On variation in Schloenbachia varians (J. Sowerby, 1817) from the Lower Cenomanian of western Kazakhstan

Science.gov (United States)

Kennedy, William James

2013-12-01

Kennedy, W.J. 2013. On variation in Schloenbachia varians (J. Sowerby, 1817) from the Lower Cenomanian of western Kazakhstan Acta Geologica Polonica, 63(4), 443-468. Warszawa. An assemblage of 94 specimens of Schloenbachia varians (J. Sowerby, 1817) from the Lower Cenomanian Sharpeiceras schlueteri Subzone of the Mantelliceras mantelli Zone of the Besakty section in the Mangyshlak Mountains of western Kazakhstan includes 26 complete adults that range from to 59-174 mm in diameter. No size-related dimorphism was detected in the assemblage, which shows wide, continuous intraspecific variation. This is described in terms of five formae; from robust to gracile these are: ventriosa, varians sensu stricto, subtuberculata , intermedia, and subplana. The ratio of robust (ventriosa + varians sensu stricto) to gracile (subtuberculata + intermedia + subplana) individuals is 34% to 66%. The reference specimens of the formae and their synonyms are described and illustrated, and related to the Besakty material. The modification of adult body chamber ornament of all formae is documented, and Jakeiceras Cooper and Owen, 2011 is shown to be based on an adult of a passage form between forma subtuberculata and forma intermedia. The differences between Lower Cenomanian S. varians, lower Middle Cenomanian S. coupei (Brongniart, 1822), and upper Middle and lower Upper Cenomanian S. lymensis Spath, 1926b are described and illustrated.

SU-E-T-06: A Comparison of IMRT Treatment of Esophageal Carcinoma in Elekta-Precise and Varian23EX Linac

Energy Technology Data Exchange (ETDEWEB)

Bai, W; Fan, X; Qiu, R; Qiao, X; Zhang, R [Hebei Medical University Fourth Hospital, Shijiazhuang, Hebei (China)

2014-06-01

Purpose: To compare and analyze the characteristics of static intensity-modulated radiotherapy (IMRT) plans designed on Elekta and Varian Linac in different esophageal cancer(EC), exploring advantages and disadvantages of different vendor Linac, thus can be better serve for clinical. Methods: Twenty-four patients with EC were selected, including 6 cases located in the cervical, upper, middle and the lower thorax, respectively. Two IMRT plans were generated with the Oncentra planning system: in Elekta and Varian Linac, prescription dose of 60Gy in 30 fractions to the PTV. We examined the dose-volume histogram parameters of PTV and the organs at risk (OAR) such as lungs, spinal cord and heart, and additional Monitor units(MU), treatment time, Homogeneity index(HI), Conformity index(CI) and Gamma index comparisons were performed. Results: All plans resulted in abundant dose coverage of PTV for EC of different locations. The doses to PTV, HI and OAR in Elekta plans were not statistically different in comparison with Varian plans, with the following exceptions: in cervical, upper and lower thoracic EC the PTV's CI, and in middle thorax EC PTV's D2, D50, V105 and PTV-average were better in Elekta plans than in Varian plans. In the cervical, upper and the middle thorax EC, treatment time were significantly decreased in Varian plans as against Elekta plans, while in the lower thoracic EC treatment time were no striking difference. MUs and gamma index were similar between the two Linac plans. Conclusion: For the the middle thorax EC Varian plans is better than Elekta plans, not only in treatment time but in the PTV dose; while for the lower thorax EC Elekta plans is the first choice for better CI; for the other part of the EC usually Elekta plans can increase the CI, while Varian plans can reduce treatment time, can be selected according to the actual situation of the patient treatment.

The Varian MAT-250 mass spectrometer. Steady isotopes laboratory

International Nuclear Information System (INIS)

Hernandez M, V.; Tavera D, M.L.

1997-01-01

This work treats over the performance and applications of the Varian Mat-250 mass spectrometer which is in the environmental isotope laboratory. It can be applied over topics such as: ions formation, acceleration and collimation, ions separation, ions detection, data transformation, sampling, δ notation. (Author)

The evaluation for the usability of the Varian Standard Couch modelingusing Treatment Planning System

Energy Technology Data Exchange (ETDEWEB)

Yang, Yong Mo; Song, Yong Min; Kim, Jin Man; Choi, Ji Min; Choi, Byeung Gi [Dept. of Radiation Oncology, Samsung Medical Center, Seoul (Korea, Republic of)

2016-06-15

When a radiation treatment, there is an attenuation by Carbon Fiber Couch. In this study, we tried to evaluate the usability of the Varian Standard Couch(VSC) by modeling with Treatment Planning System (TPS) VSC was scanned by CBCT(Cone Beam Computed Tomography) of the Linac(Clinac IX, VARIAN, USA), following the three conditions of VSC, Side Rail OutGrid(SROG), Side Rail InGrid(SRIG), Side Rail In OutSpine Down Bar(SRIOS). After scan, the data was transferred to TPS and modeled by contouring Side Rail, Side Bar Upper, Side Bar Lower, Spine Down Bar automatically. We scanned the Cheese Phantom(Middelton, USA) using Computed Tomography(Light Speed RT 16, GE, USA) and transfer the data to TPS, and apply VSC modeled previously with TPS to it. Dose was measured at the isocenter of Ion Chamber(A1SL, Standard imaging, USA) in Cheese Phantom using 4 and 10 MV radiation for every 5° gantry angle in a different filed size(3 X 3 cm{sup 2},10 X 10cm{sup 2}) without any change of MU(=100), and then we compared the calculated dose and measured dose. Also we included dose at the 127° in SRIG to compare the attenuation by Side Bar Upper. Results : The density of VSC by CBCT in TPS was 0.9g/cm{sup 3}, and in the case of Spine Down Bar, it was 0.7g/cm{sup 3}. The radiation was attenuated by 17.49%, 16.49%, 8.54%, and 7.59% at the Side Rail, Side Bar Upper, Side Bar Lower, and Spine Down Bar. For the accuracy of modeling, calculated dose and measured dose were compared. The average error was 1.13% and the maximum error was 1.98% at the 170° beam crossing the Spine Down Bar. To evaluate the usability for the VSC modeled by TPS, the maximum error was 1.98% as a result of compassion between calculated dose and measured dose. We found out that VSC modeling helped expect the dose, so we think that it will be helpful for the more accurate treatment.

Clinical application of image-guided radiotherapy, IGRT (on the Varian OBI platform)

International Nuclear Information System (INIS)

Sorcini, B.; Tilikidis, A.

2006-01-01

Image-guided radiation therapy (IGRT) can be used to measure and correct positional errors for target and critical structures immediately prior to or during treatment delivery. Some of the most recent available methods applied for target localization are: trans-abdominal ultrasound, implanted markers with in room MV or kV X-rays, optical surface tracking systems, implantable electromagnetic markers, in room CT such as kVCT on rail, kilo-voltage or mega-voltage cone-beam CT (CBCT) and helical megavoltage CT. The verification of the accurate treatment position in conjunction with detailed anatomical information before every fraction can be essential for the outcome of the treatment. In this paper we present the on-board imager (OBI, Varian Medical Systems, Palo Alto, CA) that has been in routine clinical use at the Karolinska University Hospital since June 2004. The OBI has been used for on-line set-up correction of prostate patients using internal gold markers. Displacements of these markers can be monitored radiographically during the treatment course and the registered marker shifts act as a surrogate for prostate motion. For this purpose, on-board kV-kV seems to be an ideal system in terms of image quality. The CBCT function of OBI was installed in March 2005 at our department. It focuses on localizing tumors based on internal anatomy, not just on the conventional external marks or tattoos. The CBCT system provides the capacity for soft tissue imaging in the treatment position and real-time radiographic monitoring during treatment delivery. (authors)

Orthogonal image pairs coupled with OSMS for noncoplanar beam angle, intracranial, single-isocenter, SRS treatments with multiple targets on the Varian Edge radiosurgery system

Directory of Open Access Journals (Sweden)

Jasmine A. Oliver, PhD

2017-07-01

Conclusion: Based on our study, CR-induced shifts with the Varian Edge radiosurgery system will not produce noticeable dosimetric effects for SRS treatments. Thus, replacing cone beam CT with orthogonal kV/kV pairs coupled with OSMS at the treatment couch angle could reduce the number of cone beam CT scans that are acquired during a standard SRS treatment while providing an accurate and safe treatment with negligible dosimetric effects on the treatment plan.

Female sex pheromone and male behavioral responses of the bombycid moth Trilocha varians: comparison with those of the domesticated silkmoth Bombyx mori

Science.gov (United States)

Daimon, Takaaki; Fujii, Takeshi; Yago, Masaya; Hsu, Yu-Feng; Nakajima, Yumiko; Fujii, Tsuguru; Katsuma, Susumu; Ishikawa, Yukio; Shimada, Toru

2012-03-01

Analysis of female sex pheromone components and subsequent field trap experiments demonstrated that the bombycid moth Trilocha varians uses a mixture of ( E, Z)-10,12-hexadecadienal (bombykal) and ( E,Z)-10,12-hexadecadienyl acetate (bombykyl acetate) as a sex pheromone. Both of these components are derivatives of ( E,Z)-10,12-hexadecadienol (bombykol), the sex pheromone of the domesticated silkmoth Bombyx mori. This finding prompted us to compare the antennal and behavioral responses of T. varians and B. mori to bombykol, bombykal, and bombykyl acetate in detail. The antennae of T. varians males responded to bombykal and bombykyl acetate but not to bombykol, and males were attracted only when lures contained both bombykal and bombykyl acetate. In contrast, the antennae of B. mori males responded to all the three components. Behavioral analysis showed that B. mori males responded to neither bombykal nor bombykyl acetate. Meanwhile, the wing fluttering response of B. mori males to bombykol was strongly inhibited by bombykal and bombykyl acetate, thereby indicating that bombykal and bombykyl acetate act as behavioral antagonists for B. mori males. T. varians would serve as a reference species for B. mori in future investigations into the molecular mechanisms underlying the evolution of sex pheromone communication systems in bombycid moths.

Design of planning target volume margin using an active breathing control and Varian image-guided radiotherapy (IGRT) system in unresectable liver tumor

International Nuclear Information System (INIS)

Yue Jinbo; Yu Jinming; Liu Jing; Liu Tonghai; Yin Yong; Shi Xuetao; Song Jinlong

2007-01-01

Objective: To define the planning target volume(PTV) margin with an active breathing control (ABC) and the Varian image-guided radiotherapy (IGRT) system. Methods: Thirteen patients with liver cancer were treated with radiotherapy from May 2006 to September 2006. Prior to radiotherapy, all patients had undergone transarterial chemoembolization (TACE) by infusing a mixture of iodized oil contrast medium and chemotherapeutic agents, kV fluoroscopy was used to measure the potential motion of lipiodol spot positions during ABC breath-holds. ABC was used for planning CT scan and radiation delivery, with the breath held at the same phase of the respiratory cycle (near end-exhalation). Cone beam CT (CBCT) was taken using Varian IGRT system, which was then compared online with planning CT using a 3 D-3 D matching tool. Analysis relied on lipiodol spots on planning CT and CBCT manually. The treatment table was moved to produce acceptable setup before treatment delivery. Repeated CBCT image and another analysis were obtained after irradiation. Results: No motion of the intrahepatic tumor was observed on fluoroscopy during ABC breath-holds. The estimated required PTV margins, calculated according to the Stroom formula, were 4.4 mm, 5.3 mm and 7.8 mm in the x, y and z axis directions before radiotherapy. The corresponding parameters were 2.5m, 2.6 mm and 3.9 mm after radiotherapy. Conclusions: We have adopted a PTV margin of 5 mm, 6 mm and 8 mm in the x, y and z axis directions with ABC, and 3,3 and 4 mm with ABC and on-line kilovoltage CBCT. (authors)

SU-E-T-406: Use of TrueBeam Developer Mode and API to Increase the Efficiency and Accuracy of Commissioning Measurements for the Varian EDGE Stereotactic Linac

International Nuclear Information System (INIS)

Gardner, S; Gulam, M; Song, K; Li, H; Huang, Y; Zhao, B; Qin, Y; Snyder, K; Kim, J; Gordon, J; Chetty, I; Wen, N

2014-01-01

). The scripting also allowed for creation of the files in advance without requiring access to TPS. The API scripting functionality enabled efficient creation/mining of TPS data. Finally, automation reduces the potential for human error in entering linac values at the machine console,and the script provides a log of measurements acquired for each session. This research was supported in part by a grant from Varian Medical Systems, Palo Alto, CA

Halophilic Nuclease from a Moderately Halophilic Micrococcus varians

Science.gov (United States)

Kamekura, Masahiro; Onishi, Hiroshi

1974-01-01

The moderately halophilic bacterium Micrococcus varians, isolated from soy sauce mash, produced extracellular nuclease when cultivated aerobically in media containing 1 to 4 M NaCl or KCl. The enzyme, purified to an electrophoretically homogeneous state, had both ribonuclease and deoxyribonuclease activities. The nuclease had maximal activity in the presence of 2.9 M NaCl or 2.1 M KCl at 40 C. The enzymatic activity was lost by dialysis against low-salt buffer, whereas when the inactivated enzyme was dialyzed against 3.4 M NaCl buffer as much as 77% of the initial activity could be restored. Images PMID:4852218

Monte Carlo simulation of the Varian Clinac 600C accelerator using dynamic wedges; Simulacao Monte Carlo do acelerador Varian Clinac 600C utilizando cunhas dinamicas

Energy Technology Data Exchange (ETDEWEB)

Moreno, S. [Universidade da Beira Interior (UBI), Covilha (Portugal); Chaves, A.; Lopes, M.C. [Instituto Portugues de Oncologia Doutor Francisco Gentil (IPO), Coimbra (Portugal); Peralta, L. [Laboratorio de Instrumentacao e Fisica Experimental de Particulas (LIP), Lisboa (Portugal)]|[Universidade de Lisboa (Portugal). Faculdade de Ciencias

2004-07-01

The advent of linear accelerators (linac) with computer-controlled dynamic collimation systems and functional and anatomical imaging techniques allowed a more exact delimitation and localisation of the target volume. These advanced treatment techniques inevitably increase the complexity level of dose calculation because of the introduction of the temporal variable. On account of this, it is mandatory the usage of more accurate modelling techniques of the collimator components, as it is the case of Monte Carlo (MC) simulation, which has created an enormous interest in research and clinical practice. Because the patients bodies are not homogenous nor are their body surfaces plane and regular, the dose distribution may differ significantly from the standard distribution from the linac calibration. It is in the treatment planning systems, which include algorithms that are usually measured in homogeneous water phantoms specific for each correction that the dose distributions from each case are obtained. In a real treatment, exception made to superficial lesions, two or more radiation fields are used in order to obtain the recommended dose distributions. The simplest arrangement is made from two parallel and opposed fields that originate a homogeneous dose distribution in almost all the irradiated volume. The available resources are, for example, different types of energies and of radiation, the application of bolus, the protection of healthy structures, the usage of wedged filters and the application of dynamic wedges. A virtual or dynamic wedge, modelled through the movement of one of the jaws, when compared with a set of physical wedges offers an alternative calculation method of an arbitrary number of wedged fields, instead of the four traditional fields of 15 deg, 30 deg, 45 deg and 60 deg angle and obtained with physical wedges. The goal of this work consists in the study of the application of dynamic wedges in tailoring the radiation field by the Varian Clinac 600

Analysis of output trends from Varian 2100C/D and 600C/D accelerators

International Nuclear Information System (INIS)

Grattan, M W D; Hounsell, A R

2011-01-01

Analysis of Varian linear accelerator output trends is reported. Two groups, consisting of four matched Varian 2100C/D and four matched Varian 600C/D accelerators, with different designs of monitor chamber, have been investigated and the data acquired from regular calibrated ion chamber/electrometer measurements of the output performance of the eight accelerators analysed. The trend of machine output with time, having removed the effect of adjusting the monitor chamber response, was compared on a monthly and annual basis for monitor chambers with ages ranging between 1 year and 7 years. The results indicate that the response is generally consistent within each set of accelerators with different monitor chamber designs. Those used in a Varian 600C/D machine result in a reduction in measured output over time, with an average monthly reduction of 0.35 ± 0.09% over the course of the first 4 years of use. The chambers used in a 2100C/D accelerator result in an increase in measured output over time, with an average monthly increase of 0.26 ± 0.09% over the course of the first 4 years of use. The output increase then reduces towards the end of this period of time, with the average monthly change falling to -0.03 ± 0.02% for the following 3 years. The output response trend was similar for all clinical energies used on the 2100C/D accelerators--6, 15 MV x-ray beams, and 4, 6, 9, 12, 16 and 20 MeV electron beams. By tracking these changes it has been possible to predict the response over time to allow appropriate adjustments in monitor chamber response to maintain a measured accelerator output within tolerance and give confidence in performance. It has also provided data to indicate the need for planned preventative intervention and indicate if the monitor chamber response is behaving as expected. (note)

Validation of FORTRAN emulators for the G2 varian control programs

International Nuclear Information System (INIS)

Delorme, G.

1996-01-01

The extensive use of the Gentilly full scope simulator for training and verification of plant procedures, forced the development of a reliable desktop simulator for software maintenance purposes. For that we needed emulators for the control programs which run on the DCC Varian computers in the full scope simulator. This paper presents the validation results for the Reactor Regulating System (RRS) program. This emulator was programmed in a modular fashion providing ease of maintenance and of transportation to another environment. The results obtained with specific tests or with integrated testing involving complex control rule interactions, compared favorably with the ones obtained using the actual plant control programs running on the full scope simulator, which constitutes an irrefutable validation procedure. This RRS package along with the other emulators being validated In this manner could be used in safety codes with confidence. (author)

SU-E-T-362: Enhanced Dynamic Wedge Output Factors for Varian 2300CD and the Case for a Reference Database

International Nuclear Information System (INIS)

Njeh, C

2015-01-01

Purpose: Dose inhomogeneity in treatment planning can be compensated using physical wedges. Enhanced dynamic wedges (EDW) were introduced by Varian to overcome some of the short comings of physical wedges. The objectives of this study were to measure EDW output factors for 6 MV and 20 MV photon energies for a Varian 2300CD. Secondly to review the literature in terms of published enhanced dynamic wedge output factors (EDWOF) for different Varian models and thereby adding credence to the case of the validity of reference databases. Methods: The enhanced dynamic wedge output factors were measured for the Varian 2300CD for both 6 MV and 20 MV photon energies. Twelve papers with published EDWOF for different Varian Linac models were found in the literature. Results: The EDWOF for 6 MV varied from 0.980 for a 5×5 cm 10 degree wedge to 0.424 for 20×20 cm 60 degree wedge. Similarly for 20 MV, the EDWOF varied from 0.986 for 5×5 cm 10 degree wedge to 0.529 for 20×20 cm 60 degree wedge. EDWOF are highly dependent on field size. Comparing our results with the published mean, we found an excellent agreement for 6 MV EDWOF with the percentage differences ranging from 0.01% to 0.57% with a mean of 0.03%. The coefficient of variation of published EDWOF ranged from 0.17% to 0.85% and 0.1% to 0.9% for the for 6 MV and 18MV photon energies respectively. This paper provides the first published EDWOF for 20 MV photon energy. In addition, we have provided the first compendium of EDWOFs for different Varian linac models. Conclusion: The consistency of EDWOF across models and institution provide further support that, a standard data set of basic photon and electron dosimetry could be established, as a guide for future commissioning, beam modeling and quality assurance purposes

SU-E-T-403: Evaluation of the Beam Performance of a Varian TrueBeam Linear Accelerator Under External Device-Based Gated Delivery Conditions

International Nuclear Information System (INIS)

Kobulnicky, K; Pawlak, D; Purwar, A

2015-01-01

Purpose: To examine the beam performance of a Varian TrueBeam linear accelerator under external device-based gated delivery conditions. Methods: Six gating cycles were used to evaluate the gating performance of a standard production TrueBeam system that was not specially tuned in any way. The system was equipped with a factory installed external gating interface (EXGI). An in-house EXGI tester box was used to simulate the input gating signals. The gating cycles were selected based on long beam-on and short beam-off times, short beam-on and long beam-off times, or equal beam on and off times to check linac performance. The beam latencies were measured as the time difference between the logic high gating signal and the first or last target pulses with an oscilloscope. Tissue-Phantom Ratio, beam flatness, and dose distributions from 5 different plans were measured using the 6 different gating durations and the un-gated irradiation. A PTW 729 2-D array was used to compare 5 plans versus the un-gated delivery with a 1%/1mm gamma index passing criteria. Results: The beam latencies of the linac were based off of 20 samples for beam-on and beam-off, for each gating cycle. The average beam-on delays were measured to be between 57 and 66msec, with a maximum of 88 msec. The beam off latencies averaged between 19 and 26msec, with a maximum of 48 msec. TPR20,10 measurements showed beam energy stability within 0.5% of the un-gated delivery. Beam flatness was better than 2.5% for all gated cycles. All but two deliveries, the open field with 4 seconds on, 1 second off, and a five field IMRT plan with 0.5 seconds on, 2.5 seconds off, had >90% passing rate. Conclusion: TrueBeam demonstrates excellent beam stability with minimal beam latencies under external device-based gated operations. Dosimetric measurements show minimal variation in beam energy, flatness, and plan delivery. Authors are employees of Varian Medical Systems, Inc

SU-E-T-403: Evaluation of the Beam Performance of a Varian TrueBeam Linear Accelerator Under External Device-Based Gated Delivery Conditions

Energy Technology Data Exchange (ETDEWEB)

Kobulnicky, K; Pawlak, D; Purwar, A [Varian Medical Systems, Inc., Palo Alto, CA (United States)

2015-06-15

Purpose: To examine the beam performance of a Varian TrueBeam linear accelerator under external device-based gated delivery conditions. Methods: Six gating cycles were used to evaluate the gating performance of a standard production TrueBeam system that was not specially tuned in any way. The system was equipped with a factory installed external gating interface (EXGI). An in-house EXGI tester box was used to simulate the input gating signals. The gating cycles were selected based on long beam-on and short beam-off times, short beam-on and long beam-off times, or equal beam on and off times to check linac performance. The beam latencies were measured as the time difference between the logic high gating signal and the first or last target pulses with an oscilloscope. Tissue-Phantom Ratio, beam flatness, and dose distributions from 5 different plans were measured using the 6 different gating durations and the un-gated irradiation. A PTW 729 2-D array was used to compare 5 plans versus the un-gated delivery with a 1%/1mm gamma index passing criteria. Results: The beam latencies of the linac were based off of 20 samples for beam-on and beam-off, for each gating cycle. The average beam-on delays were measured to be between 57 and 66msec, with a maximum of 88 msec. The beam off latencies averaged between 19 and 26msec, with a maximum of 48 msec. TPR20,10 measurements showed beam energy stability within 0.5% of the un-gated delivery. Beam flatness was better than 2.5% for all gated cycles. All but two deliveries, the open field with 4 seconds on, 1 second off, and a five field IMRT plan with 0.5 seconds on, 2.5 seconds off, had >90% passing rate. Conclusion: TrueBeam demonstrates excellent beam stability with minimal beam latencies under external device-based gated operations. Dosimetric measurements show minimal variation in beam energy, flatness, and plan delivery. Authors are employees of Varian Medical Systems, Inc.

