images and its application in PACS

    Science.gov (United States)

    Chen, Xu; Zhuang, Tian-ge; Wu, Wei

    2001-08-01

    Although DICOM compliant computed tomography has been prevailing in medical fields nowadays, there are some incompliant ones, from which we could hardly get the raw data and make an apropos interpretation due to the proprietary image format. Under such condition, one usually uses frame grabbers to capture CT images, the results of which could not be freely adjusted by radiologists as the original CT number array could. To alleviate the inflexibility, a new method is presented in this paper to reconstruct the array of CT number from several gray-level images acquired under different window settings. Its feasibility is investigated and a few tips are put forward to correct the errors caused respectively by 'Border Effect' and some hardware problems. The accuracy analysis proves it a good substitution for original CT number array acquisition. And this method has already been successfully used in our newly developing PACS and accepted by the radiologists in clinical use.

  10. Datafish Multiphase Data Mining Technique to Match Multiple Mutually Inclusive Independent Variables in Large PACS Databases.

    Science.gov (United States)

    Kelley, Brendan P; Klochko, Chad; Halabi, Safwan; Siegal, Daniel

    2016-06-01

    Retrospective data mining has tremendous potential in research but is time and labor intensive. Current data mining software contains many advanced search features but is limited in its ability to identify patients who meet multiple complex independent search criteria. Simple keyword and Boolean search techniques are ineffective when more complex searches are required, or when a search for multiple mutually inclusive variables becomes important. This is particularly true when trying to identify patients with a set of specific radiologic findings or proximity in time across multiple different imaging modalities. Another challenge that arises in retrospective data mining is that much variation still exists in how image findings are described in radiology reports. We present an algorithmic approach to solve this problem and describe a specific use case scenario in which we applied our technique to a real-world data set in order to identify patients who matched several independent variables in our institution's picture archiving and communication systems (PACS) database.

  11. 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

  12. Modemización: una propuesta altemativa para el Pacífico colombiano

    Directory of Open Access Journals (Sweden)

    Alvaro Pedro G.

    2009-11-01

    Full Text Available RESUMEN: Estos dos autores tratan de definir en su artículo una propuesta alternativa de modernización para el Pacífico colombiano. Pero los modelos de desarrollo que se están proponiendo y poniendo en marcha últimamente no resultan apropiados para este área geográfica, que necesita de una acción social más autonóma, endógena y pluralista para poder transformar su realidad.ABSTRACT: These two authors try to define an alternative proposal of a modernization program for the Pacific Coast of Colombia. But the models of development actually implemented are not applicable to this geographical area which is required of a more autonomous, endogenous and pluralistic social action in order to transform its reality.

  13. Condicionantes económicas de Colombia y la Alianza del Pacífico

    Directory of Open Access Journals (Sweden)

    Giovanni Reyes

    2017-02-01

    Full Text Available La principal finalidad de este estudio es presentar una visión actualizada y genérica respecto a las condicionantes económicas de Colombia en particular y las relacionadas con el conjunto de países que conforman la Alianza del Pacífico en general –Chile, Colombia, México y Perú. Se trata de un estudio no experimental, descriptivo-interpretativo con énfasis en la revisión de datos. Entre las conclusiones más importantes se destacan los niveles de crecimiento económico con mayor estabilidad que presentan Chile y Perú, una dependencia comercial exterior de México hacia Estados Unidos y en Colombia se tiene el caso de que el aumento de producción que se hace evidente no impacta tanto como era de esperarse, en la variable empleo.

  14. Utilization of a multimedia PACS workstation for surgical planning of epilepsy

    Science.gov (United States)

    Soo Hoo, Kent; Wong, Stephen T.; Hawkins, Randall A.; Knowlton, Robert C.; Laxer, Kenneth D.; Rowley, Howard A.

    1997-05-01

    Surgical treatment of temporal lobe epilepsy requires the localization of the epileptogenic zone for surgical resection. Currently, clinicians utilize electroencephalography, various neuroimaging modalities, and psychological tests together to determine the location of this zone. We investigate how a multimedia neuroimaging workstation built on top of the UCSF Picture Archiving and Communication System can be used to aid surgical planning of epilepsy and related brain diseases. This usage demonstrates the ability of the workstation to retrieve image and textural data from PACS and other image sources, register multimodality images, visualize and render 3D data sets, analyze images, generate new image and text data from the analysis, and organize all data in a relational database management system.