Evaluation of the new respiratory gating system

Science.gov (United States)

Shi, Chengyu; Tang, Xiaoli; Chan, Maria

2018-01-01

Objective The newly released Respiratory Gating for Scanners (RGSC; Varian Medical Systems, Palo Alto, CA, USA) system has limited existing quality assurance (QA) protocols and pertinent publications. Herein, we report our experiences of the RGSC system acceptance and QA. Methods The RGSC system integration was tested with peripheral equipment, spatial reproducibility, and dynamic localization accuracy for regular and irregular breathing patterns, respectively. A QUASAR Respiratory Motion Phantom and a mathematical fitting method were used for data acquisition and analysis. Results The results showed that the RGSC system could accurately measure regular motion periods of 3–10 s. For irregular breathing patterns, differences from the existing Real-time Position Management (RPM; Varian Medical Systems, Palo Alto, CA) system were observed. For dynamic localization measurements, the RGSC system showed 76% agreement with the programmed test data within ±5% tolerance in terms of fitting period. As s comparison, the RPM system showed 66% agreement within ±5% tolerance, and 65% for the RGSC versus RPM measurements. Conclusions New functions and positioning accuracy improve the RGSC system’s ability to achieve higher dynamic treatment precision. A 4D phantom is helpful for the QA tests. Further investigation is required for the whole RGSC system performance QA. PMID:29722356

PENJADWALAN JOBS PADA SINGLE MACHINE DENGAN MEMINIMUMKAN VARIANS WAKTU PENYELESAIAN JOBS Studi Kasus di P.T. XYZ

Directory of Open Access Journals (Sweden)

I Nyoman Sutapa

2001-01-01

Full Text Available This paper discusses a jobs scheduling on a single machine to minimize variance of job completion time. The objective is especially important in situations where it is desirable to provide customers or jobs with approximately the same treatment. In this case, data are collected from P.T. 'XYZ'. The focus of discussion is LB/KB Departement (Leather Board/Carton Board with carton board's production line, which produces carton board. Carton board's size is 150 x 110 cm and its thickness from 0,6 mm to 2,5 mm. In this paper a comparison analysis, the deviation of the objective value given by a heuristic (Vh method from the objective value given by P.T. 'XYZ' (Vp, is made. The percentage of deviation Vh from Vp is 50,36 %, which shows that the performance of heuristic is better, that is variance of job completion time by heuristic method smaller than by P.T. 'XYZ'. Besides the above discussion, the weakness dan superiority of heuristic are analyzed too. Abstract in Bahasa Indonesia : Makalah ini membahas penjadwalan jobs pada single machine dengan tujuan meminimumkan varians waktu penyelesaian job, yaitu untuk memberikan konsumen atau jobs kurang lebih perlakuan yang sama. Data yang diambil dalam pembahasan ini berasal dari perusahaan P.T. 'XYZ', di mana departemen yang menjadi fokus pembahasan adalah Departemen LB/KB (Leather Board/Karton Board dengan lintasan produksi karton board yang menghasilkan produk carton board ukuran 150 x 110 cm, dengan ketebalan 0,6 mm sampai dengan 2,5 mm. Dalam makalah ini dilakukan analisis perbandingan jadwal jobs pada proses produksi di perusahaan yang telah ada dengan jadwal jobs menggunakan metode heuristic, yaitu menggunakan persentase penyimpangan Vh (varians waktu penyelesaian jobs metode heuristic dari Vp (varians waktu penyelesaian jobs perusahaan. Dari hasil analisis didapatkan bahwa persentase penyimpangan Vh dari Vp sebesar 50,36%, hal ini menunjukkan bahwa performance metode heuristic lebih baik, yaitu

TU-FG-201-05: Varian MPC as a Statistical Process Control Tool

International Nuclear Information System (INIS)

Carver, A; Rowbottom, C

2016-01-01

Purpose: Quality assurance in radiotherapy requires the measurement of various machine parameters to ensure they remain within permitted values over time. In Truebeam release 2.0 the Machine Performance Check (MPC) was released allowing beam output and machine axis movements to be assessed in a single test. We aim to evaluate the Varian Machine Performance Check (MPC) as a tool for Statistical Process Control (SPC). Methods: Varian’s MPC tool was used on three Truebeam and one EDGE linac for a period of approximately one year. MPC was commissioned against independent systems. After this period the data were reviewed to determine whether or not the MPC was useful as a process control tool. Analyses on individual tests were analysed using Shewhart control plots, using Matlab for analysis. Principal component analysis was used to determine if a multivariate model was of any benefit in analysing the data. Results: Control charts were found to be useful to detect beam output changes, worn T-nuts and jaw calibration issues. Upper and lower control limits were defined at the 95% level. Multivariate SPC was performed using Principal Component Analysis. We found little evidence of clustering beyond that which might be naively expected such as beam uniformity and beam output. Whilst this makes multivariate analysis of little use it suggests that each test is giving independent information. Conclusion: The variety of independent parameters tested in MPC makes it a sensitive tool for routine machine QA. We have determined that using control charts in our QA programme would rapidly detect changes in machine performance. The use of control charts allows large quantities of tests to be performed on all linacs without visual inspection of all results. The use of control limits alerts users when data are inconsistent with previous measurements before they become out of specification. A. Carver has received a speaker’s honorarium from Varian

[Porting Radiotherapy Software of Varian to Cloud Platform].

Science.gov (United States)

Zou, Lian; Zhang, Weisha; Liu, Xiangxiang; Xie, Zhao; Xie, Yaoqin

2017-09-30

To develop a low-cost private cloud platform of radiotherapy software. First, a private cloud platform which was based on OpenStack and the virtual GPU hardware was builded. Then on the private cloud platform, all the Varian radiotherapy software modules were installed to the virtual machine, and the corresponding function configuration was completed. Finally the software on the cloud was able to be accessed by virtual desktop client. The function test results of the cloud workstation show that a cloud workstation is equivalent to an isolated physical workstation, and any clients on the LAN can use the cloud workstation smoothly. The cloud platform transplantation in this study is economical and practical. The project not only improves the utilization rates of radiotherapy software, but also makes it possible that the cloud computing technology can expand its applications to the field of radiation oncology.

Recent operating experience with Varian 70 GHz and 140 GHz gyrotrons

International Nuclear Information System (INIS)

Felch, K.; Bier, R.; Fox, L.; Huey, H.; Ives, L.; Jory, H.; Lopez, N.; Shively, J.; Spang, S.

1985-01-01

The design features and initial test results of Varian 70 GHz and 140 GHz CW gyrotrons are presented. The first experimental 140 GHz tube has achieved an output power of 102 kW at 24% efficiency under pulsed conditions in the desired TE 031 0 cavity mode. Further tests aimed at achieving the design goal of 100 kW CW are currently underway. The 70 GHz tube has achieved an output power of 200 kW under pulsed conditions and possesses a wide dynamic range for output power variations. 6 refs., 8 figs

Neutron dose measurements of Varian and Elekta linacs by TLD600 and TLD700 dosimeters and comparison with MCNP calculations.

Science.gov (United States)

Nedaie, Hassan Ali; Darestani, Hoda; Banaee, Nooshin; Shagholi, Negin; Mohammadi, Kheirollah; Shahvar, Arjang; Bayat, Esmaeel

2014-01-01

High-energy linacs produce secondary particles such as neutrons (photoneutron production). The neutrons have the important role during treatment with high energy photons in terms of protection and dose escalation. In this work, neutron dose equivalents of 18 MV Varian and Elekta accelerators are measured by thermoluminescent dosimeter (TLD) 600 and TLD700 detectors and compared with the Monte Carlo calculations. For neutron and photon dose discrimination, first TLDs were calibrated separately by gamma and neutron doses. Gamma calibration was carried out in two procedures; by standard 60Co source and by 18 MV linac photon beam. For neutron calibration by (241)Am-Be source, irradiations were performed in several different time intervals. The Varian and Elekta linac heads and the phantom were simulated by the MCNPX code (v. 2.5). Neutron dose equivalent was calculated in the central axis, on the phantom surface and depths of 1, 2, 3.3, 4, 5, and 6 cm. The maximum photoneutron dose equivalents which calculated by the MCNPX code were 7.06 and 2.37 mSv.Gy(-1) for Varian and Elekta accelerators, respectively, in comparison with 50 and 44 mSv.Gy(-1) achieved by TLDs. All the results showed more photoneutron production in Varian accelerator compared to Elekta. According to the results, it seems that TLD600 and TLD700 pairs are not suitable dosimeters for neutron dosimetry inside the linac field due to high photon flux, while MCNPX code is an appropriate alternative for studying photoneutron production.

Monte Carlo simulation of the Varian Clinac 600C accelerator using dynamic wedges

International Nuclear Information System (INIS)

Moreno, S.; Chaves, A.; Lopes, M.C.; Peralta, L.; Universidade de Lisboa

2004-01-01

The advent of linear accelerators (linac) with computer-controlled dynamic collimation systems and functional and anatomical imaging techniques allowed a more exact delimitation and localisation of the target volume. These advanced treatment techniques inevitably increase the complexity level of dose calculation because of the introduction of the temporal variable. On account of this, it is mandatory the usage of more accurate modelling techniques of the collimator components, as it is the case of Monte Carlo (MC) simulation, which has created an enormous interest in research and clinical practice. Because the patients bodies are not homogenous nor are their body surfaces plane and regular, the dose distribution may differ significantly from the standard distribution from the linac calibration. It is in the treatment planning systems, which include algorithms that are usually measured in homogeneous water phantoms specific for each correction that the dose distributions from each case are obtained. In a real treatment, exception made to superficial lesions, two or more radiation fields are used in order to obtain the recommended dose distributions. The simplest arrangement is made from two parallel and opposed fields that originate a homogeneous dose distribution in almost all the irradiated volume. The available resources are, for example, different types of energies and of radiation, the application of bolus, the protection of healthy structures, the usage of wedged filters and the application of dynamic wedges. A virtual or dynamic wedge, modelled through the movement of one of the jaws, when compared with a set of physical wedges offers an alternative calculation method of an arbitrary number of wedged fields, instead of the four traditional fields of 15 deg, 30 deg, 45 deg and 60 deg angle and obtained with physical wedges. The goal of this work consists in the study of the application of dynamic wedges in tailoring the radiation field by the Varian Clinac 600

Cognitive Medical Multiagent Systems

OpenAIRE

Barna Iantovics

2010-01-01

The development of efficient and flexible agent-based medical diagnosis systems represents a recent research direction. Medical multiagent systems may improve the efficiency of traditionally developed medical computational systems, like the medical expert systems. In our previous researches, a novel cooperative medical diagnosis multiagent system called CMDS (Contract Net Based Medical Diagnosis System) was proposed. CMDS system can solve flexibly a large variety of medical diagnosis problems...

Out‐of‐field doses and neutron dose equivalents for electron beams from modern Varian and Elekta linear accelerators

Science.gov (United States)

Cardenas, Carlos E.; Nitsch, Paige L.; Kudchadker, Rajat J.; Howell, Rebecca M.

2016-01-01

Out‐of‐field doses from radiotherapy can cause harmful side effects or eventually lead to secondary cancers. Scattered doses outside the applicator field, neutron source strength values, and neutron dose equivalents have not been broadly investigated for high‐energy electron beams. To better understand the extent of these exposures, we measured out‐of‐field dose characteristics of electron applicators for high‐energy electron beams on two Varian 21iXs, a Varian TrueBeam, and an Elekta Versa HD operating at various energy levels. Out‐of‐field dose profiles and percent depth‐dose curves were measured in a Wellhofer water phantom using a Farmer ion chamber. Neutron dose was assessed using a combination of moderator buckets and gold activation foils placed on the treatment couch at various locations in the patient plane on both the Varian 21iX and Elekta Versa HD linear accelerators. Our findings showed that out‐of‐field electron doses were highest for the highest electron energies. These doses typically decreased with increasing distance from the field edge but showed substantial increases over some distance ranges. The Elekta linear accelerator had higher electron out‐of‐field doses than the Varian units examined, and the Elekta dose profiles exhibited a second dose peak about 20 to 30 cm from central‐axis, which was found to be higher than typical out‐of‐field doses from photon beams. Electron doses decreased sharply with depth before becoming nearly constant; the dose was found to decrease to a depth of approximately E(MeV)/4 in cm. With respect to neutron dosimetry, Q values and neutron dose equivalents increased with electron beam energy. Neutron contamination from electron beams was found to be much lower than that from photon beams. Even though the neutron dose equivalent for electron beams represented a small portion of neutron doses observed under photon beams, neutron doses from electron beams may need to be considered for

Out-of-field doses and neutron dose equivalents for electron beams from modern Varian and Elekta linear accelerators.

Science.gov (United States)

Cardenas, Carlos E; Nitsch, Paige L; Kudchadker, Rajat J; Howell, Rebecca M; Kry, Stephen F

2016-07-08

Out-of-field doses from radiotherapy can cause harmful side effects or eventually lead to secondary cancers. Scattered doses outside the applicator field, neutron source strength values, and neutron dose equivalents have not been broadly investigated for high-energy electron beams. To better understand the extent of these exposures, we measured out-of-field dose characteristics of electron applicators for high-energy electron beams on two Varian 21iXs, a Varian TrueBeam, and an Elekta Versa HD operating at various energy levels. Out-of-field dose profiles and percent depth-dose curves were measured in a Wellhofer water phantom using a Farmer ion chamber. Neutron dose was assessed using a combination of moderator buckets and gold activation foils placed on the treatment couch at various locations in the patient plane on both the Varian 21iX and Elekta Versa HD linear accelerators. Our findings showed that out-of-field electron doses were highest for the highest electron energies. These doses typically decreased with increasing distance from the field edge but showed substantial increases over some distance ranges. The Elekta linear accelerator had higher electron out-of-field doses than the Varian units examined, and the Elekta dose profiles exhibited a second dose peak about 20 to 30 cm from central-axis, which was found to be higher than typical out-of-field doses from photon beams. Electron doses decreased sharply with depth before becoming nearly constant; the dose was found to decrease to a depth of approximately E(MeV)/4 in cm. With respect to neutron dosimetry, Q values and neutron dose equivalents increased with electron beam energy. Neutron contamination from electron beams was found to be much lower than that from photon beams. Even though the neutron dose equivalent for electron beams represented a small portion of neutron doses observed under photon beams, neutron doses from electron beams may need to be considered for special cases.

Cognitive Medical Multiagent Systems

Directory of Open Access Journals (Sweden)

Barna Iantovics

2010-01-01

Full Text Available The development of efficient and flexible agent-based medical diagnosis systems represents a recent research direction. Medical multiagent systems may improve the efficiency of traditionally developed medical computational systems, like the medical expert systems. In our previous researches, a novel cooperative medical diagnosis multiagent system called CMDS (Contract Net Based Medical Diagnosis System was proposed. CMDS system can solve flexibly a large variety of medical diagnosis problems. This paper analyses the increased intelligence of the CMDS system, which motivates its use for different medical problem’s solving.

Studying the induced radioactivity of a varian clinac 2100C/D accelerator

International Nuclear Information System (INIS)

Lu Feng; Li Hailiang; Deng Daping; Shang Yunying; Jing Zhongjun

2008-01-01

Objective: To Study the influences of dose, time, distance and irradiation mode on induced radioactivity by measuring a Varian Clinac 2100C/D accelerator. Methods: The induced radioactivity was measured in different dose, time, distance and irradiation mode by using of 450P model dosemeter. The results was analysed. Results: The induced radioactivity is direct ratio with dose, inverse ratio with time and distance. In different irradiation mode, the induced radioactivity is different. Conclusion: The induced radioactivity level of accelerator is related with dose, time, distance and irradiation mode. (authors)

The growth of Micrococcus varians by utilizing sugar cane blackstrap molasses as substrate

Directory of Open Access Journals (Sweden)

Miranda Luís A. S.

1999-01-01

Full Text Available Comparative studies on the growth of Micrococcus varians were carried out in BHI culture medium (control as well as in a culture medium with 2% diluted sugar cane blackstrap molasses, enriched with 0.1% yeast extract. The experiment was conducted with three samples of the experimental and control media in a 5 liter fermentor with working volume of 3.5 liters, continuous agitation (150 rpm, 35 ± 0.1°C temperature, 0.7 L air. l-1 medium. min -1, initial pH 7.0 ± 0.2, 24 hour fermentation period, and approximate inoculum of 6.0 log10 CFU/ml. Samples were collected at 2-hour intervals. Micrococcus varians grew in the two culture media studied, which confirms the experimental medium viability for the growth of this species. The final average concentration of biomass was higher in the control medium than in the experimental medium: 0.99 g.l-1 and 0.78 g.l-1, respectively. The final number of viable cells at the end of fermentation was 20.65 log10 CFU/ml for the control medium (BHI, while in the experimental medium the number of viable cells was 19.43 log10 CFU/ml. The consumption of total sugars was higher for the biomass in the control medium (79.78%, while only 50.53% was consumed for the experimental medium.

SU-F-T-526: A Comparative Study On Gating Efficiency of Varian RPM Device and Calypso System

Energy Technology Data Exchange (ETDEWEB)

Ravindran, P [Christian Medical College Hospital, Vellore (India); Wui Ann, W; Lim, Y [The Brunei Cancer Center (Brunei Darussalam)

2016-06-15

Purpose: In general, the linear accelerator is gated using respiratory signal obtained by way of external sensors to account for the breathing motion during radiotherapy. One of the commonly used gating devices is the Varian RPM device. Calypso system that uses electromagnetic tracking of implanted or surface transponders could also be used for gating. The aim of this study is to compare the gating efficiency of RPM device and the calypso system by phantom studies. Methods: An ArcCheck insert was used as the phantom with a Gafchromic film placed in its holder. The ArcCheck insert was placed on a Motion Sim platform and moved in the longitudinal direction simulating a respiratory motion with a period of 5 seconds and amplitude of ±6mm. The Gafchromic film was exposed to a 2 × 2cm{sup 2} field, i) with the phantom static, ii) phantom moving but ungated iii) gated with gating window of 2mm and 3mm. This was repeated with Calypso system using surface transponders with the same gating window. The Gafchromic films were read with an EPSON 11000 flatbed scanner and analysed with ‘Medphysto’ software. Results: The full width at half maximum (FWHM) as measured with film at the level of the film holder was 1.65cm when the phantom was static. FWHM measured with phantom moving and without gating was 1.16 cm and penumbra was 7 mm (80–20%) on both sides. When the beam was gated with 2 mm gating window the FWHM was 1.8 cm with RPM device and 1.9 cm with Calypso. Similarly, when the beam was gated with 3 mm window, the FWHM was 1.9cm with RPM device and 2cm with Calypso. Conclusion: This work suggests that the gating efficiency of RPM device is better than that of the Calypso with surface transponder, with reference to the latency in gating.

Poster — Thur Eve — 55: An automated XML technique for isocentre verification on the Varian TrueBeam

International Nuclear Information System (INIS)

Asiev, Krum; Mullins, Joel; DeBlois, François; Liang, Liheng; Syme, Alasdair

2014-01-01

Isocentre verification tests, such as the Winston-Lutz (WL) test, have gained popularity in the recent years as techniques such as stereotactic radiosurgery/radiotherapy (SRS/SRT) treatments are more commonly performed on radiotherapy linacs. These highly conformal treatments require frequent monitoring of the geometrical accuracy of the isocentre to ensure proper radiation delivery. At our clinic, the WL test is performed by acquiring with the EPID a collection of 8 images of a WL phantom fixed on the couch for various couch/gantry angles. This set of images is later analyzed to determine the isocentre size. The current work addresses the acquisition process. A manual WL test acquisition performed by and experienced physicist takes in average 25 minutes and is prone to user manipulation errors. We have automated this acquisition on a Varian TrueBeam STx linac (Varian, Palo Alto, USA). The Varian developer mode allows the execution of custom-made XML script files to control all aspects of the linac operation. We have created an XML-WL script that cycles through each couch/gantry combinations taking an EPID image at each position. This automated acquisition is done in less than 4 minutes. The reproducibility of the method was verified by repeating the execution of the XML file 5 times. The analysis of the images showed variation of the isocenter size less than 0.1 mm along the X, Y and Z axes and compares favorably to a manual acquisition for which we typically observe variations up to 0.5 mm

SU-E-T-325: The New Evaluation Method of the VMAT Plan Delivery Using Varian DynaLog Files and Modulation Complexity Score (MCS)

Energy Technology Data Exchange (ETDEWEB)

Tateoka, K [Proton Treatment Center, Radiation Therapy Research Institute, Social Medical Corporation Teishinkai, Sapporo (Japan); Graduate School of Medicine, Sapporo Medical University, Sapporo, JP (Japan); Fujimomo, K; Hareyama, M [Proton Treatment Center, Radiation Therapy Research Institute, Social Medical Corporation Teishinkai, Sapporo (Japan); Saitou, Y; Nakazawa, T; Abe, T; Nakata, A; Yano, M [Graduate School of Medicine, Sapporo Medical University, Sapporo, JP (Japan)

2014-06-01

Purpose: The aim of the study is to evaluate the use of Varian DynaLog files to verify VMAT plans delivery and modulation complexity score (MCS) of VMAT. Methods: Delivery accuracy of machine performance was quantified by multileaf collimator (MLC) position errors, gantry angle errors and fluence delivery accuracy for volumetric modulated arc therapy (VMAT). The relationship between machine performance and plan complexity were also investigated using the modulation complexity score (MCS). Plan and Actual MLC positions, gantry angles and delivered fraction of monitor units were extracted from Varian DynaLog files. These factors were taken from the record and verify system of MLC control file. Planned and delivered beam data were compared to determine leaf position errors and gantry angle errors. Analysis was also performed on planned and actual fluence maps reconstructed from those of the DynaLog files. This analysis was performed for all treatment fractions of 5 prostate VMAT plans. The analysis of DynaLog files have been carried out by in-house programming in Visual C++. Results: The root mean square of leaf position and gantry angle errors were about 0.12 and 0.15, respectively. The Gamma of planned and actual fluence maps at 3%/3 mm criterion was about 99.21. The gamma of the leaf position errors were not directly related to plan complexity as determined by the MCS. Therefore, the gamma of the gantry angle errors were directly related to plan complexity as determined by the MCS. Conclusion: This study shows Varian dynalog files for VMAT plan can be diagnosed delivery errors not possible with phantom based quality assurance. Furthermore, the MCS of VMAT plan can evaluate delivery accuracy for patients receiving of VMAT. Machine performance was found to be directly related to plan complexity but this is not the dominant determinant of delivery accuracy.