  15. Recent achievements on the development of the HERSCHEL/PACS bolometer arrays

    International Nuclear Information System (INIS)

    Billot, N.; Agnese, P.; Boulade, O.; Cigna, C.; Doumayrou, E.; Horeau, B.; Lepennec, J.; Martignac, J.; Pornin, J.-L.; Reveret, V.; Rodriguez, L.; Sauvage, M.; Simoens, F.; Vigroux, L.

    2006-01-01

    A new type of bolometer arrays sensitive in the far Infrared and Submillimeter range has been developed and manufactured by CEA/LETI/SLIR since 1997. These arrays will be integrated in the PACS instrument (Photodetector Array Camera and Spectrometer) of ESA's Herschel Space Observatory (launch date 2007). The main innovations of CEA bolometers are their collective manufacturing technique (production of 3-side buttable 16x16 arrays) and their high mapping efficiency (large format detector and instantaneous Nyquist sampling). The measured NEP is 2.10 -16 W/Hz and the thermometric passband about 4-5Hz. In this article we describe CEA bolometers and present the results obtained during the last test campaign

  16. Estudio paleoetnobotánico en la Costa Pacífica Vallecaucana

    Directory of Open Access Journals (Sweden)

    Romero Picón Yuri

    1996-06-01

    Full Text Available As part of the INCIVA's Archaeological Research Program in the Valle del Cauca region of the Pacilic coast, this study seeks to contribute, from the anthropological and ecological perspective of paleoethnobotany, elements that will aid in the reconstruction of the nutritional base of the prehispanic populations settled in the alluvial valleys of the San Juan and Calimarivers.Inscrito dentro del Programa de Investigaciones Arqueológicas que adelanta el INCIVA en la Costa Pacífica Vallecaucana, este estudio busca aportar desde un enfoque antropológico y ecológico de la Paleoetnobotánica, elementos que contribuyan a reconstruir la naturaleza de la base alimenticia de las poblaciones prehispánicas asentadas en la llanura aluvial de los ríos Calima y San Juan.

  17. 1st oPAC Topical Workshop: Grand Challenges in Accelerator Optimisation

    CERN Document Server

    2013-01-01

    Accelerators are key instruments for fundamental research, health and industry applications. International collaboration is very important for their continued optimisation. To address this oPAC is organising this two-day international workshop on Grand Challenges in Accelerator Optimisation. The workshop will provide an overview of the current state of the art in beam physics, numerical simulations and beam instrumentation and highlight existing limitations. It will discuss research and development being undertaken and ambitions to further improve the performance of existing and future facilities. In addition to invited talks, there will be industry displays and a special seminar covering recent LHC discoveries. All participants will have an opportunity to contribute a poster.

  18. Recent achievements on the development of the HERSCHEL/PACS bolometer arrays

    Energy Technology Data Exchange (ETDEWEB)