Analysis of daily quality assurance tests for tomotherapy and two Varian linear accelerators - three months review

International Nuclear Information System (INIS)

Kushwaha, Pratishtha; Jaiswal, Deeksha; Dheera, A.; Upreti, Udita; Chaudhari, Suresh; Kinhikar, Rajesh; Deshpande, Deepak; Shrivastava, Shyam

2016-01-01

Daily quality assurance (QA) for high precision radiotherapy equipments is very important to maintain the mechanical and dosimetric accuracy for patient treatments. Gross deviations in these parameters may have an adverse impact on the delivery of the treatments to patients. We report the results of daily QA tests performed over a period of three months for two Varian linear accelerators and a Tomotherapy machine

Clinical application of image-guided radiotherapy, IGRT (on the Varian OBI platform); Applications cliniques de la radiotherapie guidee par l'image (RTGI)

Energy Technology Data Exchange (ETDEWEB)

Sorcini, B.; Tilikidis, A. [Karolinska Univ. Hospital, Dept. of Medical Physics, Stockholm (Sweden)

2006-09-15

Image-guided radiation therapy (IGRT) can be used to measure and correct positional errors for target and critical structures immediately prior to or during treatment delivery. Some of the most recent available methods applied for target localization are: trans-abdominal ultrasound, implanted markers with in room MV or kV X-rays, optical surface tracking systems, implantable electromagnetic markers, in room CT such as kVCT on rail, kilo-voltage or mega-voltage cone-beam CT (CBCT) and helical megavoltage CT. The verification of the accurate treatment position in conjunction with detailed anatomical information before every fraction can be essential for the outcome of the treatment. In this paper we present the on-board imager (OBI, Varian Medical Systems, Palo Alto, CA) that has been in routine clinical use at the Karolinska University Hospital since June 2004. The OBI has been used for on-line set-up correction of prostate patients using internal gold markers. Displacements of these markers can be monitored radiographically during the treatment course and the registered marker shifts act as a surrogate for prostate motion. For this purpose, on-board kV-kV seems to be an ideal system in terms of image quality. The CBCT function of OBI was installed in March 2005 at our department. It focuses on localizing tumors based on internal anatomy, not just on the conventional external marks or tattoos. The CBCT system provides the capacity for soft tissue imaging in the treatment position and real-time radiographic monitoring during treatment delivery. (authors)

SU-F-T-66: Characteristics of Electron Beams From Varian Trubeam

International Nuclear Information System (INIS)

Dimofte, A; Kennedy, C; Zhu, T

2016-01-01

Purpose: The purpose of this study was to compare the electron beam data between Truebeam and 2300ix Varian accelerators for percent depth dose for broad beam and small circular cutouts, cone factors, head scatter factor as a function of cone size and SSD, phantom scatter factor, blocking factor, distance factor and virtual source position. Methods: Measurements were performed for Truebeam and 2300ix Varian accelerators. The main energies used were: 6, 9, 12, 16 and 20 MeV. PDD was measured at SSD = 100 cm for open beam and small circular cutouts (r = 0.5, 1.0, 1.5, 2.0, 3.0, 4.0 and 6.6cm) for different energies. Measurements to determine the head scatter factor (H) were done as a function of radius for six representative energies and five cone sizes (6, 10, 15, 20 and 25cm2). The phantom scatter factor (PSF) is defined as the ratio of blocking factor in water at reference depth and head scatter factor in air. PSF was measured as a function of radius and electron energy. Distance factor was measured for all energies and cones for three SSD’s (100, 110 and 120cm). Results: The percent depth dose (PDD) was measured for small cutouts of radius r = 0.5, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0 and 5.6cm. Blocking factor (BF) was measured for Truebeam and 2300ix accelerators, for different circular cutouts and energies for a 10×10 cone. Cone factors were compared between the two accelerators for different energies and applicator sizes. Conclusion: Cone factors measured for the two accelerator types differ by up to 5% for the largest applicator size. Blocking factors differs by up to 3%, with the largest variation for the smallest field size (0.5cm). Distance factor for different SSD’s differ by up to 4.5%.

SU-F-T-66: Characteristics of Electron Beams From Varian Trubeam

Energy Technology Data Exchange (ETDEWEB)

Dimofte, A; Kennedy, C; Zhu, T [University Pennsylvania, Philadelphia, PA (United States)

2016-06-15

Purpose: The purpose of this study was to compare the electron beam data between Truebeam and 2300ix Varian accelerators for percent depth dose for broad beam and small circular cutouts, cone factors, head scatter factor as a function of cone size and SSD, phantom scatter factor, blocking factor, distance factor and virtual source position. Methods: Measurements were performed for Truebeam and 2300ix Varian accelerators. The main energies used were: 6, 9, 12, 16 and 20 MeV. PDD was measured at SSD = 100 cm for open beam and small circular cutouts (r = 0.5, 1.0, 1.5, 2.0, 3.0, 4.0 and 6.6cm) for different energies. Measurements to determine the head scatter factor (H) were done as a function of radius for six representative energies and five cone sizes (6, 10, 15, 20 and 25cm2). The phantom scatter factor (PSF) is defined as the ratio of blocking factor in water at reference depth and head scatter factor in air. PSF was measured as a function of radius and electron energy. Distance factor was measured for all energies and cones for three SSD’s (100, 110 and 120cm). Results: The percent depth dose (PDD) was measured for small cutouts of radius r = 0.5, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0 and 5.6cm. Blocking factor (BF) was measured for Truebeam and 2300ix accelerators, for different circular cutouts and energies for a 10×10 cone. Cone factors were compared between the two accelerators for different energies and applicator sizes. Conclusion: Cone factors measured for the two accelerator types differ by up to 5% for the largest applicator size. Blocking factors differs by up to 3%, with the largest variation for the smallest field size (0.5cm). Distance factor for different SSD’s differ by up to 4.5%.

Treatment-Planning Study of Prostate Cancer Intensity-Modulated Radiotherapy With a Varian Clinac Operated Without a Flattening Filter

International Nuclear Information System (INIS)

Vassiliev, Oleg N.; Kry, Stephen F.; Kuban, Deborah A.; Salehpour, Mohammad; Mohan, Radhe; Titt, Uwe

2007-01-01

Purpose: To assess the feasibility of intensity-modulated radiotherapy for prostate cancer using photon beams from an accelerator operated without a flattening filter; and to determine potential benefits and drawbacks of using unflattened beams for this type of treatment. Methods and Materials: Intensity-modulated radiotherapy plans were generated for 10 patients with early-stage prostate cancer. For each patient, four plans were generated: with and without the flattening filter, at 6 and 18 MV. The prescription dose was 75.6 Gy to 98% of the planning target volume. The number of beams, their orientations, and optimization constraints were the same for all plans. Plans were generated with Eclipse 8.0 (Varian Medical Systems). Results: All the plans developed with unflattened beams were clinically acceptable. In terms of patient dose distributions, plans with unflattened beams were similar to the corresponding plans with flattened beams. Plans with unflattened beams required fewer monitor units (MUs) per plan: on average, by a factor of 2.0 at 6 MV and 2.6 at 18 MV, assuming that removal of the flattening filter was not followed by recalibration of MUs. Conclusions: Clinically acceptable intensity-modulated radiotherapy plans for prostate cancer can be developed with unflattened beams at both 6 and 18 MV. Dosimetrically, flattened and unflattened beams generated similar treatment plans. The plans with unflattened beams required substantially fewer MUs. The reduction in the number of MUs indicates corresponding reduction in beam-on time and in the amount of radiation outside the target

An EPID-based method for comprehensive verification of gantry, EPID and the MLC carriage positional accuracy in Varian linacs during arc treatments

International Nuclear Information System (INIS)

Rowshanfarzad, Pejman; McGarry, Conor K; Barnes, Michael P; Sabet, Mahsheed; Ebert, Martin A

2014-01-01

In modern radiotherapy, it is crucial to monitor the performance of all linac components including gantry, collimation system and electronic portal imaging device (EPID) during arc deliveries. In this study, a simple EPID-based measurement method has been introduced in conjunction with an algorithm to investigate the stability of these systems during arc treatments with the aim of ensuring the accuracy of linac mechanical performance. The Varian EPID sag, gantry sag, changes in source-to-detector distance (SDD), EPID and collimator skewness, EPID tilt, and the sag in MLC carriages as a result of linac rotation were separately investigated by acquisition of EPID images of a simple phantom comprised of 5 ball-bearings during arc delivery. A fast and robust software package was developed for automated analysis of image data. Twelve Varian linacs of different models were investigated. The average EPID sag was within 1 mm for all tested linacs. All machines showed less than 1 mm gantry sag. Changes in SDD values were within 1.7 mm except for three linacs of one centre which were within 9 mm. Values of EPID skewness and tilt were negligible in all tested linacs. The maximum sag in MLC leaf bank assemblies was around 1 mm. The EPID sag showed a considerable improvement in TrueBeam linacs. The methodology and software developed in this study provide a simple tool for effective investigation of the behaviour of linac components with gantry rotation. It is reproducible and accurate and can be easily performed as a routine test in clinics

Uptake and depuration of PCB-153 in edible shrimp Palaemonetes varians and human health risk assessment.

Science.gov (United States)

Grilo, T F; Cardoso, P G; Pato, P; Duarte, A C; Pardal, M A

2014-03-01

A medium-term mesocosm exposure study was conducted to elucidate bioaccumulation and depuration of polychlorinated biphenyl congener 153 (PCB-153) in edible shrimp Palaemonetes varians. Over the 15-day exposure period, shrimp under different exposure concentrations exhibited a significant increase in PCB-153 concentration compared with control organisms. Distinct bioaccumulation patterns and uptake rates were observed depending on the exposure concentrations. For low PCB-153 exposure levels (0.25μgL(-1)), accumulation followed a saturation model, reaching an apparent steady state after fifteen days exposure. For intermediate (2.5μgL(-1)) and high PCB-153 levels (25μgL(-1)), accumulation was faster and linear. In addition, the bioaccumulation rate was not proportional to PCB-153 concentration, and the bioaccumulation was higher at intermediate exposure concentrations. Regarding the depuration phase, P. varians lost up to 30% of PCB-153 after 72h and levels continued slowly to decrease until the end of the 30-d experimental period. However, PCB-153 levels in shrimp did not reach background values, and those exposed to moderate and high PCB-153 concentrations presented contamination levels much higher than the regulatory limit for human food consumption (75ngg(-1) ww for Σ6 PCB). Copyright © 2013 Elsevier Inc. All rights reserved.

BRAIN Journal - Cognitive Medical Multiagent Systems

OpenAIRE

Barna Iantovics

2017-01-01

Abstract The development of efficient and flexible agent-based medical diagnosis systems represents a recent research direction. Medical multiagent systems may improve the efficiency of traditionally developed medical computational systems, like the medical expert systems. In our previous researches, a novel cooperative medical diagnosis multiagent system called CMDS (Contract Net Based Medical Diagnosis System) was proposed. CMDS system can solve flexibly a large variety of medical diagn...

Application of halophilic nuclease H of Micrococcus varians subsp. halophilus to commercial production of flavoring agent 5'-GMP.

Science.gov (United States)

Kamekura, M; Hamakawa, T; Onishi, H

1982-01-01

RNA was degraded at 60 degrees C for 24 h by halophilic nuclease H in supernatants from broth cultures of Micrococcus varians subsp. halophilus containing 12% NaCl. Since contaminating 5'-nucleotidase exhibited almost no activity under these conditions, the 5'-GMP formed could be recovered from the reaction mixture, and the yield was 805 mg from 5 g of RNA. PMID:6184020

Technical Report: Reference photon dosimetry data for Varian accelerators based on IROC-Houston site visit data

Energy Technology Data Exchange (ETDEWEB)

Kerns, James R.; Followill, David S.; Kry, Stephen F., E-mail: sfkry@mdanderson.org [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Imaging and Radiation Oncology Core-Houston, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Graduate School of Biomedical Sciences, The University of Texas Health Science Center-Houston, Houston, Texas 77030 (United States); Lowenstein, Jessica; Molineu, Andrea; Alvarez, Paola; Taylor, Paige A. [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Imaging and Radiation Oncology Core-Houston, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Stingo, Francesco C. [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States)

2016-05-15

Purpose: Accurate data regarding linear accelerator (Linac) radiation characteristics are important for treatment planning system modeling as well as regular quality assurance of the machine. The Imaging and Radiation Oncology Core-Houston (IROC-H) has measured the dosimetric characteristics of numerous machines through their on-site dosimetry review protocols. Photon data are presented and can be used as a secondary check of acquired values, as a means to verify commissioning a new machine, or in preparation for an IROC-H site visit. Methods: Photon data from IROC-H on-site reviews from 2000 to 2014 were compiled and analyzed. Specifically, data from approximately 500 Varian machines were analyzed. Each dataset consisted of point measurements of several dosimetric parameters at various locations in a water phantom to assess the percentage depth dose, jaw output factors, multileaf collimator small field output factors, off-axis factors, and wedge factors. The data were analyzed by energy and parameter, with similarly performing machine models being assimilated into classes. Common statistical metrics are presented for each machine class. Measurement data were compared against other reference data where applicable. Results: Distributions of the parameter data were shown to be robust and derive from a student’s t distribution. Based on statistical and clinical criteria, all machine models were able to be classified into two or three classes for each energy, except for 6 MV for which there were eight classes. Quantitative analysis of the measurements for 6, 10, 15, and 18 MV photon beams is presented for each parameter; supplementary material has also been made available which contains further statistical information. Conclusions: IROC-H has collected numerous data on Varian Linacs and the results of photon measurements from the past 15 years are presented. The data can be used as a comparison check of a physicist’s acquired values. Acquired values that are well

Technical Report: Reference photon dosimetry data for Varian accelerators based on IROC-Houston site visit data

International Nuclear Information System (INIS)

Kerns, James R.; Followill, David S.; Kry, Stephen F.; Lowenstein, Jessica; Molineu, Andrea; Alvarez, Paola; Taylor, Paige A.; Stingo, Francesco C.

2016-01-01

Purpose: Accurate data regarding linear accelerator (Linac) radiation characteristics are important for treatment planning system modeling as well as regular quality assurance of the machine. The Imaging and Radiation Oncology Core-Houston (IROC-H) has measured the dosimetric characteristics of numerous machines through their on-site dosimetry review protocols. Photon data are presented and can be used as a secondary check of acquired values, as a means to verify commissioning a new machine, or in preparation for an IROC-H site visit. Methods: Photon data from IROC-H on-site reviews from 2000 to 2014 were compiled and analyzed. Specifically, data from approximately 500 Varian machines were analyzed. Each dataset consisted of point measurements of several dosimetric parameters at various locations in a water phantom to assess the percentage depth dose, jaw output factors, multileaf collimator small field output factors, off-axis factors, and wedge factors. The data were analyzed by energy and parameter, with similarly performing machine models being assimilated into classes. Common statistical metrics are presented for each machine class. Measurement data were compared against other reference data where applicable. Results: Distributions of the parameter data were shown to be robust and derive from a student’s t distribution. Based on statistical and clinical criteria, all machine models were able to be classified into two or three classes for each energy, except for 6 MV for which there were eight classes. Quantitative analysis of the measurements for 6, 10, 15, and 18 MV photon beams is presented for each parameter; supplementary material has also been made available which contains further statistical information. Conclusions: IROC-H has collected numerous data on Varian Linacs and the results of photon measurements from the past 15 years are presented. The data can be used as a comparison check of a physicist’s acquired values. Acquired values that are well

Medical image information system 2001. Development of the medical image information system to risk management- Medical exposure management

International Nuclear Information System (INIS)

Kuranishi, Makoto; Kumagai, Michitomo; Shintani, Mitsuo

2000-01-01

This paper discusses the methods and systems for optimizing the following supplements 10 and 17 for national health and medical care. The supplements 10 and 17 of DICOM (digital imaging and communications in medicine) system, which is now under progress for the purpose to keep compatibility within medical image information system as an international standard, are important for making the cooperation between HIS (hospital information system)/RIS (radiation information system) and modality (imaging instruments). Supplement 10 concerns the system to send the information of patients and their orders through HIS/RIS to modality and 17, the information of modality performed procedure step (MPPS) to HIS/RIS. The latter defines to document patients' exposure, a part of which has not been recognized in Japan. Thus the medical information system can be useful for risk-management of medical exposure in future. (K.H.)

Medical image information system 2001. Development of the medical image information system to risk management- Medical exposure management

Energy Technology Data Exchange (ETDEWEB)

Kuranishi, Makoto; Kumagai, Michitomo; Shintani, Mitsuo [Toyama Medical and Pharmaceutical Univ. (Japan). Hospital

2000-12-01

This paper discusses the methods and systems for optimizing the following supplements 10 and 17 for national health and medical care. The supplements 10 and 17 of DICOM (digital imaging and communications in medicine) system, which is now under progress for the purpose to keep compatibility within medical image information system as an international standard, are important for making the cooperation between HIS (hospital information system)/RIS (radiation information system) and modality (imaging instruments). Supplement 10 concerns the system to send the information of patients and their orders through HIS/RIS to modality and 17, the information of modality performed procedure step (MPPS) to HIS/RIS. The latter defines to document patients' exposure, a part of which has not been recognized in Japan. Thus the medical information system can be useful for risk-management of medical exposure in future. (K.H.)

Source to Skin Distance (SSD) Characteristics from Varian CX Linear Accelerator

Science.gov (United States)

Bahari Nurdin, Wira; Purnomo, Aji; Dewang, Syamsir

2018-03-01

This study aims to describe the characteristics of the source to skin distance (SSD) of Varian CX linear accelerator (LINAC) using the X-ray beam of 6 MV and 10 MV. The variation of the source to the SSD are 90, 100 and 110 cms; the depth of the water phantom used are 5, 10, 15, 20, and 25 cms, respectively. The depth of the water phantom was created for analysis of percentage depth dose (PDD) and profile dose. It can be concluded from the tests that from the measured SSD, SSD of 110 cm with the depth water phantom of 20-25 cm for energy beam of 6 MV and at all levels of depth for 10 MV energy corresponding tolerance limits to be used in clinical radiotherapy. For the SSD 90 and 100, the values beam symmetry and flatness obtained slightly beyond the limits of tolerance.

Total centralisation and optimisation of an oncology management suite via Citrix®

International Nuclear Information System (INIS)

James, C; Frantzis, J; Fenton, P; Ripps, L

2014-01-01

The management of patient information and treatment planning is traditionally an intra-departmental requirement of a radiation oncology service. Epworth Radiation Oncology systems must support the transient nature of Visiting Medical Officers (VMOs). This unique work practice created challenges when implementing the vision of a completely paperless solution that allows for a responsive and efficient service delivery. ARIA ® and Eclipse TM (Varian Medical Systems, Palo Alto, CA, USA) have been deployed across four dedicated Citrix ® (Citrix Systems, Santa Clara, CA, USA) servers allowing VMOs to access these applications remotely. A range of paperless solutions were developed within ARIA ® to facilitate clinical and organisational management whilst optimising efficient work practices. The IT infrastructure and paperless workflow has enabled VMOs to securely access the Varian TM (Varian Medical Systems, Palo Alto, CA, USA) oncology software and experience full functionality from any location on multiple devices. This has enhanced access to patient information and improved the responsiveness of the service. Epworth HealthCare has developed a unique solution to enable remote access to a centralised oncology management suite, while maintaining a secure and paperless working environment.

Medical Imaging System

Science.gov (United States)

1991-01-01

The MD Image System, a true-color image processing system that serves as a diagnostic aid and tool for storage and distribution of images, was developed by Medical Image Management Systems, Huntsville, AL, as a "spinoff from a spinoff." The original spinoff, Geostar 8800, developed by Crystal Image Technologies, Huntsville, incorporates advanced UNIX versions of ELAS (developed by NASA's Earth Resources Laboratory for analysis of Landsat images) for general purpose image processing. The MD Image System is an application of this technology to a medical system that aids in the diagnosis of cancer, and can accept, store and analyze images from other sources such as Magnetic Resonance Imaging.

SU-E-T-370: Measurement of Conical Cone Output Factors for the Varian Edge Linear Accelerator

International Nuclear Information System (INIS)

Li, H; Kim, J; Gordon, J; Chetty, I; Wang, S; Zhong, H; Wen, N

2014-01-01

Purpose: To quantify the impact of detector type, SSD/depth, and intermediate reference on conical cone output factor (OF) measurements for the Varian Edge linac. Methods: OF's for 4, 5, 7.5, 10, 12.5, 15, and 17.5 mm diameter cones relative to 10cmx10cm field were measured for the 6X FFF and 10X FFF energies, with jaws set to 5cmx5cm. Measurements were performed with an Edge diode (0.8mmx0.8mmx0.03mm WxLxT), stereotatic diode SFD, photon diode, CC01 and pinpoint chambers (2mm diameter for both). 95cm SSD/5cm depth were used in a water tank. For the measurement with diodes, OF's were cross-referred to CC13 ion chamber measurements with 3cmx3cm field, as recommended, to help mitigate the energy variation in diode response with field size. Results were compared to the representative data from Varian measured with Edge detector. With SFD, OF's at 98.5cm SSD/1.5cm depth and 90cm SSD/10cm depth were also measured. Results: OF's measured with the Edge detector matched within 1.3% (max diff) with the representative data from Varian. For the SFD, OF's matched within 1.3% for the 4, 5 and 17.5 mm cones and within 3.7% for the other cones. OF's with photon diode were within 1.3% except for the 4 and 5 mm cones where they were 8.1% and 3.7%, respectively. OF's for the CC01 and pinpoint chamber deviated up to 36% and 44%, respectively for the 4 mm cone. OF's after intermediate reference with 3cmx3cm field changed by 3.7% for SFD, 0.8% for photon diode, and 0.6% for Edge detector. OF's at 98.5cm SSD/1.5cm depth were 10.8% higher than that at 95cm SSD/5cm depth, and OF's at 90cm SSD/1.5cm depth were 7.5% lower. Conclusion: OF's measured with the Edge detector appear to be reliable. CC01 and pinpoint chambers do not appear suitable for measuring the small cone OF's. SSD/depth affects OF measurements significantly

Interactions between Lactobacillus sakei and CNC (Staphylococcus xylosus and Kocuria varians) and their influence on proteolytic activity.

Science.gov (United States)

Tremonte, P; Reale, A; Di Renzo, T; Tipaldi, L; Di Luccia, A; Coppola, R; Sorrentino, E; Succi, M

2010-11-01

To evaluate interactions between Lactobacillus sakei and coagulase negative cocci (CNC) (Staphylococcus xylosus and Kocuria varians) and to investigate the influence of these interactions on their own proteolytic activity. Interactions occurring between strains of Lact. sakei and CNC were assessed by spectrophotometric analysis. The growth of 35 strains of Lact. sakei, used as indicators, was compared to that obtained combining the same strains with growing cells or cell-free supernatants of 20 CNC (18 Staph. xylosus and 2 K. varians). The proteolytic activity expressed by single strains or by their combinations was assessed on sarcoplasmic protein extracts by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The results evidenced that interactions are able to affect not only the growth but also the in vitro proteolytic activity of Lact. sakei and CNC used in combination. A relationship between the presence of interactions among useful strains and the strength of technological characteristics, such as proteolysis, was defined. The study highlighted that CNC are able to stimulate the growth of some Lact. sakei strains. At the same time, this interaction positively influences the proteolytic activity of strains used in combination. Given the importance of proteolysis during the ripening of fermented meats, this phenomenon should be taken into account to select meat starter cultures. © 2010 The Authors. © 2010 The Society for Applied Microbiology.

SU-F-J-14: Kilovoltage Cone-Beam CT Dose Estimation of Varian On-Board Imager Using GMctdospp Monte Carlo Framework

Energy Technology Data Exchange (ETDEWEB)

Kim, S; Rangaraj, D [Baylor Scott & White Health, Temple, TX (United States)

2016-06-15

Purpose: Although cone-beam CT (CBCT) imaging became popular in radiation oncology, its imaging dose estimation is still challenging. The goal of this study is to assess the kilovoltage CBCT doses using GMctdospp - an EGSnrc based Monte Carlo (MC) framework. Methods: Two Varian OBI x-ray tube models were implemented in the GMctpdospp framework of EGSnrc MC System. The x-ray spectrum of 125 kVp CBCT beam was acquired from an EGSnrc/BEAMnrc simulation and validated with IPEM report 78. Then, the spectrum was utilized as an input spectrum in GMctdospp dose calculations. Both full and half bowtie pre-filters of the OBI system were created by using egs-prism module. The x-ray tube MC models were verified by comparing calculated dosimetric profiles (lateral and depth) to ion chamber measurements for a static x-ray beam irradiation to a cuboid water phantom. An abdominal CBCT imaging doses was simulated in GMctdospp framework using a 5-year-old anthropomorphic phantom. The organ doses and effective dose (ED) from the framework were assessed and compared to the MOSFET measurements and convolution/superposition dose calculations. Results: The lateral and depth dose profiles in the water cuboid phantom were well matched within 6% except a few areas - left shoulder of the half bowtie lateral profile and surface of water phantom. The organ doses and ED from the MC framework were found to be closer to MOSFET measurements and CS calculations within 2 cGy and 5 mSv respectively. Conclusion: This study implemented and validated the Varian OBI x-ray tube models in the GMctdospp MC framework using a cuboid water phantom and CBCT imaging doses were also evaluated in a 5-year-old anthropomorphic phantom. In future study, various CBCT imaging protocols will be implemented and validated and consequently patient CT images will be used to estimate the CBCT imaging doses in patients.

Recovering traditional raw-milk Tetilla cheese flavour and sensory attributes by using Kocuria varians and Yarrowia lipolytica adjunct cultures.

Science.gov (United States)

Centeno, J A; Garabal, J I; Docampo, F; Lorenzo, J M; Carballo, J

2017-06-19

The rationale of the present study was to evaluate the potential of microbial adjunct cultures including Kocuria varians and/or Yarrowia lipolytica strains in the recovery of the typical sensory profile of traditional (raw-milk) Tetilla cheese. Four batches of Tetilla cheese, a short ripened cows' milk cheese produced in Galicia (NW Spain), were made in duplicate from pasteurized milk inoculated with different microbial cultures. A control batch was manufactured by adding a mesophilic commercial D-starter only. The other three batches were made with the same starter after a cheese-milk pre-ripening step carried out with (i) an adjunct culture of K. varians, (ii) an adjunct culture of Y. lipolytica, or (iii) a combination of both adjunct cultures. The highest pH and water activity values, associated with softer textures were determined in the cheeses manufactured with the Y. lipolytica adjunct after 21days of ripening. The contents of the volatile compounds 3-methylbutanol, dimethyl disulfide and dimethyl trisulfide were higher in the cheeses made with only the K. varians adjunct than in the cheeses made with the only yeast adjunct and in the control cheeses. The contents of hexanoic and octanoic acids were highest in the cheeses made with the Y. lipolytica adjunct, and levels of ethyl hexanoate, ethyl octanoate and ethyl decanoate were higher in the cheeses made with only the yeast adjunct than in the other batches of cheese. The cheeses manufactured with both adjunct cultures were awarded the highest scores for flavour and overall sensory parameters (considering the standards of the traditional product) and were considered very similar to 'good quality' artisanal raw-milk cheeses. We conclude that use of selected Micrococcaceae and Y. lipolytica strains as adjunct cultures would differentiate the sensory properties and contribute to the quality and typicality of the short-ripened rennet-curd Galician Tetilla and Arzúa-Ulloa cheeses. Copyright © 2017 Elsevier B

Electronic tissue compensation achieved with both dynamic and static multileaf collimator in eclipse treatment planning system for Clinac 6 EX and 2100 CD Varian linear accelerators: Feasibility and dosimetric study

Directory of Open Access Journals (Sweden)

Kinhikar Rajesh

2007-01-01

Full Text Available Dynamic multileaf collimator (DMLC and static multileaf collimator (SMLC, along with three-dimensional treatment planning system (3-D TPS, open the possibility of tissue compensation. A method using electronic tissue compensator (ETC has been implemented in Eclipse 3-D TPS (V 7.3, Varian Medical Systems, Palo Alto, USA at our center. The ETC was tested for head and neck conformal radiotherapy planning. The purpose of this study was to verify the feasibility of DMLC and SMLC in head and neck field irradiation for delivering homogeneous dose in the midplane at a pre-defined depth. In addition, emphasis was given to the dosimetric aspects in commissioning ETC in Eclipse. A Head and Neck Phantom (The Phantom Laboratory, USA was used for the dosimetric verification. Planning was carried out for both DMLC and SMLC ETC plans. The dose calculated at central axis by eclipse with DMLC and SMLC was noted. This was compared with the doses measured on machine with ion chamber and thermoluminescence dosimetry (TLD. The calculated isodose curves and profiles were compared with the measured ones. The dose profiles along the two major axes from Eclipse were also compared with the profiles obtained from Amorphous Silicon (AS500 Electronic portal imaging device (EPID on Clinac 6 EX machine. In uniform dose regions, measured dose values agreed with the calculated doses within 3%. Agreement between calculated and measured isodoses in the dose gradient zone was within 3 mm. The isodose curves and the profiles were found to be in good agreement with the measured curves and profiles. The measured and the calculated dose profiles along the two major axes were flat for both DMLC and SMLC. The dosimetric verification of ETC for both the linacs demonstrated the feasibility and the accuracy of the ETC treatment modality for achieving uniform dose distributions. Therefore, ETC can be used as a tool in head and neck treatment planning optimization for improved dose uniformity.

Exploration Medical System Technical Architecture Overview

Science.gov (United States)

Cerro, J.; Rubin, D.; Mindock, J.; Middour, C.; McGuire, K.; Hanson, A.; Reilly, J.; Burba, T.; Urbina, M.

2018-01-01

The Exploration Medical Capability (ExMC) Element Systems Engineering (SE) goals include defining the technical system needed to support medical capabilities for a Mars exploration mission. A draft medical system architecture was developed based on stakeholder needs, system goals, and system behaviors, as captured in an ExMC concept of operations document and a system model. This talk will discuss a high-level view of the medical system, as part of a larger crew health and performance system, both of which will support crew during Deep Space Transport missions. Other mission components, such as the flight system, ground system, caregiver, and patient, will be discussed as aspects of the context because the medical system will have important interactions with each. Additionally, important interactions with other aspects of the crew health and performance system are anticipated, such as health & wellness, mission task performance support, and environmental protection. This talk will highlight areas in which we are working with other disciplines to understand these interactions.

SU-E-T-405: Evaluation of the Raystation Electron Monte Carlo Algorithm for Varian Linear Accelerators

Energy Technology Data Exchange (ETDEWEB)

Sansourekidou, P; Allen, C [Health Quest, Poughkeepsie, NY (United States)

2015-06-15

Purpose: To evaluate the Raystation v4.51 Electron Monte Carlo algorithm for Varian Trilogy, IX and 2100 series linear accelerators and commission for clinical use. Methods: Seventy two water and forty air scans were acquired with a water tank in the form of profiles and depth doses, as requested by vendor. Data was imported into Rayphysics beam modeling module. Energy spectrum was modeled using seven parameters. Contamination photons were modeled using five parameters. Source phase space was modeled using six parameters. Calculations were performed in clinical version 4.51 and percent depth dose curves and profiles were extracted to be compared to water tank measurements. Sensitivity tests were performed for all parameters. Grid size and particle histories were evaluated per energy for statistical uncertainty performance. Results: Model accuracy for air profiles is poor in the shoulder and penumbra region. However, model accuracy for water scans is acceptable. All energies and cones are within 2%/2mm for 90% of the points evaluated. Source phase space parameters have a cumulative effect. To achieve distributions with satisfactory smoothness level a 0.1cm grid and 3,000,000 particle histories were used for commissioning calculations. Calculation time was approximately 3 hours per energy. Conclusion: Raystation electron Monte Carlo is acceptable for clinical use for the Varian accelerators listed. Results are inferior to Elekta Electron Monte Carlo modeling. Known issues were reported to Raysearch and will be resolved in upcoming releases. Auto-modeling is limited to open cone depth dose curves and needs expansion.

Medical cyber-physical systems: A survey.

Science.gov (United States)

Dey, Nilanjan; Ashour, Amira S; Shi, Fuqian; Fong, Simon James; Tavares, João Manuel R S

2018-03-10

Medical cyber-physical systems (MCPS) are healthcare critical integration of a network of medical devices. These systems are progressively used in hospitals to achieve a continuous high-quality healthcare. The MCPS design faces numerous challenges, including inoperability, security/privacy, and high assurance in the system software. In the current work, the infrastructure of the cyber-physical systems (CPS) are reviewed and discussed. This article enriched the researches of the networked Medical Device (MD) systems to increase the efficiency and safety of the healthcare. It also can assist the specialists of medical device to overcome crucial issues related to medical devices, and the challenges facing the design of the medical device's network. The concept of the social networking and its security along with the concept of the wireless sensor networks (WSNs) are addressed. Afterward, the CPS systems and platforms have been established, where more focus was directed toward CPS-based healthcare. The big data framework of CPSs is also included.

The implications of temperature-mediated plasticity in larval instar number for development within a marine invertebrate, the shrimp Palaemonetes varians.

Directory of Open Access Journals (Sweden)

Andrew Oliphant

Full Text Available Variations in larval instar number are common among arthropods. Here, we assess the implications of temperature-mediated variations in larval instar number for larval development time, larval growth rates, and juvenile dry weight within the palaemonid shrimp, Palaemonetes varians. In contrast with previous literature, which focuses on terrestrial arthropods, particularly model and pest species often of laboratory lines, we use wild shrimp, which differ in their life history from previous models. Newly-hatched P. varians larvae were first reared at 5, 10, 17, 25, and 30 °C to assess their thermal scope for development. Larvae developed at 17, 25, and 30 °C. At higher temperatures, larvae developed through fewer larval instars. Two dominant developmental pathways were observed; a short pathway of four instars and a long pathway of five instars. Longer developmental pathways of six to seven instars were rarely observed (mostly at lower temperatures and consisted of additional instars as 'repeat' instars; i.e. little developmental advance over the preceding instar. To assess the implications of temperature-mediated variation in larval instar number, newly-hatched larvae were then reared at 15, 20, and 25 °C. Again, the proportion of larvae developing through four instars increased with temperature. At all temperatures, larval development time and juvenile dry weight were greater for larvae developing through five instars. Importantly, because of the increasing proportion of larvae developing through four instars with increasing temperature, larval traits associated with this pathway (reduced development time and juvenile dry weight became more dominant. As a consequence of increasing growth rate with temperature, and the shift in the proportion of larvae developing through four instars, juvenile dry weight was greatest at intermediate temperatures (20 °C. We conclude that at settlement P. varians juveniles do not follow the temperature-size rule

The implications of temperature-mediated plasticity in larval instar number for development within a marine invertebrate, the shrimp Palaemonetes varians.

Science.gov (United States)

Oliphant, Andrew; Hauton, Chris; Thatje, Sven

2013-01-01

Variations in larval instar number are common among arthropods. Here, we assess the implications of temperature-mediated variations in larval instar number for larval development time, larval growth rates, and juvenile dry weight within the palaemonid shrimp, Palaemonetes varians. In contrast with previous literature, which focuses on terrestrial arthropods, particularly model and pest species often of laboratory lines, we use wild shrimp, which differ in their life history from previous models. Newly-hatched P. varians larvae were first reared at 5, 10, 17, 25, and 30 °C to assess their thermal scope for development. Larvae developed at 17, 25, and 30 °C. At higher temperatures, larvae developed through fewer larval instars. Two dominant developmental pathways were observed; a short pathway of four instars and a long pathway of five instars. Longer developmental pathways of six to seven instars were rarely observed (mostly at lower temperatures) and consisted of additional instars as 'repeat' instars; i.e. little developmental advance over the preceding instar. To assess the implications of temperature-mediated variation in larval instar number, newly-hatched larvae were then reared at 15, 20, and 25 °C. Again, the proportion of larvae developing through four instars increased with temperature. At all temperatures, larval development time and juvenile dry weight were greater for larvae developing through five instars. Importantly, because of the increasing proportion of larvae developing through four instars with increasing temperature, larval traits associated with this pathway (reduced development time and juvenile dry weight) became more dominant. As a consequence of increasing growth rate with temperature, and the shift in the proportion of larvae developing through four instars, juvenile dry weight was greatest at intermediate temperatures (20 °C). We conclude that at settlement P. varians juveniles do not follow the temperature-size rule; this is of

Medical-Information-Management System

Science.gov (United States)

Alterescu, Sidney; Friedman, Carl A.; Frankowski, James W.

1989-01-01

Medical Information Management System (MIMS) computer program interactive, general-purpose software system for storage and retrieval of information. Offers immediate assistance where manipulation of large data bases required. User quickly and efficiently extracts, displays, and analyzes data. Used in management of medical data and handling all aspects of data related to care of patients. Other applications include management of data on occupational safety in public and private sectors, handling judicial information, systemizing purchasing and procurement systems, and analyses of cost structures of organizations. Written in Microsoft FORTRAN 77.

Performance studies of varian VPM-154D.6D VPM-154A/1.6L static crossed field photomultipliers

International Nuclear Information System (INIS)

Lo, C.C.; Leskovar, B.

1977-01-01

Characteristics have been measured for the Varian VPM-154D.6D and VPM-154A/1.6L Static Crossed Field Photomultipliers. Some typical photomultiplier characteristics such as: gain, dark current, quantum efficiency, and rise-time--are compared with data provided by the manufacturer. Photomultiplier characteristics generally not available from the manufacturer, such as: transit time, FWHM of the output pulse, peak output current measurement and multiphotoelectron time resolution were measured and are discussed

Exploration Medical System Demonstration

Science.gov (United States)

Rubin, D. A.; Watkins, S. D.

2014-01-01

BACKGROUND: Exploration class missions will present significant new challenges and hazards to the health of the astronauts. Regardless of the intended destination, beyond low Earth orbit a greater degree of crew autonomy will be required to diagnose medical conditions, develop treatment plans, and implement procedures due to limited communications with ground-based personnel. SCOPE: The Exploration Medical System Demonstration (EMSD) project will act as a test bed on the International Space Station (ISS) to demonstrate to crew and ground personnel that an end-to-end medical system can assist clinician and non-clinician crew members in optimizing medical care delivery and data management during an exploration mission. Challenges facing exploration mission medical care include limited resources, inability to evacuate to Earth during many mission phases, and potential rendering of medical care by non-clinicians. This system demonstrates the integration of medical devices and informatics tools for managing evidence and decision making and can be designed to assist crewmembers in nominal, non-emergent situations and in emergent situations when they may be suffering from performance decrements due to environmental, physiological or other factors. PROJECT OBJECTIVES: The objectives of the EMSD project are to: a. Reduce or eliminate the time required of an on-orbit crew and ground personnel to access, transfer, and manipulate medical data. b. Demonstrate that the on-orbit crew has the ability to access medical data/information via an intuitive and crew-friendly solution to aid in the treatment of a medical condition. c. Develop a common data management framework that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all activities pertaining to crew health and life sciences. d. Ensure crew access to medical data during periods of restricted ground communication. e. Develop a common data management framework that

Exploration Medical System Demonstration Project

Science.gov (United States)

Chin, D. A.; McGrath, T. L.; Reyna, B.; Watkins, S. D.

2011-01-01

A near-Earth Asteroid (NEA) mission will present significant new challenges including hazards to crew health created by exploring a beyond low earth orbit destination, traversing the terrain of asteroid surfaces, and the effects of variable gravity environments. Limited communications with ground-based personnel for diagnosis and consultation of medical events require increased crew autonomy when diagnosing conditions, creating treatment plans, and executing procedures. Scope: The Exploration Medical System Demonstration (EMSD) project will be a test bed on the International Space Station (ISS) to show an end-to-end medical system assisting the Crew Medical Officers (CMO) in optimizing medical care delivery and medical data management during a mission. NEA medical care challenges include resource and resupply constraints limiting the extent to which medical conditions can be treated, inability to evacuate to Earth during many mission phases, and rendering of medical care by a non-clinician. The system demonstrates the integration of medical technologies and medical informatics tools for managing evidence and decision making. Project Objectives: The objectives of the EMSD project are to: a) Reduce and possibly eliminate the time required for a crewmember and ground personnel to manage medical data from one application to another. b) Demonstrate crewmember's ability to access medical data/information via a software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities. d) Develop a common data management architecture that allows for scalability, extensibility, and interoperability of data sources and data users. e) Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management f) Provide

Exploration Medical Cap Ability System Engineering Overview

Science.gov (United States)

McGuire, K.; Mindock, J.

2018-01-01

Deep Space Gateway and Transport missions will change the way NASA currently practices medicine. The missions will require more autonomous capability compared to current low Earth orbit operations. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The ExMC Systems Engineering team's mission is to "Define, develop, validate, and manage the technical system design needed to implement exploration medical capabilities for Mars and test the design in a progression of proving grounds." The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is using Model-Based System Engineering (MBSE) to accomplish its integrative goals. The MBSE approach to medical system design offers a paradigm shift toward greater integration between vehicle and the medical system, and directly supports the transition of Earth-reliant ISS operations to the Earth-independent operations envisioned for Mars. This talk will discuss how ExMC is using MBSE to define operational needs, decompose requirements and architecture, and identify medical capabilities needed to support human exploration. How MBSE is being used to integrate across disciplines and NASA Centers will also be described. The medical system being discussed in this talk is one system within larger habitat systems. Data generated within the medical system will be inputs to other systems and vice versa. This talk will also describe the next steps in model development that include: modeling the different systems that comprise the larger system and interact with the medical system, understanding how the various systems work together, and

Medical imaging systems

Science.gov (United States)

Frangioni, John V

2013-06-25

A medical imaging system provides simultaneous rendering of visible light and diagnostic or functional images. The system may be portable, and may include adapters for connecting various light sources and cameras in open surgical environments or laparascopic or endoscopic environments. A user interface provides control over the functionality of the integrated imaging system. In one embodiment, the system provides a tool for surgical pathology.

Assessment of dosimetrical performance in 11 Varian a-Si500 electronic portal imaging devices

International Nuclear Information System (INIS)

Kavuma, Awusi; Glegg, Martin; Currie, Garry; Elliott, Alex

2008-01-01

Dosimetrical characteristics of 11 Varian a-Si-500 electronic portal imaging devices (EPIDs) in clinical use for periods ranging between 10 and 86 months were investigated for consistency of performance and portal dosimetry implications. Properties studied include short-term reproducibility, signal linearity with monitor units, response to reference beam, signal uniformity across the detector panel, signal dependence on field size, dose-rate influence, memory effects and image profiles as a function of monitor units. The EPID measurements were also compared with those of the ionization chambers' to ensure stability of the linear accelerators. Depending on their clinical installation date, the EPIDs were interfaced with one of the two different acquisition control software packages, IAS2/IDU-II or IAS3/IDU-20. Both the EPID age and image acquisition system influenced the dosimetric characteristics with the newer version (IAS3 with IDU-20) giving better data reproducibility and linearity fit than the older version (IAS2 with IDU-II). The relative signal response (uniformity) after 50 MU was better than 95% of the central value and independent of detector. Sensitivity for all EPIDs reduced continuously with increasing dose rates for the newer image acquisition software. In the dose-rate range 100-600 MU min -1 , the maximum variation in sensitivity ranged between 1 and 1.8% for different EPIDs. For memory effects, the increase in the measured signal at the centre of the irradiated field for successive images was within 1.8% and 1.0% for the older and newer acquisition systems, respectively. Image profiles acquired at a lower MU in the radial plane (gun-target) had gradients in measured pixel values of up to 25% for the older system. Detectors with software/hardware versions IAS3/IDU-20 have a high degree of accuracy and are more suitable for routine quantitative IMRT dosimetrical verification.

Implementing and Integrating a Clinically-Driven Electronic Medical Record (EMR for Radiation Oncology in a Large Medical Enterprise

Directory of Open Access Journals (Sweden)

John Paxton Kirkpatrick

2013-04-01

Full Text Available Purpose/Objective: While our department is heavily invested in computer-based treatment planning, we historically relied on paper-based charts for management of Radiation Oncology patients. In early 2009, we initiated the process of conversion to an electronic medical record (EMR eliminating the need for paper charts. Key goals included the ability to readily access information wherever and whenever needed, without compromising safety, treatment quality, confidentiality or productivity.Methodology: In February, 2009, we formed a multi-disciplinary team of Radiation Oncology physicians, nurses, therapists, administrators, physicists/dosimetrists, and information technology (IT specialists, along with staff from the Duke Health System IT department. The team identified all existing processes and associated information/reports, established the framework for the EMR system and generated, tested and implemented specific EMR processes.Results: Two broad classes of information were identified: information which must be readily accessed by anyone in the health system versus that used solely within the Radiation Oncology department. Examples of the former are consultation reports, weekly treatment check notes and treatment summaries; the latter includes treatment plans, daily therapy records and quality assurance reports. To manage the former, we utilized the enterprise-wide system , which required an intensive effort to design and implement procedures to export information from Radiation Oncology into that system. To manage "Radiation Oncology" data, we used our existing system (ARIA, Varian Medical Systems. The ability to access both systems simultaneously from a single workstation (WS was essential, requiring new WS and modified software. As of January, 2010, all new treatments were managed solely with an EMR. We find that an EMR makes information more widely accessible and does not compromise patient safety, treatment quality or confidentiality

Generalized monitor unit calculation for the Varian enhanced dynamic wedge field

International Nuclear Information System (INIS)

Liu Chihray; Kim, Siyong; Kahler, Darren L.; Palta, Jatinder R.

2003-01-01

The generalized monitor unit (MU) calculation equation for the Varian enhanced dynamic wedge (EDW) is derived. The assumption of this MU calculation method is that the wedge factor of the EDW at the center of the field is a function of field size, the position of the center of the field in the wedge direction, and the final position of the moving jaw. The wedge factors at the center of the field in both symmetric and asymmetric fields are examined. The difference between calculated and measured wedge factors is within 1.0%. The method developed here is easy to implement. The only datum required in addition to the standard set of conventional physical wedge implementation data is the off-axis output factor for the open field in the reference condition. The off-center point calculation is also examined. For the off-center point calculation, the dose profile in the wedge direction for the largest EDW field is used to obtain the relative off-center ratio in any smaller wedge field. The accuracy of the off-center point calculation decreases when the point of calculation is too close to the field edge

21 CFR 880.6315 - Remote Medication Management System.

Science.gov (United States)

2010-04-01

... Miscellaneous Devices § 880.6315 Remote Medication Management System. (a) Identification. A remote medication..., and medication packaging. The system is intended to store the patient's prescribed medications in a... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Remote Medication Management System. 880.6315...