    Billot, N. [CEA/Saclay/SAp, UMR CEA/CNRS/UP7 Laboratoire AIM, Bat. 709, l' Orme des merisiers, 91191 Gif-sur-Yvette (France)]. E-mail: nbillot@cea.fr; Agnese, P. [CEA/LETI Grenoble, 17 Avenue des Martyrs, 38054 Grenoble (France); Boulade, O. [CEA/Saclay/SAp, UMR CEA/CNRS/UP7 Laboratoire AIM, Bat. 709, l' Orme des merisiers, 91191 Gif-sur-Yvette (France); Cigna, C. [CEA/LETI Grenoble, 17 Avenue des Martyrs, 38054 Grenoble (France); Doumayrou, E. [CEA/Saclay/SAp, UMR CEA/CNRS/UP7 Laboratoire AIM, Bat. 709, l' Orme des merisiers, 91191 Gif-sur-Yvette (France); Horeau, B. [CEA/Saclay/SAp, UMR CEA/CNRS/UP7 Laboratoire AIM, Bat. 709, l' Orme des merisiers, 91191 Gif-sur-Yvette (France); Lepennec, J. [CEA/Saclay/SAp, UMR CEA/CNRS/UP7 Laboratoire AIM, Bat. 709, l' Orme des merisiers, 91191 Gif-sur-Yvette (France); Martignac, J. [CEA/Saclay/SAp, UMR CEA/CNRS/UP7 Laboratoire AIM, Bat. 709, l' Orme des merisiers, 91191 Gif-sur-Yvette (France); Pornin, J.-L. [CEA/LETI Grenoble, 17 Avenue des Martyrs, 38054 Grenoble (France); Reveret, V. [CEA/Saclay/SAp, UMR CEA/CNRS/UP7 Laboratoire AIM, Bat. 709, l' Orme des merisiers, 91191 Gif-sur-Yvette (France); Rodriguez, L. [CEA/Saclay/SAp, UMR CEA/CNRS/UP7 Laboratoire AIM, Bat. 709, l' Orme des merisiers, 91191 Gif-sur-Yvette (France); Sauvage, M. [CEA/Saclay/SAp, UMR CEA/CNRS/UP7 Laboratoire AIM, Bat. 709, l' Orme des merisiers, 91191 Gif-sur-Yvette (France); Simoens, F. [CEA/LETI Grenoble, 17 Avenue des Martyrs, 38054 Grenoble (France); Vigroux, L. [CEA/Saclay/SAp, UMR CEA/CNRS/UP7 Laboratoire AIM, Bat. 709, l' Orme des merisiers, 91191 Gif-sur-Yvette (France); Institut d' Astrophysique de Paris, 75014 Paris (France)

    2006-11-01

    A new type of bolometer arrays sensitive in the far Infrared and Submillimeter range has been developed and manufactured by CEA/LETI/SLIR since 1997. These arrays will be integrated in the PACS instrument (Photodetector Array Camera and Spectrometer) of ESA's Herschel Space Observatory (launch date 2007). The main innovations of CEA bolometers are their collective manufacturing technique (production of 3-side buttable 16x16 arrays) and their high mapping efficiency (large format detector and instantaneous Nyquist sampling). The measured NEP is 2.10{sup -16}W/Hz and the thermometric passband about 4-5Hz. In this article we describe CEA bolometers and present the results obtained during the last test campaign.

  19. Proceedings of the 22nd Particle Accelerator Conference (PAC'07)

    Energy Technology Data Exchange (ETDEWEB)

    N/A

    2007-08-01

    The twenty-second Particle Accelerator Conference, PAC'07, took place at the Albuquerque Convention Centre in Albuquerque, the largest city in New Mexico, from Monday to Friday, 2007 June 25 to 29. It was attended by over 1350 delegates from 25 different countries (63% North America, 24% Europe, 11% Asia and 2% Other), and was held under the auspices of the two professional societies that oversee and make holding this series of conferences possible, the Division of Physics of Beams within APS, and the Nuclear and Plasma Sciences Society within IEEE. As host of the conference, Los Alamos National Laboratory (LANL) is especially thanked for their many contributions and assistance both prior to and during the conference. The Convention Center was an ideal location for information sharing and discussions between the interdisciplinary aspects of the accelerator community, as well as for related meetings and ad-hoc 'rump' sessions.

  20. $^{80m}$Br/$^{80}$Br a new electron-$\\gamma$ - PAC Probe

    CERN Document Server

    Correia, J G; Araújo, J P; Marques, J G; Soares, J C; Melo, A A

    2001-01-01

    Conversion electron-$\\gamma$ PAC measurements of the 49 keV - 37 keV cascade in $^{80}$Br through the intermediate 2$^{-}$ state with T$_{1/2}$=7.4 ns were performed with a system of two magnetic lens spectrometers and two BaF$_{2}$ scintillation detectors. The parent $^{80m}$Br activity with half-life of 4.4 hrs was implanted into Ni, Zn and graphite at the ISOLDE separator at CERN. The observed interaction frequency in the nickel matrix is in good agreement with the known value of the hyperfine field for Br in Ni and the magnetic moment of the 2$^{-}$ state. From the measured quadrupole interaction in Zn and graphite the electric field gradients at Br were obtained.