SU-E-T-317: The Development of a DIBH Technique for Left Sided Breast Patients Undergoing Radiation Therapy Utilizing Varians RPM System in a Community Hospital

International Nuclear Information System (INIS)

Hasson, B; Young, M; Workie, D; Geraghty, C

2014-01-01

Purpose: To develop and implement a Deep Inhalation Breath Hold program (DIBH) for treatment of patients with Left-sided breast cancer in a community hospital. Methods: All patients with left sided breast cancer underwent a screening free breathing CT. Evaluation of the conventional tangent treatment fields and the heart was conducted. If the heart would not be excluded using tangents, the patient then received DIBH breathe coaching. The patients returned for a 4D CT simulation. The patients breathing cycle was monitored using the Varian Real-Time position ManagementTM (RPM) system to assess duration of DIBH, amplitude, phase and recovery time to normal breathing. Then a DIBH CT was obtained at the desired amplitude. Duplicate plans were developed for both free breathing and DIBH on the Eclipse planning system and comparison DVH's were created. The plan that provided the prescribed treatment coverage and the least doses to the OAR (heart, Lt. Lung) was determined. Those patients selected to receive treatment with DIBH were set up for treatment, and breathing was monitored using the RPM system. Practice trials were used to confirm that the amplitude, phase and recovery were consistent with findings from simulation. Results: 10 patients have been treated using the DIBH procedure in our clinic. The DIBH patients had an average increase of 80% lung volume on DIBH, decreased lung volume receiving 50% of the dose, and decreases in the V20 dose. Significant reduction in the maximum and mean dose to the heart, as well as the dose to 1CC of the volume for the DIBH plans. Conclusion: Using the RPM system already available in the clinic, staff training, and patient coaching a simple DIBH program was setup. The use of DIBH has shown promise in reducing doses to the critical organs while maintaining PTV coverage for left sided breast treatments

SU-E-T-317: The Development of a DIBH Technique for Left Sided Breast Patients Undergoing Radiation Therapy Utilizing Varians RPM System in a Community Hospital

Energy Technology Data Exchange (ETDEWEB)

Hasson, B; Young, M; Workie, D; Geraghty, C [Anne Arundel Medical Center, Annapolis, MD (United States)

2014-06-01

Purpose: To develop and implement a Deep Inhalation Breath Hold program (DIBH) for treatment of patients with Left-sided breast cancer in a community hospital. Methods: All patients with left sided breast cancer underwent a screening free breathing CT. Evaluation of the conventional tangent treatment fields and the heart was conducted. If the heart would not be excluded using tangents, the patient then received DIBH breathe coaching. The patients returned for a 4D CT simulation. The patients breathing cycle was monitored using the Varian Real-Time position ManagementTM (RPM) system to assess duration of DIBH, amplitude, phase and recovery time to normal breathing. Then a DIBH CT was obtained at the desired amplitude. Duplicate plans were developed for both free breathing and DIBH on the Eclipse planning system and comparison DVH's were created. The plan that provided the prescribed treatment coverage and the least doses to the OAR (heart, Lt. Lung) was determined. Those patients selected to receive treatment with DIBH were set up for treatment, and breathing was monitored using the RPM system. Practice trials were used to confirm that the amplitude, phase and recovery were consistent with findings from simulation. Results: 10 patients have been treated using the DIBH procedure in our clinic. The DIBH patients had an average increase of 80% lung volume on DIBH, decreased lung volume receiving 50% of the dose, and decreases in the V20 dose. Significant reduction in the maximum and mean dose to the heart, as well as the dose to 1CC of the volume for the DIBH plans. Conclusion: Using the RPM system already available in the clinic, staff training, and patient coaching a simple DIBH program was setup. The use of DIBH has shown promise in reducing doses to the critical organs while maintaining PTV coverage for left sided breast treatments.

Systems Engineering for Space Exploration Medical Capabilities

Science.gov (United States)

Mindock, Jennifer; Reilly, Jeffrey; Rubin, David; Urbina, Michelle; Hailey, Melinda; Hanson, Andrea; Burba, Tyler; McGuire, Kerry; Cerro, Jeffrey; Middour, Chris;

Procedure of quality control specific of patient treatment with VMAT (RAPIDARC) implemented in the HUGC Dr Negrin (Las Palmas); Procedimiento de control de calidad especifico de paciente para tratamientos con VMAT (RAPIDARC) implantado en el HUGC DR Negrin (Las Palmas)

Energy Technology Data Exchange (ETDEWEB)

Luque Japon, I.; Sanchez Carrascal, M.; Torres Pozas, S.; Marti Asenjo, J.; Madan Rodriguez, C.; Ruiz Egea, E.; Godoy Cazorla, J. I.; Martin Oliva, R.

2013-07-01

Following the introduction of the new RapidArc (Varian Medical Systems) technology to treat patients in our department, it became necessary to establish a protocol specific quality control of each. (Author)

Medical Robots: Current Systems and Research Directions

Directory of Open Access Journals (Sweden)

Ryan A. Beasley

2012-01-01

Full Text Available First used medically in 1985, robots now make an impact in laparoscopy, neurosurgery, orthopedic surgery, emergency response, and various other medical disciplines. This paper provides a review of medical robot history and surveys the capabilities of current medical robot systems, primarily focusing on commercially available systems while covering a few prominent research projects. By examining robotic systems across time and disciplines, trends are discernible that imply future capabilities of medical robots, for example, increased usage of intraoperative images, improved robot arm design, and haptic feedback to guide the surgeon.

TU-F-CAMPUS-T-04: An Evaluation of Out-Of-Field Doses for Electron Beams From Modern Varian and Elekta Linear Accelerators

Energy Technology Data Exchange (ETDEWEB)

Cardenas, C; Nitsch, P; Kudchadker, R; Howell, R; Kry, S [UT MD Anderson Cancer Center, Houston, TX (United States)

2015-06-15

Purpose: Accurately determining out-of-field doses when using electron beam radiotherapy is of importance when treating pregnant patients or patients with implanted electronic devices. Scattered doses outside of the applicator field in electron beams have not been broadly investigated, especially since manufacturers have taken different approaches in applicator designs. Methods: In this study, doses outside of the applicator field were measured for electron beams produced by a 10×10 applicator on two Varian 21iXs operating at 6, 9, 12, 16, and 20 MeV, a Varian TrueBeam operating at 6, 9, 12, 16, and 20 MeV, and an Elekta Versa HD operating at 6, 9, 12 and 15 MeV. Peripheral dose profiles and percent depth doses were measured in a Wellhofer water phantom at 100 cm SSD with a Farmer ion chamber. Doses were compared to peripheral photon doses from AAPM’s Task Group #36 report. Results: Doses were highest for the highest electron energies. Doses typically decreased with increasing distance from the field edge but showed substantial increases over some distance ranges. Substantial dose differences were observed between different accelerators; the Elekta accelerator had much higher doses than any Varian unit examined. Surprisingly, doses were often similar to, and could be much higher than, doses from photon therapy. Doses decreased sharply with depth before becoming nearly constant; the dose was found to decrease to a depth of approximately E(MeV)/4 in cm. Conclusion: The results of this study indicate that proper shielding may be very important when utilizing electron beams, particularly on a Versa HD, while treating pregnant patients or those with implanted electronic devices. Applying a water equivalent bolus of Emax(MeV)/4 thickness (cm) on the patient would reduce fetal dose drastically for all clinical energies and is a practical solution to manage the potentially high peripheral doses seen from modern electron beams. Funding from NIH Grant number: #CA180803.

Exploration Medical System Trade Study Tools Overview

Science.gov (United States)

Mindock, J.; Myers, J.; Latorella, K.; Cerro, J.; Hanson, A.; Hailey, M.; Middour, C.

2018-01-01

ExMC is creating an ecosystem of tools to enable well-informed medical system trade studies. The suite of tools address important system implementation aspects of the space medical capabilities trade space and are being built using knowledge from the medical community regarding the unique aspects of space flight. Two integrating models, a systems engineering model and a medical risk analysis model, tie the tools together to produce an integrated assessment of the medical system and its ability to achieve medical system target requirements. This presentation will provide an overview of the various tools that are a part of the tool ecosystem. Initially, the presentation's focus will address the tools that supply the foundational information to the ecosystem. Specifically, the talk will describe how information that describes how medicine will be practiced is captured and categorized for efficient utilization in the tool suite. For example, the talk will include capturing what conditions will be planned for in-mission treatment, planned medical activities (e.g., periodic physical exam), required medical capabilities (e.g., provide imaging), and options to implement the capabilities (e.g., an ultrasound device). Database storage and configuration management will also be discussed. The presentation will include an overview of how these information tools will be tied to parameters in a Systems Modeling Language (SysML) model, allowing traceability to system behavioral, structural, and requirements content. The discussion will also describe an HRP-led enhanced risk assessment model developed to provide quantitative insight into each capability's contribution to mission success. Key outputs from these various tools, to be shared with the space medical and exploration mission development communities, will be assessments of medical system implementation option satisfaction of requirements and per-capability contributions toward achieving requirements.

[Medication error management climate and perception for system use according to construction of medication error prevention system].

Science.gov (United States)

Kim, Myoung Soo

2012-08-01

The purpose of this cross-sectional study was to examine current status of IT-based medication error prevention system construction and the relationships among system construction, medication error management climate and perception for system use. The participants were 124 patient safety chief managers working for 124 hospitals with over 300 beds in Korea. The characteristics of the participants, construction status and perception of systems (electric pharmacopoeia, electric drug dosage calculation system, computer-based patient safety reporting and bar-code system) and medication error management climate were measured in this study. The data were collected between June and August 2011. Descriptive statistics, partial Pearson correlation and MANCOVA were used for data analysis. Electric pharmacopoeia were constructed in 67.7% of participating hospitals, computer-based patient safety reporting systems were constructed in 50.8%, electric drug dosage calculation systems were in use in 32.3%. Bar-code systems showed up the lowest construction rate at 16.1% of Korean hospitals. Higher rates of construction of IT-based medication error prevention systems resulted in greater safety and a more positive error management climate prevailed. The supportive strategies for improving perception for use of IT-based systems would add to system construction, and positive error management climate would be more easily promoted.

Wearable medical systems for p-Health.

Science.gov (United States)

Teng, Xiao-Fei; Zhang, Yuan-Ting; Poon, Carmen C Y; Bonato, Paolo

2008-01-01

Driven by the growing aging population, prevalence of chronic diseases, and continuously rising healthcare costs, the healthcare system is undergoing a fundamental transformation, from the conventional hospital-centered system to an individual-centered system. Current and emerging developments in wearable medical systems will have a radical impact on this paradigm shift. Advances in wearable medical systems will enable the accessibility and affordability of healthcare, so that physiological conditions can be monitored not only at sporadic snapshots but also continuously for extended periods of time, making early disease detection and timely response to health threats possible. This paper reviews recent developments in the area of wearable medical systems for p-Health. Enabling technologies for continuous and noninvasive measurements of vital signs and biochemical variables, advances in intelligent biomedical clothing and body area networks, approaches for motion artifact reduction, strategies for wearable energy harvesting, and the establishment of standard protocols for the evaluation of wearable medical devices are presented in this paper with examples of clinical applications of these technologies.

Establishment of a Quantitative Medical Technology Evaluation System and Indicators within Medical Institutions.

Science.gov (United States)

Wu, Suo-Wei; Chen, Tong; Pan, Qi; Wei, Liang-Yu; Wang, Qin; Li, Chao; Song, Jing-Chen; Luo, Ji

2018-06-05

The development and application of medical technologies reflect the medical quality and clinical capacity of a hospital. It is also an effective approach in upgrading medical service and core competitiveness among medical institutions. This study aimed to build a quantitative medical technology evaluation system through questionnaire survey within medical institutions to perform an assessment to medical technologies more objectively and accurately, and promote the management of medical quality technologies and ensure the medical safety of various operations among the hospitals. A two-leveled quantitative medical technology evaluation system was built through a two-round questionnaire survey of chosen experts. The Delphi method was applied in identifying the structure of evaluation system and indicators. The judgment of the experts on the indicators was adopted in building the matrix so that the weight coefficient and maximum eigenvalue (λ max), consistency index (CI), and random consistency ratio (CR) could be obtained and collected. The results were verified through consistency tests, and the index weight coefficient of each indicator was conducted and calculated through analytical hierarchy process. Twenty-six experts of different medical fields were involved in the questionnaire survey, 25 of whom successfully responded to the two-round research. Altogether, 4 primary indicators (safety, effectiveness, innovativeness, and benefits), as well as 13 secondary indicators, were included in the evaluation system. The matrix is built to conduct the λ max, CI, and CR of each expert in the survey, and the index weight coefficients of primary indicators were 0.33, 0.28, 0.27, and 0.12, respectively, and the index weight coefficients of secondary indicators were conducted and calculated accordingly. As the two-round questionnaire survey of experts and statistical analysis were performed and credibility of the results was verified through consistency evaluation test, the

Using A Model-Based Systems Engineering Approach For Exploration Medical System Development

Science.gov (United States)

Hanson, A.; Mindock, J.; McGuire, K.; Reilly, J.; Cerro, J.; Othon, W.; Rubin, D.; Urbina, M.; Canga, M.

2017-01-01

NASA's Human Research Program's Exploration Medical Capabilities (ExMC) element is defining the medical system needs for exploration class missions. ExMC's Systems Engineering (SE) team will play a critical role in successful design and implementation of the medical system into exploration vehicles. The team's mission is to "Define, develop, validate, and manage the technical system design needed to implement exploration medical capabilities for Mars and test the design in a progression of proving grounds." Development of the medical system is being conducted in parallel with exploration mission architecture and vehicle design development. Successful implementation of the medical system in this environment will require a robust systems engineering approach to enable technical communication across communities to create a common mental model of the emergent engineering and medical systems. Model-Based Systems Engineering (MBSE) improves shared understanding of system needs and constraints between stakeholders and offers a common language for analysis. The ExMC SE team is using MBSE techniques to define operational needs, decompose requirements and architecture, and identify medical capabilities needed to support human exploration. Systems Modeling Language (SysML) is the specific language the SE team is utilizing, within an MBSE approach, to model the medical system functional needs, requirements, and architecture. Modeling methods are being developed through the practice of MBSE within the team, and tools are being selected to support meta-data exchange as integration points to other system models are identified. Use of MBSE is supporting the development of relationships across disciplines and NASA Centers to build trust and enable teamwork, enhance visibility of team goals, foster a culture of unbiased learning and serving, and be responsive to customer needs. The MBSE approach to medical system design offers a paradigm shift toward greater integration between

[Approaches to development and implementation of the medical information system for military-medical commission of the multidisciplinary military-medical organisation].

Science.gov (United States)

Kuvshinov, K E; Klipak, V M; Chaplyuk, A L; Moskovko, V M; Belyshev, D V; Zherebko, O A

2015-06-01

The current task of the implementation of medical information systems in the military and medical organizations is an automation of the military-medical expertise as one of the most important activities. In this regard, noteworthy experience of the 9th Medical Diagnostic Centre (9th MDC), where on the basis of medical information system "Interi PROMIS" for the first time was implemented the automation of the work of military medical commission. The given paper presents an algorithm for constructing of the information system for the military-medical examination; detailed description of its elements is given. According to military servicemen the implementation of the Military Medical Commission (MMC) subsystem of the medical information system implemented into the 9th MDC has reduced the time required for the MMC and paperwork, greatly facilitate the work of physicians and medical specialists on military servicemen examination. This software can be widely applied in ambulatory and hospital practice, especially in case of mass military-medical examinations.

The current medical education system in the world.

Science.gov (United States)

Nara, Nobuo; Suzuki, Toshiya; Tohda, Shuji

2011-07-04

To contribute to the innovation of the medical education system in Japan, we visited 35 medical schools and 5 institutes in 12 countries of North America, Europe, Australia and Asia in 2008-2010 and observed the education system. We met the deans, medical education committee and administration affairs and discussed about the desirable education system. We also observed the facilities of medical schools.Medical education system shows marked diversity in the world. There are three types of education course; non-graduate-entry program(non-GEP), graduate-entry program(GEP) and mixed program of non-GEP and GEP. Even in the same country, several types of medical schools coexist. Although the education methods are also various among medical schools, most of the medical schools have introduced tutorial system based on PBL or TBL and simulation-based learning to create excellent medical physicians. The medical education system is variable among countries depending on the social environment. Although the change in education program may not be necessary in Japan, we have to innovate education methods; clinical training by clinical clerkship must be made more developed to foster the training of the excellent clinical physicians, and tutorial education by PBL or TBL and simulation-based learning should be introduced more actively.

MedRapid--medical community & business intelligence system.

Science.gov (United States)

Finkeissen, E; Fuchs, H; Jakob, T; Wetter, T

2002-01-01

currently, it takes at least 6 months for researchers to communicate their results. This delay is caused (a) by partial lacks of machine support for both representation as well as communication and (b) by media breaks during the communication process. To make an integrated communication between researchers and practitioners possible, a general structure for medical content representation has been set up. The procedure for data entry and quality management has been generalized and implemented in a web-based authoring system. The MedRapid-system supports the medical experts in entering their knowledge into a database. Here, the level of detail is still below that of current medical guidelines representation. However, the symmetric structure for an area-wide medical knowledge representation is highly retrievable and thus can quickly be communicated into daily routine for the improvement of the treatment quality. In addition, other sources like journal articles and medical guidelines can be references within the MedRapid-system and thus be communicated into daily routine. The fundamental system for the representation of medical reference knowledge (from reference works/books) itself is not sufficient for the friction-less communication amongst medical staff. Rather, the process of (a) representing medical knowledge, (b) refereeing the represented knowledge, (c) communicating the represented knowledge, and (d) retrieving the represented knowledge has to be unified. MedRapid will soon support the whole process on one server system.

Mass Medication Clinic (MMC) Patient Medical Assistant (PMA) System Training Initiative

Science.gov (United States)

2007-06-01

AD_________________ Award Number: W81XWH-06-2-0045 TITLE: Mass Medication Clinic (MMC) Patient ...SUBTITLE 5a. CONTRACT NUMBER Mass Medication Clinic (MMC) Patient Medical Assistant (PMA) System Training Initiative 5b. GRANT NUMBER W81XWH-06-2...sections will describe the events, results, and accomplishments of this study. With validation through this project the Patient Medical Assistant

Exploration Medical System Demonstration (EMSD) Project

Science.gov (United States)

Chin, Duane

2012-01-01

The Exploration Medical System Demonstration (EMSD) is a project under the Exploration Medical Capability (ExMC) element managed by the Human Research Program (HRP). The vision for the EMSD is to utilize ISS as a test bed to show that several medical technologies needed for an exploration mission and medical informatics tools for managing evidence and decision making can be integrated into a single system and used by the on-orbit crew in an efficient and meaningful manner. Objectives: a) Reduce and even possibly eliminate the time required for on-orbit crew and ground personnel (which include Surgeon, Biomedical Engineer (BME) Flight Controller, and Medical Operations Data Specialist) to access and move medical data from one application to another. b) Demonstrate that the on-orbit crew has the ability to access medical data/information using an intuitive and crew-friendly software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management framework and architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities.

Conceptual Drivers for an Exploration Medical System

Science.gov (United States)

Antonsen, Erik; Hanson, Andrea; Shah, Ronak; Reed, Rebekah; Canga, Michael

2016-01-01

Interplanetary spaceflight, such as NASA's proposed three-year mission to Mars, provides unique and novel challenges when compared with human spaceflight to date. Extended distance and multi-year missions introduce new elements of operational complexity and additional risk. These elements include: inability to resupply medications and consumables, inability to evacuate injured or ill crew, uncharted psychosocial conditions, and communication delays that create a requirement for some level of autonomous medical capability. Because of these unique challenges, the approaches used in prior programs have limited application to a Mars mission. On a Mars mission, resource limitations will significantly constrain available medical capabilities, and require a paradigm shift in the approach to medical system design and risk mitigation for crew health. To respond to this need for a new paradigm, the Exploration Medical Capability (ExMC) Element is assessing each Mars mission phase-transit, surface stay, rendezvous, extravehicular activity, and return-to identify and prioritize medical needs for the journey beyond low Earth orbit (LEO). ExMC is addressing both planned medical operations, and unplanned contingency medical operations that meld clinical needs and research needs into a single system. This assessment is being used to derive a gap analysis and studies to support meaningful medical capabilities trades. These trades, in turn, allow the exploration medical system design to proceed from both a mission centric and ethics-based approach, and to manage the risks associated with the medical limitations inherent in an exploration class mission. This paper outlines the conceptual drivers used to derive medical system and vehicle needs from an integrated vision of how medical care will be provided within this paradigm. Keywords: (Max 6 keywords: exploration, medicine, spaceflight, Mars, research, NASA)

MO-D-BRB-02: SBRT Treatment Planning and Delivery

International Nuclear Information System (INIS)

Yang, Y.

2016-01-01

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems

MO-D-BRB-03: Quality Assurance of SBRT

International Nuclear Information System (INIS)

Roper, J.

2016-01-01

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems

MO-D-BRB-01: Fundamental Aspects of SBRT

International Nuclear Information System (INIS)

Yin, F.

2016-01-01

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems

MO-D-BRB-00: SBRT Workflow Overview

International Nuclear Information System (INIS)

2016-01-01

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems

MO-D-BRB-01: Fundamental Aspects of SBRT

Energy Technology Data Exchange (ETDEWEB)

Yin, F. [Duke University Medical Center (United States)

2016-06-15

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.

MO-D-BRB-02: SBRT Treatment Planning and Delivery

Energy Technology Data Exchange (ETDEWEB)

Yang, Y. [Stanford University Cancer Center (United States)

2016-06-15

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.

MO-D-BRB-00: SBRT Workflow Overview

Energy Technology Data Exchange (ETDEWEB)

NONE

2016-06-15

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.

MO-D-BRB-03: Quality Assurance of SBRT

Energy Technology Data Exchange (ETDEWEB)

Roper, J. [Emory University School of Medicine (United States)

2016-06-15

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.

Monte Carlo simulation of the Varian Clinac 600C accelerator dynamic and physical wedges

Energy Technology Data Exchange (ETDEWEB)

Soares, S [Universidade da Beira Interior, Av. Marques d' Avila e Bolama, Covilha 6201-001 (Portugal); Chaves, A [Instituto Portugues de Oncologia Doutor Francisco Gentil (IPO), Av. Bissaya Barreto, Coimbra 3000-075 (Portugal); Peralta, L [Laboratorio de Instrumentacao e Fisica Experimental de PartIculas (LIP), Av. Elias Garcia no14 1o, Lisbon 1000-149 (Portugal); Lopes, Mc [Faculdade de Ciencias da Universidade de Lisboa, Campo Grande EdifIcio C5, Lisbon 1149-016 (Portugal)

2007-06-15

The present paper describes the study done on the dosimetric characteristics of the Varian Clinac 600C dynamic wedges (DW) and their comparison with the physical wedges (PW) in terms of the differences affecting the dose distributions, beam spectra, energy fluence and angular distributions. The geometry of the 4 MV photon beam and the dose distributions in a water phantom were simulated with GEANT3 and DPM Monte Carlo code systems. The DW was modelled through the constant movement of the upper jaws. The depth dose distributions and lateral profiles for the DW, PW and open fields were measured and compared with the Monte Carlo simulations and the global agreement was found to be within 3%. It was also found that the effects of a DW on beam spectral and angular distributions are much less significant than those produced by a PW. For example, in our study we found out that the 45{sup 0}PW, when compared with the corresponding open field, can introduce a 30% increase in the mean photon energy due to the beam hardening effect and that it can also introduce a 4.5% dose reduction in the build-up region because of the reduction of the contaminated electrons by the PW. For the DW neither this mean-energy increase nor such dose reduction was found. The PW, when compared to the DW, significantly alters the photon-beam spectrum and these dosimetric differences are significant and further investigation must be performed to quantify the impact in clinical use of these beams.

Family Systems Training for Medical Students.

Science.gov (United States)

Thabrew, Hiran

2018-05-01

To evaluate whether a workshop on family systems delivered to medical students could improve participants' understanding of families from a systemic point of view and help them recognise and address systemic issues that may be affecting their patients. Fifth year (senior) medical students ( n = 36) from the University of Auckland participated in a 90-min workshop about family systems. Pre- and post-workshop, self-reported measures of knowledge and confidence were completed and qualitative feedback was also obtained from participants. The workshop was well received and its interactive and role-play based nature were particularly appreciated. Participants reported gains in all explored areas of knowledge and understanding, suggesting that the workshop met its desired aims. This workshop is an educationally effective and expedient way to equip medical students with some knowledge and understanding about family systems. It may benefit their future work with individual patients and families.

Asan medical information system for healthcare quality improvement.

Science.gov (United States)

Ryu, Hyeon Jeong; Kim, Woo Sung; Lee, Jae Ho; Min, Sung Woo; Kim, Sun Ja; Lee, Yong Su; Lee, Young Ha; Nam, Sang Woo; Eo, Gi Seung; Seo, Sook Gyoung; Nam, Mi Hyun

2010-09-01

This purpose of this paper is to introduce the status of the Asan Medical Center (AMC) medical information system with respect to healthcare quality improvement. Asan Medical Information System (AMIS) is projected to become a completely electronic and digital information hospital. AMIS has played a role in improving the health care quality based on the following measures: safety, effectiveness, patient-centeredness, timeliness, efficiency, privacy, and security. AMIS CONSISTED OF SEVERAL DISTINCTIVE SYSTEMS: order communication system, electronic medical record, picture archiving communication system, clinical research information system, data warehouse, enterprise resource planning, IT service management system, and disaster recovery system. The most distinctive features of AMIS were the high alert-medication recognition & management system, the integrated and severity stratified alert system, the integrated patient monitoring system, the perioperative diabetic care monitoring and support system, and the clinical indicator management system. AMIS provides IT services for AMC, 7 affiliated hospitals and over 5,000 partners clinics, and was developed to improve healthcare services. The current challenge of AMIS is standard and interoperability. A global health IT strategy is needed to get through the current challenges and to provide new services as needed.

Assessment of beam stability of high energy and low energy Varian medical linear accelerators

International Nuclear Information System (INIS)

Jayesh, K.; Mohan, R.; Joshi, R.C.; Ganesh, T.; Hegazy, M.; Oubaye, A.J.; AI Idrisi, Maha

2008-01-01

An accurate measurement of the dose delivered to the tumor in external beam radiotherapy is one of the primary responsibilities of a medical physicist. In general, such measurements have been based on the application of a dosimetry protocol and quality assurance procedures. Clinically one must be able to assess the beam quality, flatness and symmetry and variation in the output on daily basis. Flatness and symmetry are the main parameters for determining the pattern of a photon and electron beam produced by linear accelerators. The quality assurance in routine clinical practice of radiotherapy and consequently the treatment-outcome depends definitely on the physical parameters of treatment-delivery. Several recommendations from national and international associations are reported to define the limits for the beam parameters. The review of literature and various reports on quality assurance in radiotherapy show that for flatness, symmetry and output constancy the optimal level of deviation should be within ±3%

[A medical consumable material management information system].

Science.gov (United States)

Tang, Guoping; Hu, Liang

2014-05-01

Medical consumables material is essential supplies to carry out medical work, which has a wide range of varieties and a large amount of usage. How to manage it feasibly and efficiently that has been a topic of concern to everyone. This article discussed about how to design a medical consumable material management information system that has a set of standardized processes, bring together medical supplies administrator, suppliers and clinical departments. Advanced management mode, enterprise resource planning (ERP) applied to the whole system design process.

Development of an integrated medical supply information system

Science.gov (United States)

Xu, Eric; Wermus, Marek; Blythe Bauman, Deborah

2011-08-01

The integrated medical supply inventory control system introduced in this study is a hybrid system that is shaped by the nature of medical supply, usage and storage capacity limitations of health care facilities. The system links demand, service provided at the clinic, health care service provider's information, inventory storage data and decision support tools into an integrated information system. ABC analysis method, economic order quantity model, two-bin method and safety stock concept are applied as decision support models to tackle inventory management issues at health care facilities. In the decision support module, each medical item and storage location has been scrutinised to determine the best-fit inventory control policy. The pilot case study demonstrates that the integrated medical supply information system holds several advantages for inventory managers, since it entails benefits of deploying enterprise information systems to manage medical supply and better patient services.

Development of Patient Status-Based Dynamic Access System for Medical Information Systems

Directory of Open Access Journals (Sweden)

Chang Won Jeong

2015-06-01

Full Text Available Recently, the hospital information system environment using IT communication technology and utilization of medical information has been increasing. In the medical field, the medical information system only supports the transfer of patient information to medical staff through an electronic health record, without information about patient status. Hence, it needs a method of real-time monitoring for the patient. Also, in this environment, a secure method in approaching healthcare through various smart devices is required. Therefore, in this paper, in order to classify the status of the patients, we propose a dynamic approach of the medical information system in a hospital information environment using the dynamic access control method. Also, we applied the symmetric method of AES (Advanced Encryption Standard. This was the best encryption algorithm for sending and receiving biological information. We can define usefulness as the dynamic access application service based on the final result of the proposed system. The proposed system is expected to provide a new solution for a convenient medical information system.

Determination of the dose equivalents due to neutrons produced during therapeutic irradiations with a Varian CLINAC 2500; Determinacion de la dosis equivalente debida a neutrones producidos durante irradiaciones terapeuticas con un Varian CLINAC 2500

Energy Technology Data Exchange (ETDEWEB)

Carrillo, Ricardo E [Centro de Investigacion y de Estudios Avanzados del IPN, Unidad Merida, Yucatan (Mexico)

1991-07-01

This experiment it was designed to quantify that so important it is the dose equivalent deposited by the neutron flow that is generated by photonuclear reactions during therapeutic irradiations with X rays of produced high-energy for an accelerator Varian CLINAC 2500. This accelerator type is routinely used in the Department of Radiotherapy of the Hospital of the University of Wisconsin, E.U. The equivalent dose was measured in diverse towns of the room of irradiations using the activation of thin sheets of gold put in the center of plastic recipients full with water. In general, the recipients were 1 m or more than the floor and at distances still bigger than the walls. The irradiations were made using photons with the highest energy that you can select with this team - 24 MeV. The due equivalent dose to neutrons taken place here by the energy photons used they were measured and reported. (author)

The application in detection the position accuracy of the multi-leaf collimator of Varian linear accelerator with dynamic therapy log files

International Nuclear Information System (INIS)

Li Changhu; Xu Liming; Teng Jianjian; Ge Wei; Zhang Jun; Ma Guangdong

2010-01-01

Objective: To explorer the application in detection the position accuracy of the multileaf collimator of Varian accelerator with dynamic therapy log files. Methods: A pre-designed MLC format files named PMLC for two Varian accelerators, the dynamic treatment log files were recorded 10 times on a different date, and be converted into the MLC format files named DMLC, compared with the original plan PMLC, so we can analysis two files for each leaf position deviation. In addition, we analysis the repeatability of MLC leaves position accuracy between 10 dynalog files of two accelerators. Results: No statistically significant difference between the average position of the 10 times leaf position of the two accelerators,their were 0.29 -0.29 and 0.29 -0.30 (z = -0.77, P=0.442). About 40%, 30%, 20% and 10% of the leaf position deviation was at ≤0.2 mm, 0.3 mm, 0.5 mm and 0.4 mm, respectively. the maximum value was 0.5 mm. More than 86% of the leaf position are completely coincident between 10 dynamic treatment files of two accelerators. The rate of position deviation no more 0. 05 mm was 96. 6% and 97.3%, respectively. And the maximum value was 0.09 mm. Conclusions: Dynamic treatment log file is a splendid tool in testing the actual position of multi-leaf collimator. The multi-leaf collimator of two accelerators be detected are precise and stabilized. (authors)

[Application of information management system about medical equipment].

Science.gov (United States)

Hang, Jianjin; Zhang, Chaoqun; Wu, Xiang-Yang

2011-05-01

Based on the practice of workflow, information management system about medical equipment was developed and its functions such as gathering, browsing, inquiring and counting were introduced. With dynamic and complete case management of medical equipment, the system improved the management of medical equipment.

Video-coaching as biofeedback tool to improve gated treatments. Possibilities and limitations

International Nuclear Information System (INIS)

Cossmann, Peter H.

2012-01-01

For respiratory gated radiotherapy the manufacturers of linear accelerators offer dedicated gating technologies. The video-based Varian RPM Gating system (Varian Medical Systems, Palo Alto/CA, USA) includes in a standard configuration a support tool for regular breathing called audiocoaching. As this approach has limitations regarding direct control of the patient's breathing due to a missing feedback, we designed an additional tool offering videocoaching. In order to evaluate the impact of this additional functionality, we measured parameters defining the image quality of 4D-CT data as well as the treatment duration which is mainly influenced by the patient's limited ability to achieve a stable breathing pattern. (orig.)

Building a medical system for nuclear facilities

International Nuclear Information System (INIS)

Maeda, Mitsuya

2016-01-01

To build a medical system for nuclear facilities, I explained what kinds of actions were performed with the TEPCO Fukushima Daiichi Nuclear Power Plant Accident and what kinds of actions are going to be performed in the future. We examined the health and medical care of the emergency workers in nuclear facilities including TEPCO Fukushima Daiichi Nuclear Power Plant from 2014 to 2015 in the Ministry of Health, Labour and Welfare (MHLW). We carried out a detailed hearing from stakeholders of electric companies and medical institutions about the medical system in nuclear facilities carrying out urgent activities. It has been said that the electric company is responsible to maintain the medical system for affected workers in nuclear facilities. However, TEPCO could not find the medical staff, such as doctors, by their own effort at the TEPCO Fukushima Daiichi Nuclear Power Plant Accident. The network of doctors familiar with emergency medical care support dispatched the medical staff after July of 2011. The stakeholders indicated that the following six tasks must be resolved: (1) the fact that no electric company performs the action of bringing up medical staff who can be dispatched into nuclear facilities in emergencies in 2015; (2) bringing up personnel in charge of radiation management and logistics other than the medical staff, such as doctors; (3) cooperation with the community medicine system given the light and shade by nuclear facilities; (4) performing training for the many concurrent wounded based on the scenario of a severe accident; (5) indicating both the condition of the contract and the guarantee of status that is appropriate for dispatched medical staffs; and (6) clarifying the organization of the network of stakeholders. The stakeholders showed the future directionality as follows: (1) To recruit the medical staff expected to be dispatched into nuclear facilities, (2) to carry out the discussion and conveyance training to strengthen cooperation with

Development of total medical material distribution management system.

Science.gov (United States)

Uto, Y; Kumamoto, I

1994-07-01

Since September 1992, attempts have been made at Kagoshima University Hospital to develop the Medical Material Distribution Management System which helps to realize optimal hospital management as a subsystem of the Total Hospital Information System of Kagoshima University (THINK). As this system has been established, it has become possible for us to have an accurate grasp of the flow and stock of medical materials at our hospital. Furthermore, since September 1993, the Medical Material Distribution Management System has been improved and the Total Medical Material Distribution Management System has been smoothly introduced into the site of clinical practice. This system enables automatic demands for fees for treatment with specific instruments and materials covered by health insurance. It was difficult to predict the effect of this system, because no similar system had been developed in Japan. However, more satisfactory results than expected have been obtained since its introduction.

Implementation of medical monitor system based on networks

Science.gov (United States)

Yu, Hui; Cao, Yuzhen; Zhang, Lixin; Ding, Mingshi

2006-11-01

In this paper, the development trend of medical monitor system is analyzed and portable trend and network function become more and more popular among all kinds of medical monitor devices. The architecture of medical network monitor system solution is provided and design and implementation details of medical monitor terminal, monitor center software, distributed medical database and two kind of medical information terminal are especially discussed. Rabbit3000 system is used in medical monitor terminal to implement security administration of data transfer on network, human-machine interface, power management and DSP interface while DSP chip TMS5402 is used in signal analysis and data compression. Distributed medical database is designed for hospital center according to DICOM information model and HL7 standard. Pocket medical information terminal based on ARM9 embedded platform is also developed to interactive with center database on networks. Two kernels based on WINCE are customized and corresponding terminal software are developed for nurse's routine care and doctor's auxiliary diagnosis. Now invention patent of the monitor terminal is approved and manufacture and clinic test plans are scheduled. Applications for invention patent are also arranged for two medical information terminals.

20 CFR 405.10 - Medical and Vocational Expert System.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Medical and Vocational Expert System. 405.10... Vocational Expert System. (a) General. The Medical and Vocational Expert System is comprised of the Medical... Vocational Expert System. (3) Experts who provide evidence at your request. Experts whom you ask to provide...

76 FR 59167 - Siemens Medical Solutions USA, Inc., Oncology Care Systems Division, Concord, CA; Siemens Medical...

Science.gov (United States)

2011-09-23

... Medical Solutions USA, Inc., Oncology Care Systems Division, Concord, CA; Siemens Medical Solutions USA... Solutions USA, Inc. (Siemens), Oncology Care Systems Division, Concord, California (subject firm). The...., Oncology Care Systems Division, Concord, California (TA-W-73,158) and Siemens Medical Solutions USA, Inc...

SU-D-BRD-07: Automatic Patient Data Audit and Plan Quality Check to Support ARIA and Eclipse

Energy Technology Data Exchange (ETDEWEB)

Li, X; Li, H; Wu, Y; Mutic, S; Yang, D [Washington University School of Medicine, St. Louis, MO (United States)

2014-06-01

Purpose: To ensure patient safety and treatment quality in RT departments that use Varian ARIA and Eclipse, we developed a computer software system and interface functions that allow previously developed electron chart checking (EcCk) methodologies to support these Varian systems. Methods: ARIA and Eclipse store most patient information in its MSSQL database. We studied the contents in the hundreds database tables and identified the data elements used for patient treatment management and treatment planning. Interface functions were developed in both c-sharp and MATLAB to support data access from ARIA and Eclipse servers using SQL queries. These functions and additional data processing functions allowed the existing rules and logics from EcCk to support ARIA and Eclipse. Dose and structure information are important for plan quality check, however they are not stored in the MSSQL database but as files in Varian private formats, and cannot be processed by external programs. We have therefore implemented a service program, which uses the DB Daemon and File Daemon services on ARIA server to automatically and seamlessly retrieve dose and structure data as DICOM files. This service was designed to 1) consistently monitor the data access requests from EcCk programs, 2) translate the requests for ARIA daemon services to obtain dose and structure DICOM files, and 3) monitor the process and return the obtained DICOM files back to EcCk programs for plan quality check purposes. Results: EcCk, which was previously designed to only support MOSAIQ TMS and Pinnacle TPS, can now support Varian ARIA and Eclipse. The new EcCk software has been tested and worked well in physics new start plan check, IMRT plan integrity and plan quality checks. Conclusion: Methods and computer programs have been implemented to allow EcCk to support Varian ARIA and Eclipse systems. This project was supported by a research grant from Varian Medical System.

SU-D-BRD-07: Automatic Patient Data Audit and Plan Quality Check to Support ARIA and Eclipse

International Nuclear Information System (INIS)

Li, X; Li, H; Wu, Y; Mutic, S; Yang, D

2014-01-01

Purpose: To ensure patient safety and treatment quality in RT departments that use Varian ARIA and Eclipse, we developed a computer software system and interface functions that allow previously developed electron chart checking (EcCk) methodologies to support these Varian systems. Methods: ARIA and Eclipse store most patient information in its MSSQL database. We studied the contents in the hundreds database tables and identified the data elements used for patient treatment management and treatment planning. Interface functions were developed in both c-sharp and MATLAB to support data access from ARIA and Eclipse servers using SQL queries. These functions and additional data processing functions allowed the existing rules and logics from EcCk to support ARIA and Eclipse. Dose and structure information are important for plan quality check, however they are not stored in the MSSQL database but as files in Varian private formats, and cannot be processed by external programs. We have therefore implemented a service program, which uses the DB Daemon and File Daemon services on ARIA server to automatically and seamlessly retrieve dose and structure data as DICOM files. This service was designed to 1) consistently monitor the data access requests from EcCk programs, 2) translate the requests for ARIA daemon services to obtain dose and structure DICOM files, and 3) monitor the process and return the obtained DICOM files back to EcCk programs for plan quality check purposes. Results: EcCk, which was previously designed to only support MOSAIQ TMS and Pinnacle TPS, can now support Varian ARIA and Eclipse. The new EcCk software has been tested and worked well in physics new start plan check, IMRT plan integrity and plan quality checks. Conclusion: Methods and computer programs have been implemented to allow EcCk to support Varian ARIA and Eclipse systems. This project was supported by a research grant from Varian Medical System

Medical ADP Systems: Automated Medical Records Hold Promise to Improve Patient Care

Science.gov (United States)

1991-01-01

automated medical records. The report discusses the potential benefits that automation could make to the quality of patient care and the factors that impede...information systems, but no organization has fully automated one of the most critical types of information, patient medical records. The patient medical record...its review of automated medical records. GAO’s objectives in this study were to identify the (1) benefits of automating patient records and (2) factors

The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Space Flight Medical Systems

Science.gov (United States)

Kerstman, Eric; Minard, Charles; Saile, Lynn; deCarvalho, Mary Freire; Myers, Jerry; Walton, Marlei; Butler, Douglas; Iyengar, Sriram; Johnson-Throop, Kathy; Baumann, David

2009-01-01

The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning.

Characterization of the radiation environment at the UNLV accelerator facility during operation of the Varian M6 linac

Science.gov (United States)

Hodges, M.; Barzilov, A.; Chen, Y.; Lowe, D.

2016-10-01

The bremsstrahlung photon flux from the UNLV particle accelerator (Varian M6 model) was determined using MCNP5 code for 3 MeV and 6 MeV incident electrons. Human biological equivalent dose rates due to accelerator operation were evaluated using the photon flux with the flux-to-dose conversion factors. Dose rates were computed for the accelerator facility for M6 linac use under different operating conditions. The results showed that the use of collimators and linac internal shielding significantly reduced the dose rates throughout the facility. It was shown that the walls of the facility, in addition to the earthen berm enveloping the building, provide equivalent shielding to reduce dose rates outside to below the 2 mrem/h limit.

Trophic transfer of trace metals from the polychaete worm Nereis diversicolor to the polychaete N. virens and the decapod crustacean Palaemonetes varians

Science.gov (United States)

Rainbow, P.S.; Poirier, L.; Smith, B.D.; Brix, K.V.; Luoma, S.N.

2006-01-01

Diet is an important exposure route for the uptake of trace metals by aquatic invertebrates, with trace metal trophic transfer depending on 2 stages - assimilation and subsequent accumulation by the predator. This study investigated the trophic transfer of trace metals from the sediment-dwelling polychaete worm Nereis diversicolor from metal-rich estuarine sediments in southwestern UK to 2 predators - another polychaete N. virens (Cu, Zn, Pb, Cd, Fe) and the decapod crustacean Palaemonetes varians (Cu, Zn, Pb, Cd, Fe, Ag, As, Mn). N. virens showed net accumulation of Cu, Zn, Pb and Cd from the prey; accumulation increased with increasing prey concentration, but a coefficient of trophic transfer decreased with increasing prey concentration, probably because a higher proportion of accumulated metal in the prey is bound in less trophically available (insoluble) detoxified forms. The trace metal accumulation patterns of P. varians apparently restricted significant net accumulation of metals from the diet of N. diversicolor to just Cd. There was significant mortality of the decapods fed on the diets of metal-rich worms. Metal-rich invertebrates that have accumulated metals from the rich historical store in the sediments of particular SW England estuaries can potentially pass these metals along food chains, with accumulation and total food chain transfer depending on the metal assimilation efficiencies and accumulation patterns of the animal at each trophic level. This trophic transfer may be significant enough to have ecotoxicological effects. ?? Inter-Research 2006.

MO-FG-BRC-00: Joint AAPM-ESTRO Symposium: Advances in Experimental Medical Physics

International Nuclear Information System (INIS)

2016-01-01

Experimental research in medical physics has expanded the limits of our knowledge and provided novel imaging and therapy technologies for patients around the world. However, experimental efforts are challenging due to constraints in funding, space, time and other forms of institutional support. In this joint ESTRO-AAPM symposium, four exciting experimental projects from four different countries are highlighted. Each project is focused on a different aspect of radiation therapy. From the USA, we will hear about a new linear accelerator concept for more compact and efficient therapy devices. From Canada, we will learn about novel linear accelerator target design and the implications for imaging and therapy. From France, we will discover a mature translational effort to incorporate theranostic nanoparticles in MR-guided radiation therapy. From Germany, we will find out about a novel in-treatment imaging modality for particle therapy. These examples of high impact, experimental medical physics research are representative of the diversity of such efforts that are on-going around the globe. J. Robar, Research is supported through collaboration with Varian Medical Systems and Brainlab AGD. Westerly, This work is supported by the Department of Radiation Oncology at the University of Colorado School of Medicine. COI: NONEK. Parodi, Part of the presented work is supported by the DFG (German Research Foundation) Cluster of Excellence MAP (Munich-Centre for Advanced Photonics) and has been carried out in collaboration with IBA.

Implementing RapidArc into clinical routine

DEFF Research Database (Denmark)

Van Esch, Ann; Huyskens, Dominique P; Behrens, Claus F

2011-01-01

With the increased commercial availability of intensity modulated arc therapy (IMAT) comes the need for comprehensive QA programs, covering the different aspects of this newly available technology. This manuscript proposes such a program for the RapidArc (RA) (Varian Medical Systems, Palo Alto...

Value-Added Clinical Systems Learning Roles for Medical Students That Transform Education and Health: A Guide for Building Partnerships Between Medical Schools and Health Systems.

Science.gov (United States)

Gonzalo, Jed D; Lucey, Catherine; Wolpaw, Terry; Chang, Anna

2017-05-01

To ensure physician readiness for practice and leadership in changing health systems, an emerging three-pillar framework for undergraduate medical education integrates the biomedical and clinical sciences with health systems science, which includes population health, health care policy, and interprofessional teamwork. However, the partnerships between medical schools and health systems that are commonplace today use health systems as a substrate for learning. Educators need to transform the relationship between medical schools and health systems. One opportunity is the design of authentic workplace roles for medical students to add relevance to medical education and patient care. Based on the experiences at two U.S. medical schools, the authors describe principles and strategies for meaningful medical school-health system partnerships to engage students in value-added clinical systems learning roles. In 2013, the schools began large-scale efforts to develop novel required longitudinal, authentic health systems science curricula in classrooms and workplaces for all first-year students. In designing the new medical school-health system partnerships, the authors combined two models in an intersecting manner-Kotter's change management and Kern's curriculum development steps. Mapped to this framework, they recommend strategies for building mutually beneficial medical school-health system partnerships, including developing a shared vision and strategy and identifying learning goals and objectives; empowering broad-based action and overcoming barriers in implementation; and generating short-term wins in implementation. Applying this framework can lead to value-added clinical systems learning roles for students, meaningful medical school-health system partnerships, and a generation of future physicians prepared to lead health systems change.

Super-rapid medical film processing system

International Nuclear Information System (INIS)

Honda, C.; Iwata, M.; Nozaki, H.

1988-01-01

A new super-rapid medical film processing system cuts processing time from 90 to 45 seconds, a critical advantage in traumatic injury, surgical operation, and other time-vital applications. The system consists of new films new processing chemicals (developer and fixer), and a new high-speed medical film processor. The system's creation is made possible by three new technologies. In film, multilayered monodispersed grains reduce processing time. In processing chemicals, an innovative design maximizes processing speed. And in the processor itself, a new drying apparatus increases drying efficiency. Together, these technologies achieve 45-second processing without degradation of image quality

The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems

Directory of Open Access Journals (Sweden)

Menizibeya Osain Welcome

2011-01-01

Full Text Available Objectives : As an important element of national security, public health not only functions to provide adequate and timely medical care but also track, monitor, and control disease outbreak. The Nigerian health care had suffered several infectious disease outbreaks year after year. Hence, there is need to tackle the problem. This study aims to review the state of the Nigerian health care system and to provide possible recommendations to the worsening state of health care in the country. To give up-to-date recommendations for the Nigerian health care system, this study also aims at reviewing the dynamics of health care in the United States, Britain, and Europe with regards to methods of medical intelligence/surveillance. Materials and Methods : Databases were searched for relevant literatures using the following keywords: Nigerian health care, Nigerian health care system, and Nigerian primary health care system. Additional keywords used in the search were as follows: United States (OR Europe health care dynamics, Medical Intelligence, Medical Intelligence systems, Public health surveillance systems, Nigerian medical intelligence, Nigerian surveillance systems, and Nigerian health information system. Literatures were searched in scientific databases Pubmed and African Journals OnLine. Internet searches were based on Google and Search Nigeria. Results : Medical intelligence and surveillance represent a very useful component in the health care system and control diseases outbreak, bioattack, etc. There is increasing role of automated-based medical intelligence and surveillance systems, in addition to the traditional manual pattern of document retrieval in advanced medical setting such as those in western and European countries. Conclusion : The Nigerian health care system is poorly developed. No adequate and functional surveillance systems are developed. To achieve success in health care in this modern era, a system well grounded in routine

WE-H-202-00: Session in Memory of Jean Pouliot: Next-Generation Deformable Image Registration

Energy Technology Data Exchange (ETDEWEB)

NONE

2016-06-15

Deformable image registration has now been commercially available for several years, with solid performance in a number of sites and for several applications including contour and dose mapping. However, more complex applications have arisen, such as assessing response to radiation therapy over time, registering images pre- and post-surgery, and auto-segmentation from atlases. These applications require innovative registration algorithms to achieve accurate alignment. The goal of this session is to highlight emerging registration technology and these new applications. The state of the art in image registration will be presented from an engineering perspective. Translational clinical applications will also be discussed to tie these new registration approaches together with imaging and radiation therapy applications in specific diseases such as cervical and lung cancers. Learning Objectives: To understand developing techniques and algorithms in deformable image registration that are likely to translate into clinical tools in the near future. To understand emerging imaging and radiation therapy clinical applications that require such new registration algorithms. Research supported in part by the National Institutes of Health under award numbers P01CA059827, R01CA166119, and R01CA166703. Disclosures: Phillips Medical systems (Hugo), Roger Koch (Christensen) support, Varian Medical Systems (Brock), licensing agreements from Raysearch (Brock) and Varian (Hugo).; K. Brock, Licensing Agreement - RaySearch Laboratories. Research Funding - Varian Medical Systems; G. Hugo, Research grant from National Institutes of Health, award number R01CA166119.; G. Christensen, Research support from NIH grants CA166119 and CA166703 and a gift from Roger Koch. There are no conflicts of interest.

WE-H-202-00: Session in Memory of Jean Pouliot: Next-Generation Deformable Image Registration

International Nuclear Information System (INIS)

2016-01-01

Deformable image registration has now been commercially available for several years, with solid performance in a number of sites and for several applications including contour and dose mapping. However, more complex applications have arisen, such as assessing response to radiation therapy over time, registering images pre- and post-surgery, and auto-segmentation from atlases. These applications require innovative registration algorithms to achieve accurate alignment. The goal of this session is to highlight emerging registration technology and these new applications. The state of the art in image registration will be presented from an engineering perspective. Translational clinical applications will also be discussed to tie these new registration approaches together with imaging and radiation therapy applications in specific diseases such as cervical and lung cancers. Learning Objectives: To understand developing techniques and algorithms in deformable image registration that are likely to translate into clinical tools in the near future. To understand emerging imaging and radiation therapy clinical applications that require such new registration algorithms. Research supported in part by the National Institutes of Health under award numbers P01CA059827, R01CA166119, and R01CA166703. Disclosures: Phillips Medical systems (Hugo), Roger Koch (Christensen) support, Varian Medical Systems (Brock), licensing agreements from Raysearch (Brock) and Varian (Hugo).; K. Brock, Licensing Agreement - RaySearch Laboratories. Research Funding - Varian Medical Systems; G. Hugo, Research grant from National Institutes of Health, award number R01CA166119.; G. Christensen, Research support from NIH grants CA166119 and CA166703 and a gift from Roger Koch. There are no conflicts of interest.

WE-H-202-01: Memorial Introduction

International Nuclear Information System (INIS)

Kirby, N.

2016-01-01

Deformable image registration has now been commercially available for several years, with solid performance in a number of sites and for several applications including contour and dose mapping. However, more complex applications have arisen, such as assessing response to radiation therapy over time, registering images pre- and post-surgery, and auto-segmentation from atlases. These applications require innovative registration algorithms to achieve accurate alignment. The goal of this session is to highlight emerging registration technology and these new applications. The state of the art in image registration will be presented from an engineering perspective. Translational clinical applications will also be discussed to tie these new registration approaches together with imaging and radiation therapy applications in specific diseases such as cervical and lung cancers. Learning Objectives: To understand developing techniques and algorithms in deformable image registration that are likely to translate into clinical tools in the near future. To understand emerging imaging and radiation therapy clinical applications that require such new registration algorithms. Research supported in part by the National Institutes of Health under award numbers P01CA059827, R01CA166119, and R01CA166703. Disclosures: Phillips Medical systems (Hugo), Roger Koch (Christensen) support, Varian Medical Systems (Brock), licensing agreements from Raysearch (Brock) and Varian (Hugo).; K. Brock, Licensing Agreement - RaySearch Laboratories. Research Funding - Varian Medical Systems; G. Hugo, Research grant from National Institutes of Health, award number R01CA166119.; G. Christensen, Research support from NIH grants CA166119 and CA166703 and a gift from Roger Koch. There are no conflicts of interest.

WE-H-202-03: Accounting for Large Geometric Changes During Radiotherapy

International Nuclear Information System (INIS)

Hugo, G.

2016-01-01

Deformable image registration has now been commercially available for several years, with solid performance in a number of sites and for several applications including contour and dose mapping. However, more complex applications have arisen, such as assessing response to radiation therapy over time, registering images pre- and post-surgery, and auto-segmentation from atlases. These applications require innovative registration algorithms to achieve accurate alignment. The goal of this session is to highlight emerging registration technology and these new applications. The state of the art in image registration will be presented from an engineering perspective. Translational clinical applications will also be discussed to tie these new registration approaches together with imaging and radiation therapy applications in specific diseases such as cervical and lung cancers. Learning Objectives: To understand developing techniques and algorithms in deformable image registration that are likely to translate into clinical tools in the near future. To understand emerging imaging and radiation therapy clinical applications that require such new registration algorithms. Research supported in part by the National Institutes of Health under award numbers P01CA059827, R01CA166119, and R01CA166703. Disclosures: Phillips Medical systems (Hugo), Roger Koch (Christensen) support, Varian Medical Systems (Brock), licensing agreements from Raysearch (Brock) and Varian (Hugo).; K. Brock, Licensing Agreement - RaySearch Laboratories. Research Funding - Varian Medical Systems; G. Hugo, Research grant from National Institutes of Health, award number R01CA166119.; G. Christensen, Research support from NIH grants CA166119 and CA166703 and a gift from Roger Koch. There are no conflicts of interest.

WE-H-202-02: Biomechanical Modeling of Anatomical Response Over the Course of Therapy

Energy Technology Data Exchange (ETDEWEB)

Brock, K. [University of Michigan (United States)

2016-06-15

Deformable image registration has now been commercially available for several years, with solid performance in a number of sites and for several applications including contour and dose mapping. However, more complex applications have arisen, such as assessing response to radiation therapy over time, registering images pre- and post-surgery, and auto-segmentation from atlases. These applications require innovative registration algorithms to achieve accurate alignment. The goal of this session is to highlight emerging registration technology and these new applications. The state of the art in image registration will be presented from an engineering perspective. Translational clinical applications will also be discussed to tie these new registration approaches together with imaging and radiation therapy applications in specific diseases such as cervical and lung cancers. Learning Objectives: To understand developing techniques and algorithms in deformable image registration that are likely to translate into clinical tools in the near future. To understand emerging imaging and radiation therapy clinical applications that require such new registration algorithms. Research supported in part by the National Institutes of Health under award numbers P01CA059827, R01CA166119, and R01CA166703. Disclosures: Phillips Medical systems (Hugo), Roger Koch (Christensen) support, Varian Medical Systems (Brock), licensing agreements from Raysearch (Brock) and Varian (Hugo).; K. Brock, Licensing Agreement - RaySearch Laboratories. Research Funding - Varian Medical Systems; G. Hugo, Research grant from National Institutes of Health, award number R01CA166119.; G. Christensen, Research support from NIH grants CA166119 and CA166703 and a gift from Roger Koch. There are no conflicts of interest.

WE-H-202-01: Memorial Introduction

Energy Technology Data Exchange (ETDEWEB)

Kirby, N. [University of Texas HSC SA (United States)

2016-06-15

Deformable image registration has now been commercially available for several years, with solid performance in a number of sites and for several applications including contour and dose mapping. However, more complex applications have arisen, such as assessing response to radiation therapy over time, registering images pre- and post-surgery, and auto-segmentation from atlases. These applications require innovative registration algorithms to achieve accurate alignment. The goal of this session is to highlight emerging registration technology and these new applications. The state of the art in image registration will be presented from an engineering perspective. Translational clinical applications will also be discussed to tie these new registration approaches together with imaging and radiation therapy applications in specific diseases such as cervical and lung cancers. Learning Objectives: To understand developing techniques and algorithms in deformable image registration that are likely to translate into clinical tools in the near future. To understand emerging imaging and radiation therapy clinical applications that require such new registration algorithms. Research supported in part by the National Institutes of Health under award numbers P01CA059827, R01CA166119, and R01CA166703. Disclosures: Phillips Medical systems (Hugo), Roger Koch (Christensen) support, Varian Medical Systems (Brock), licensing agreements from Raysearch (Brock) and Varian (Hugo).; K. Brock, Licensing Agreement - RaySearch Laboratories. Research Funding - Varian Medical Systems; G. Hugo, Research grant from National Institutes of Health, award number R01CA166119.; G. Christensen, Research support from NIH grants CA166119 and CA166703 and a gift from Roger Koch. There are no conflicts of interest.

WE-H-202-03: Accounting for Large Geometric Changes During Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Hugo, G. [Virginia Commonwealth University (United States)

2016-06-15

Deformable image registration has now been commercially available for several years, with solid performance in a number of sites and for several applications including contour and dose mapping. However, more complex applications have arisen, such as assessing response to radiation therapy over time, registering images pre- and post-surgery, and auto-segmentation from atlases. These applications require innovative registration algorithms to achieve accurate alignment. The goal of this session is to highlight emerging registration technology and these new applications. The state of the art in image registration will be presented from an engineering perspective. Translational clinical applications will also be discussed to tie these new registration approaches together with imaging and radiation therapy applications in specific diseases such as cervical and lung cancers. Learning Objectives: To understand developing techniques and algorithms in deformable image registration that are likely to translate into clinical tools in the near future. To understand emerging imaging and radiation therapy clinical applications that require such new registration algorithms. Research supported in part by the National Institutes of Health under award numbers P01CA059827, R01CA166119, and R01CA166703. Disclosures: Phillips Medical systems (Hugo), Roger Koch (Christensen) support, Varian Medical Systems (Brock), licensing agreements from Raysearch (Brock) and Varian (Hugo).; K. Brock, Licensing Agreement - RaySearch Laboratories. Research Funding - Varian Medical Systems; G. Hugo, Research grant from National Institutes of Health, award number R01CA166119.; G. Christensen, Research support from NIH grants CA166119 and CA166703 and a gift from Roger Koch. There are no conflicts of interest.

Video-coaching as biofeedback tool to improve gated treatments. Possibilities and limitations

Energy Technology Data Exchange (ETDEWEB)

Cossmann, Peter H. [Medtech Consulting Cossmann, Wettingen (Switzerland); Private Univ. im Fuerstentum Liechtenstein, Triesen (Liechtenstein)

2012-11-01

For respiratory gated radiotherapy the manufacturers of linear accelerators offer dedicated gating technologies. The video-based Varian RPM Gating system (Varian Medical Systems, Palo Alto/CA, USA) includes in a standard configuration a support tool for regular breathing called audiocoaching. As this approach has limitations regarding direct control of the patient's breathing due to a missing feedback, we designed an additional tool offering videocoaching. In order to evaluate the impact of this additional functionality, we measured parameters defining the image quality of 4D-CT data as well as the treatment duration which is mainly influenced by the patient's limited ability to achieve a stable breathing pattern. (orig.)

Stereoscopic medical imaging collaboration system

Science.gov (United States)

Okuyama, Fumio; Hirano, Takenori; Nakabayasi, Yuusuke; Minoura, Hirohito; Tsuruoka, Shinji

2007-02-01

The computerization of the clinical record and the realization of the multimedia have brought improvement of the medical service in medical facilities. It is very important for the patients to obtain comprehensible informed consent. Therefore, the doctor should plainly explain the purpose and the content of the diagnoses and treatments for the patient. We propose and design a Telemedicine Imaging Collaboration System which presents a three dimensional medical image as X-ray CT, MRI with stereoscopic image by using virtual common information space and operating the image from a remote location. This system is composed of two personal computers, two 15 inches stereoscopic parallax barrier type LCD display (LL-151D, Sharp), one 1Gbps router and 1000base LAN cables. The software is composed of a DICOM format data transfer program, an operation program of the images, the communication program between two personal computers and a real time rendering program. Two identical images of 512×768 pixcels are displayed on two stereoscopic LCD display, and both images show an expansion, reduction by mouse operation. This system can offer a comprehensible three-dimensional image of the diseased part. Therefore, the doctor and the patient can easily understand it, depending on their needs.

Implementation of an Electronic Medical Records System

Science.gov (United States)

2008-05-07

Hartman, MAJ Roddex Barlow , CPT Christopher Besser and Capt Michael Emerson...thank you I am truly honored to call each of you my friends. Electronic... abnormal findings are addressed. 18 Electronic Medical Record Implementation Barriers of the Electronic Medical Records System There are several...examination findings • Psychological and social assessment findings N. The system provides a flexible mechanism for retrieval of encounter

Medication Safety Systems and the Important Role of Pharmacists.

Science.gov (United States)

Mansur, Jeannell M

2016-03-01

Preventable medication-related adverse events continue to occur in the healthcare setting. While the Institute of Medicine's To Err is Human, published in 2000, highlighted the prevalence of medical and medication-related errors in patient morbidity and mortality, there has not been significant documented progress in addressing system contributors to medication errors. The lack of progress may be related to the myriad of pharmaceutical options now available and the nuances of optimizing drug therapy to achieve desired outcomes and prevent undesirable outcomes. However, on a broader scale, there may be opportunities to focus on the design and performance of the many processes that are part of the medication system. Errors may occur in the storage, prescribing, transcription, preparation and dispensing, or administration and monitoring of medications. Each of these nodes of the medication system, with its many components, is prone to failure, resulting in harm to patients. The pharmacist is uniquely trained to be able to impact medication safety at the individual patient level through medication management skills that are part of the clinical pharmacist's role, but also to analyze the performance of medication processes and to lead redesign efforts to mitigate drug-related outcomes that may cause harm. One population that can benefit from a focus on medication safety through clinical pharmacy services and medication safety programs is the elderly, who are at risk for adverse drug events due to their many co-morbidities and the number of medications often used. This article describes the medication safety systems and provides a blueprint for creating a foundation for medication safety programs within healthcare organizations. The specific role of pharmacists and clinical pharmacy services in medication safety is also discussed here and in other articles in this Theme Issue.

SU-E-T-781: Using An Electronic Portal Imaging Device (EPID) for Correlating Linac Photon Beam Energies

Energy Technology Data Exchange (ETDEWEB)

Yaddanapudi, S; Cai, B; Sun, B; Noel, C; Goddu, S; Mutic, S [Washington University School of Medicine, Saint Louis, MO (United States)

2015-06-15

Purpose: Electronic portal imaging devices (EPIDs) have proven to be useful for measuring several parameters of interest in linear accelerator (linac) quality assurance (QA). The purpose of this project was to evaluate the feasibility of using EPIDs for determining linac photon beam energies. Methods: Two non-clinical Varian TrueBeam linacs (Varian Medical Systems, Palo Alto, CA) with 6MV and 10MV photon beams were used to perform the measurements. The linacs were equipped with an amorphous silicon based EPIDs (aSi1000) that were used for the measurements. We compared the use of flatness versus percent depth dose (PDD) for predicting changes in linac photon beam energy. PDD was measured in 1D water tank (Sun Nuclear Corporation, Melbourne FL) and the profiles were measured using 2D ion-chamber array (IC-Profiler, Sun Nuclear) and the EPID. Energy changes were accomplished by varying the bending magnet current (BMC). The evaluated energies conformed with the AAPM TG142 tolerance of ±1% change in PDD. Results: BMC changes correlating with a ±1% change in PDD corresponded with a change in flatness of ∼1% to 2% from baseline values on the EPID. IC Profiler flatness values had the same correlation. We observed a similar trend for the 10MV beam energy changes. Our measurements indicated a strong correlation between changes in linac photon beam energy and changes in flatness. For all machines and energies, beam energy changes produced change in the uniformity (AAPM TG-142), varying from ∼1% to 2.5%. Conclusions: EPID image analysis of beam profiles can be used to determine linac photon beam energy changes. Flatness-based metrics or uniformity as defined by AAPM TG-142 were found to be more sensitive to linac photon beam energy changes than PDD. Research funding provided by Varian Medical Systems. Dr. Sasa Mutic receives compensation for providing patient safety training services from Varian Medical Systems, the sponsor of this study.

Medical imaging systems

Science.gov (United States)

Frangioni, John V [Wayland, MA

2012-07-24

A medical imaging system provides simultaneous rendering of visible light and fluorescent images. The system may employ dyes in a small-molecule form that remains in a subject's blood stream for several minutes, allowing real-time imaging of the subject's circulatory system superimposed upon a conventional, visible light image of the subject. The system may also employ dyes or other fluorescent substances associated with antibodies, antibody fragments, or ligands that accumulate within a region of diagnostic significance. In one embodiment, the system provides an excitation light source to excite the fluorescent substance and a visible light source for general illumination within the same optical guide that is used to capture images. In another embodiment, the system is configured for use in open surgical procedures by providing an operating area that is closed to ambient light. More broadly, the systems described herein may be used in imaging applications where a visible light image may be usefully supplemented by an image formed from fluorescent emissions from a fluorescent substance that marks areas of functional interest.

Evaluation of imaging quality for flat-panel detector based low dose C-arm CT system

International Nuclear Information System (INIS)

Seo, Chang-Woo; Cha, Bo Kyung; Jeon, Sungchae; Huh, Young

2015-01-01

The image quality associated with the extent of the angle of gantry rotation, the number of projection views, and the dose of X-ray radiation was investigated in flat-panel detector (FPD) based C-arm cone-beam computed tomography (CBCT) system for medical applications. A prototype CBCT system for the projection acquisition used the X-ray tube (A-132, Varian inc.) having rhenium-tungsten molybdenum target and flat panel a-Si X-ray detector (PaxScan 4030CB, Varian inc.) having a 397 x 298 mm active area with 388 μm pixel pitch and 1024 x 768 pixels in 2 by 2 binning mode. The performance comparison of X-ray imaging quality was carried out using the Feldkamp, Davis, and Kress (FDK) reconstruction algorithm between different conditions of projection acquisition. In this work, head-and-dental (75 kVp/20 mA) and chest (90 kVp/25 mA) phantoms were used to evaluate the image quality. The 361 (30 fps x 12 s) projection data during 360 deg. gantry rotation with 1 deg. interval for the 3D reconstruction were acquired. Parke weighting function were applied to handle redundant data and improve the reconstructed image quality in a mobile C-arm system with limited rotation angles. The reconstructed 3D images were investigated for comparison of qualitative image quality in terms of scan protocols (projection views, rotation angles and exposure dose). Furthermore, the performance evaluation in image quality will be investigated regarding X-ray dose and limited projection data for a FPD based mobile C-arm CBCT system. (authors)

Army medical imaging system: ARMIS

International Nuclear Information System (INIS)

Siedband, M.P.; Kramp, D.C.

1987-01-01

Recent advances of stimulable phosphor screens, data cards using optical storage means, and new personal computers with image processing capability have made possible the design of economical filmless medical imaging systems. The addition of communication links means that remote interpretation of images is also possible. The Army Medical Imaging System uses stimulable phosphor screens, digital readout, a small computer, an optical digital data card device, and a DIN/PACS link. Up to 200 images can be stored in the computer hard disk for rapid recall and reading by the radiologist. The computer permits image processing, annotation, insertion of text, and control of the system. Each device contains an image storage RAM and communicates with the computer via the small computer systems interface. Data compression is used to reduce the required storage capacity and transmission times of the 1-mB images. The credit card-size optical data cards replace film and can store 12 or more images. The data cards can be read on an independent viewer. The research is supported by the U.S. Army Biomedical Research and Development Laboratory

Quality system for Medical laboratories

Directory of Open Access Journals (Sweden)

Shiva Raj K.C.

2015-03-01

Full Text Available According to William Edwards Deming “Good quality does not necessarily mean high quality. Instead it means a predicable degree of uniformity and dependability at low cost with a quality suited to the market.” Whereas according to famous engineer and management consultant Joseph M. Juran quality is “fitness for purpose”. It should meet the customers’ expectations and requirements, should be cost effective.ISO began in 1926 as the International Federation of the National Standardizing Associations (ISA. The name, "ISO" was derived from the Greek word "isos" meaning "equal". (The relation to standards is that if two objects meet the same standard, they should be equal. This name eliminates any confusion that could result from the translation of "International Organization for Standardization" into different languages which would lead to different acronyms.In health sector, quality plays pivotal role, as it is directly related to patient’s care. Earlier time, health service was simple, quite safe but ineffective. Now health care system is an organizational system with more complex processes to deliver care. Medical laboratory service is an integral part in patient’s management system. So, for everyone involved in the treatment of the patient, the accuracy, reliability and safety of those services must be the primary concerns. Accreditation is a significant enabler of quality, thereby delivering confidence to healthcare providers, clinicians, the medical laboratories and the patients themselves.ISO announced meeting in Philadelphia to form a technical committee to develop a new standard for medical laboratory quality. It took 7 years for the creation of a new Quality standard for medical laboratories. It was named as “ISO 15189” and was first published in 2003. The ISO has released three versions of the standard. The first two were released in 2003 and 2007. In 2012, a revised and updated version of the standard, ISO 15189

Establishment of a Quantitative Medical Technology Evaluation System and Indicators within Medical Institutions

Directory of Open Access Journals (Sweden)

Suo-Wei Wu

2018-01-01

Conclusions: As the two-round questionnaire survey of experts and statistical analysis were performed and credibility of the results was verified through consistency evaluation test, the study established a quantitative medical technology evaluation system model and assessment indicators within medical institutions based on the Delphi method and analytical hierarchy process. Moreover, further verifications, adjustments, and optimizations of the system and indicators will be performed in follow-up studies.

Evaluation of the Analytical Anisotropic Algorithm (AAA) in dose calculation for fields with non-uniform fluences considering heterogeneity correction; Avaliacao do Algoritmo Analitico Anisotropico (AAA) no calculo de dose para campos com fluencia nao uniforme considerando correcao de heterogeneidade

Energy Technology Data Exchange (ETDEWEB)

Bornatto, P.; Funchal, M.; Bruning, F.; Toledo, H.; Lyra, J.; Fernandes, T.; Toledo, F.; Marciao, C., E-mail: pricila_bornatto@yahoo.com.br [Hospital Erasto Gaertner (LPCC), Curitiba, PR (Brazil). Departamento de Radioterapia

2014-08-15

The purpose of this study is to evaluate the calculation of dose distribution AAA (Varian Medical Systems) for fields with non-uniform fluences considering heterogeneity correction. Five different phantoms were used with different density materials. These phantoms were scanned in the CT BrightSpeed (©GE Healthcare) upon the array of detectors MAPCHECK2 TM (Sun Nuclear Corporation) and irradiated in a linear accelerator 600 CD (Varian Medical Systems) 6MV and rate dose 400MU/min with isocentric setup. The fluences used were exported from IMRT plans, calculated by ECLIPSE™ planning system (Varian Medical Systems), and a 10x10 cm{sup 2} field to assess the heterogeneity correction for uniform fluence. The measured dose distribution was compared to the calculated by Gamma analysis with approval criteria of 3% / 3 mm and 10% threshold. The evaluation was performed using the software SNCPatient (Sun Nuclear Corporation) and considering absolute dose normalized at maximum. The phantoms best performers were those with low density materials, with an average of 99.2% approval. Already phantoms with plates of higher density material presented various fluences below 95% of the points approved. The average value reached 94.3%. It was observed a dependency between fluency and approved percentage points, whereas for the same fluency, 100% of the points have been approved in all phantoms. The approval criteria for IMRT plans recommended in most centers is 3% / 3mm with at least 95% of points approved, it can be concluded that, under these conditions, the IMRT plans with heterogeneity correction can be performed , however the quality control must be careful because the difficulty of the system to accurately predict the dose distribution in certain situations. (author)

Dosimetric evaluation of total marrow irradiation using 2 different planning systems

International Nuclear Information System (INIS)

Nalichowski, Adrian; Eagle, Don G.; Burmeister, Jay

2016-01-01

This study compared 2 different treatment planning systems (TPSs) for quality and efficiency of total marrow irradiation (TMI) plans. The TPSs used in this study were VOxel-Less Optimization (VoLO) (Accuray Inc, Sunnyvale, CA) using helical dose delivery on a Tomotherapy Hi-Art treatment unit and Eclipse (Varian Medical Systems Inc, Palo Alto, CA) using volumetric modulated arc therapy (VMAT) dose delivery on a Varian iX treatment unit. A total dose of 1200 cGy was prescribed to cover 95% of the planning target volume (PTV). The plans were optimized and calculated based on a single CT data and structure set using the Alderson Rando phantom (The Phantom Laboratory, Salem, NY) and physician contoured target and organ at risk (OAR) volumes. The OARs were lungs, heart, liver, kidneys, brain, and small bowel. The plans were evaluated based on plan quality, time to optimize the plan and calculate the dose, and beam on time. The resulting mean and maximum doses to the PTV were 1268 and 1465 cGy for VoLO and 1284 and 1541 cGy for Eclipse, respectively. For 5 of 6 OAR structures the VoLO system achieved lower mean and D10 doses ranging from 22% to 52% and 3% to 44%, respectively. Total computational time including only optimization and dose calculation were 0.9 hours for VoLO and 3.8 hours for Eclipse. These times do not include user-dependent target delineation and field setup. Both planning systems are capable of creating high-quality plans for total marrow irradiation. The VoLO planning system was able to achieve more uniform dose distribution throughout the target volume and steeper dose fall off, resulting in superior OAR sparing. VoLO's graphics processing unit (GPU)–based optimization and dose calculation algorithm also allowed much faster creation of TMI plans.

Dosimetric evaluation of total marrow irradiation using 2 different planning systems

Energy Technology Data Exchange (ETDEWEB)

Nalichowski, Adrian, E-mail: nalichoa@karmanos.org [Karmanos Cancer Center, Detroit, MI (United States); Eagle, Don G. [Wayne State University School of Medicine, Detroit, MI (United States); Burmeister, Jay [Karmanos Cancer Center, Detroit, MI (United States); Wayne State University School of Medicine, Detroit, MI (United States)

2016-10-01

This study compared 2 different treatment planning systems (TPSs) for quality and efficiency of total marrow irradiation (TMI) plans. The TPSs used in this study were VOxel-Less Optimization (VoLO) (Accuray Inc, Sunnyvale, CA) using helical dose delivery on a Tomotherapy Hi-Art treatment unit and Eclipse (Varian Medical Systems Inc, Palo Alto, CA) using volumetric modulated arc therapy (VMAT) dose delivery on a Varian iX treatment unit. A total dose of 1200 cGy was prescribed to cover 95% of the planning target volume (PTV). The plans were optimized and calculated based on a single CT data and structure set using the Alderson Rando phantom (The Phantom Laboratory, Salem, NY) and physician contoured target and organ at risk (OAR) volumes. The OARs were lungs, heart, liver, kidneys, brain, and small bowel. The plans were evaluated based on plan quality, time to optimize the plan and calculate the dose, and beam on time. The resulting mean and maximum doses to the PTV were 1268 and 1465 cGy for VoLO and 1284 and 1541 cGy for Eclipse, respectively. For 5 of 6 OAR structures the VoLO system achieved lower mean and D10 doses ranging from 22% to 52% and 3% to 44%, respectively. Total computational time including only optimization and dose calculation were 0.9 hours for VoLO and 3.8 hours for Eclipse. These times do not include user-dependent target delineation and field setup. Both planning systems are capable of creating high-quality plans for total marrow irradiation. The VoLO planning system was able to achieve more uniform dose distribution throughout the target volume and steeper dose fall off, resulting in superior OAR sparing. VoLO's graphics processing unit (GPU)–based optimization and dose calculation algorithm also allowed much faster creation of TMI plans.

A wearable sensor system for medication adherence prediction.

Science.gov (United States)

Kalantarian, Haik; Motamed, Babak; Alshurafa, Nabil; Sarrafzadeh, Majid

2016-05-01

Studies have revealed that non-adherence to prescribed medication can lead to hospital readmissions, clinical complications, and other negative patient outcomes. Though many techniques have been proposed to improve patient adherence rates, they suffer from low accuracy. Our objective is to develop and test a novel system for assessment of medication adherence. Recently, several smart pill bottle technologies have been proposed, which can detect when the bottle has been opened, and even when a pill has been retrieved. However, very few systems can determine if the pill is subsequently ingested or discarded. We propose a system for detecting user adherence to medication using a smart necklace, capable of determining if the medication has been ingested based on the skin movement in the lower part of the neck during a swallow. This, coupled with existing medication adherence systems that detect when medicine is removed from the bottle, can detect a broader range of use-cases with respect to medication adherence. Using Bayesian networks, we were able to correctly classify between chewable vitamins, saliva swallows, medication capsules, speaking, and drinking water, with average precision and recall of 90.17% and 88.9%, respectively. A total of 135 instances were classified from a total of 20 subjects. Our experimental evaluations confirm the accuracy of the piezoelectric necklace for detecting medicine swallows and disambiguating them from related actions. Further studies in real-world conditions are necessary to evaluate the efficacy of the proposed scheme. Copyright © 2016 Elsevier B.V. All rights reserved.

Development of digital dashboard system for medical practice: maximizing efficiency of medical information retrieval and communication.

Science.gov (United States)

Lee, Kee Hyuck; Yoo, Sooyoung; Shin, HoGyun; Baek, Rong-Min; Chung, Chin Youb; Hwang, Hee

2013-01-01

It is reported that digital dashboard systems in hospitals provide a user interface (UI) that can centrally manage and retrieve various information related to patients in a single screen, support the decision-making of medical professionals on a real time basis by integrating the scattered medical information systems and core work flows, enhance the competence and decision-making ability of medical professionals, and reduce the probability of misdiagnosis. However, the digital dashboard systems of hospitals reported to date have some limitations when medical professionals use them to generally treat inpatients, because those were limitedly used for the work process of certain departments or developed to improve specific disease-related indicators. Seoul National University Bundang Hospital developed a new concept of EMR system to overcome such limitations. The system allows medical professionals to easily access all information on inpatients and effectively retrieve important information from any part of the hospital by displaying inpatient information in the form of digital dashboard. In this study, we would like to introduce the structure, development methodology and the usage of our new concept.

Physician medical direction and clinical performance at an established emergency medical services system.

Science.gov (United States)

Munk, Marc-David; White, Shaun D; Perry, Malcolm L; Platt, Thomas E; Hardan, Mohammed S; Stoy, Walt A

2009-01-01

Few developed emergency medical services (EMS) systems operate without dedicated medical direction. We describe the experience of Hamad Medical Corporation (HMC) EMS, which in 2007 first engaged an EMS medical director to develop and implement medical direction and quality assurance programs. We report subsequent changes to system performance over time. Over one year, changes to the service's clinical infrastructure were made: Policies were revised, paramedic scopes of practice were adjusted, evidence-based clinical protocols were developed, and skills maintenance and education programs were implemented. Credentialing, physician chart auditing, clinical remediation, and online medical command/hospital notification systems were introduced. Following these interventions, we report associated improvements to key indicators: Chart reviews revealed significant improvements in clinical quality. A comparison of pre- and post-intervention audited charts reveals a decrease in cases requiring remediation (11% to 5%, odds ratio [OR] 0.43 [95% confidence interval (CI) 0.20-0.85], p = 0.01). The proportion of charts rated as clinically acceptable rose from 48% to 84% (OR 6 [95% CI 3.9-9.1], p < 0.001). The proportion of misplaced endotracheal tubes fell (3.8% baseline to 0.6%, OR 0.16 [95% CI 0.004-1.06], (exact) p = 0.05), corresponding to improved adherence to an airway placement policy mandating use of airway confirmation devices and securing devices (0.7% compliance to 98%, OR 714 [95% CI 64-29,334], (exact) p < 0.001). Intravenous catheter insertion in unstable cases increased from 67% of cases to 92% (OR 1.31 [95% CI 1.09-1.71], p = 0.004). EMS administration of aspirin to patients with suspected ischemic chest pain improved from 2% to 77% (OR 178 [95% CI 35-1,604], p < 0.001). We suggest that implementation of a physician medical direction is associated with improved clinical indicators and overall quality of care at an established EMS system.

SU-E-J-47: Comparison of Online Image Registrations of Varian TrueBeam Cone-Beam CT and BrainLab ExacTrac Imaging Systems

International Nuclear Information System (INIS)

Li, J; Shi, W; Andrews, D; Werner-Wasik, M; Yu, Y; Liu, H

2015-01-01

Purpose To compare online image registrations of TrueBeam cone-beam CT (CBCT) and BrainLab ExacTrac imaging systems. Methods Tests were performed on a Varian TrueBeam STx linear accelerator (Version 2.0), which is integrated with a BrainLab ExacTrac imaging system (Version 6.0.5). The study was focused on comparing the online image registrations for translational shifts. A Rando head phantom was placed on treatment couch and immobilized with a BrainLab mask. The phantom was shifted by moving the couch translationally for 8 mm with a step size of 1 mm, in vertical, longitudinal, and lateral directions, respectively. At each location, the phantom was imaged with CBCT and ExacTrac x-ray. CBCT images were registered with TrueBeam and ExacTrac online registration algorithms, respectively. And ExacTrac x-ray image registrations were performed. Shifts calculated from different registrations were compared with nominal couch shifts. Results The averages and ranges of absolute differences between couch shifts and calculated phantom shifts obtained from ExacTrac x-ray registration, ExacTrac CBCT registration with default window, ExaxTrac CBCT registration with adjusted window (bone), Truebeam CBCT registration with bone window, and Truebeam CBCT registration with soft tissue window, were: 0.07 (0.02–0.14), 0.14 (0.01–0.35), 0.12 (0.02–0.28), 0.09 (0–0.20), and 0.06 (0–0.10) mm, in vertical direction; 0.06 (0.01–0.12), 0.27 (0.07–0.57), 0.23 (0.02–0.48), 0.04 (0–0.10), and 0.08 (0– 0.20) mm, in longitudinal direction; 0.05 (0.01–0.21), 0.35 (0.14–0.80), 0.25 (0.01–0.56), 0.19 (0–0.40), and 0.20 (0–0.40) mm, in lateral direction. Conclusion The shifts calculated from ExacTrac x-ray and TrueBeam CBCT registrations were close to each other (the differences between were less than 0.40 mm in any direction), and had better agreements with couch shifts than those from ExacTrac CBCT registrations. There were no significant differences between True

SU-E-J-11: Measurement of Eye Lens Dose for Varian On-Board Imaging with Different CBCT Acquisition Techniques

International Nuclear Information System (INIS)

Deshpande, S; Dhote, D; Kumar, R; Thakur, K

2015-01-01

Purpose: To measure actual patient eye lens dose for different cone beam computed tomography (CBCT) acquisition protocol of Varian’s On Board Imagining (OBI) system using Optically Stimulated Luminescence (OSL) dosimeter and study the eye lens dose with patient geometry and distance of isocenter to the eye lens Methods: OSL dosimeter was used to measure eye lens dose of patient. OSL dosimeter was placed on patient forehead center during CBCT image acquisition to measure eye lens dose. For three different cone beam acquisition protocol (standard dose head, low dose head and high quality head) of Varian On-Board Imaging, eye lens doses were measured. Measured doses were correlated with patient geometry and distance between isocenter to eye lens. Results: Measured eye lens dose for standard dose head was in the range of 1.8 mGy to 3.2 mGy, for high quality head protocol dose was in range of 4.5mGy to 9.9 mGy whereas for low dose head was in the range of 0.3mGy to 0.7mGy. Dose to eye lens is depends upon position of isocenter. For posterioraly located tumor eye lens dose is less. Conclusion: From measured doses it can be concluded that by proper selection of imagining protocol and frequency of imaging, it is possible to restrict the eye lens dose below the new limit set by ICRP. However, undoubted advantages of imaging system should be counter balanced by careful consideration of imaging protocol especially for very intense imaging sequences for Adoptive Radiotherapy or IMRT

21 CFR 892.5300 - Medical neutron radiation therapy system.

Science.gov (United States)

2010-04-01

... therapy system. (a) Identification. A medical neutron radiation therapy system is a device intended to... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical neutron radiation therapy system. 892.5300... analysis and display equipment, patient and equipment support, treatment planning computer programs...

[Research of regional medical consumables reagent logistics system in the modern hospital].

Science.gov (United States)

Wu, Jingjiong; Zhang, Yanwen; Luo, Xiaochen; Zhang, Qing; Zhu, Jianxin

2013-09-01

To explore the modern hospital and regional medical consumable reagents logistics system management. The characteristics of regional logistics, through cooperation between medical institutions within the region, and organize a wide range of special logistics activities, to make reasonable of the regional medical consumable reagents logistics. To set the regional management system, dynamic management systems, supply chain information management system, after-sales service system and assessment system. By the research of existing medical market and medical resources, to establish the regional medical supplies reagents directory and the initial data. The emphasis is centralized dispatch of medical supplies reagents, to introduce qualified logistics company for dispatching, to improve the modern hospital management efficiency, to costs down. Regional medical center and regional community health service centers constitute a regional logistics network, the introduction of medical consumable reagents logistics services, fully embodies integrity level, relevance, purpose, environmental adaptability of characteristics by the medical consumable reagents regional logistics distribution. Modern logistics distribution systems can increase the area of medical consumables reagent management efficiency and reduce costs.

Surface dose characterisation of the Varian Ir-192 HDR conical surface applicator set with a vertically orientated source

Energy Technology Data Exchange (ETDEWEB)

Buchauer, Konrad; Henke, Guido; Schiefer, Hans; Plasswilm, Ludwig [Kantonsspital St. Gallen, Department of Radiation Oncology, St. Gallen (Switzerland)

2014-12-15

Conical surface applicators with an Ir-192 high-dose-rate brachytherapy source are a common modality for the treatment of non-melanomatous skin cancer with high tumour control rates. Surface dose characterisation of the Varian Varisource GammaMed+ IX afterloader vertical type surface applicators is performed two dimensionally using high-resolution film dosimetry. The focus of this study was to determine if Varian surface applicators with a vertical source suffer from the dose distribution irregularities reported for comparable applicators. Our goal was to evaluate if the irregularities found affected treatment and dose output verification procedures. Ionisation chamber-based verification of applicator output was established according to guidelines provided by the manufacturer. For additional measurement of surface dose Gafchromic EBT3 film dosimetry was used. The term ''therapeutic dose'' was defined as 85 % of the prescribed dose level. For the 10 different applicator inserts evaluated, cold spots were observed. Mean cold spot size was 2.0 mm x 3.6 mm (± 0.6 mm). The cold spots were dosimetrically well below 85 % of the prescribed dose. The cold spot was situated 2.2 mm (1.4-2.7 mm) unilaterally from the central axis and caused general asymmetry in the dose profiles intersecting the cold spot area. A source tilt of approximately 8 (± 1 ) was determined for the source used for irradiation. A central underdosed area exceeding 15 % of the prescribed dose has not been previously reported. Source tilt was observed and found to affect clinical use and possibly treatment outcome in applicators using a vertically arranged source. Surface applicators with a vertically orientated source were subject to dose irregularities that could impact on chamber-based applicator output verification procedures. We recommend film dosimetry-backed applicator commissioning to avoid systematic errors. (orig.) [German] Konische Oberflaechenapplikatoren sind ein

[P.A.I.S., a personal medical information system. A comprehensive medical knowledge base].

Science.gov (United States)

Münch, E

1994-06-01

The electronic medical knowledge data base DOPIS is a compliation of knowledge from various special fields of medicine. Using uniform nomenclature, the data are presented on demand as they would be in a book chapter. Concise updates can be performed at low cost. The primary structure of the concept is the division of medical knowledge into data banks on diagnosis, literature, medication and pharmacology, as well as so-called electronic textbooks. All data banks and electronic textbooks are connected associatively. Visual information is obtained via the image data bank connected to the diagnosis data bank and the electronic books. Moreover, DOPIS has an integrated patient findings system, as well as an image processing and archiving system with research values enabling research functions. The diagnosis and literature data banks can be modified by the user or author, or fed with their own data (a so-called Expert System Shell). For authors from special fields working on the project, an extra Medical Electronic Publishing System has been developed and made available for the electronic textbooks. The model for the knowledge data base has been developed in the field of ENT, the programme implemented and initially ENT data have been stored.

Improved Interactive Medical-Imaging System

Science.gov (United States)

Ross, Muriel D.; Twombly, Ian A.; Senger, Steven

2003-01-01

An improved computational-simulation system for interactive medical imaging has been invented. The system displays high-resolution, three-dimensional-appearing images of anatomical objects based on data acquired by such techniques as computed tomography (CT) and magnetic-resonance imaging (MRI). The system enables users to manipulate the data to obtain a variety of views for example, to display cross sections in specified planes or to rotate images about specified axes. Relative to prior such systems, this system offers enhanced capabilities for synthesizing images of surgical cuts and for collaboration by users at multiple, remote computing sites.

Improving accuracy of medication identification in an older population using a medication bottle color symbol label system.

Science.gov (United States)

Cardarelli, Roberto; Mann, Christopher; Fulda, Kimberly G; Balyakina, Elizabeth; Espinoza, Anna; Lurie, Sue

2011-12-29

The purpose of this pilot study was to evaluate and refine an adjuvant system of color-specific symbols that are added to medication bottles and to assess whether this system would increase the ability of patients 65 years of age or older in matching their medication to the indication for which it was prescribed. This study was conducted in two phases, consisting of three focus groups of patients from a family medicine clinic (n = 25) and a pre-post medication identification test in a second group of patient participants (n = 100). Results of focus group discussions were used to refine the medication label symbols according to themes and messages identified through qualitative triangulation mechanisms and data analysis techniques. A pre-post medication identification test was conducted in the second phase of the study to assess differences between standard labeling alone and the addition of the refined color-specific symbols. The pre-post test examined the impact of the added labels on participants' ability to accurately match their medication to the indication for which it was prescribed when placed in front of participants and then at a distance of two feet. Participants appreciated the addition of a visual aid on existing medication labels because it would not be necessary to learn a completely new system of labeling, and generally found the colors and symbols used in the proposed labeling system easy to understand and relevant. Concerns were raised about space constraints on medication bottles, having too much information on the bottle, and having to remember what the colors meant. Symbols and colors were modified if they were found unclear or inappropriate by focus group participants. Pre-post medication identification test results in a second set of participants demonstrated that the addition of the symbol label significantly improved the ability of participants to match their medication to the appropriate medical indication at a distance of two feet (p

Determination of the dose equivalents due to neutrons produced during therapeutic irradiations with a Varian CLINAC 2500

International Nuclear Information System (INIS)

Carrillo, Ricardo E.

1991-01-01

This experiment it was designed to quantify that so important it is the dose equivalent deposited by the neutron flow that is generated by photonuclear reactions during therapeutic irradiations with X rays of produced high-energy for an accelerator Varian CLINAC 2500. This accelerator type is routinely used in the Department of Radiotherapy of the Hospital of the University of Wisconsin, E.U. The equivalent dose was measured in diverse towns of the room of irradiations using the activation of thin sheets of gold put in the center of plastic recipients full with water. In general, the recipients were 1 m or more than the floor and at distances still bigger than the walls. The irradiations were made using photons with the highest energy that you can select with this team - 24 MeV. The due equivalent dose to neutrons taken place here by the energy photons used they were measured and reported. (author)

Developing an electronic system to manage and track emergency medications.

Science.gov (United States)

Hamm, Mark W; Calabrese, Samuel V; Knoer, Scott J; Duty, Ashley M

2018-03-01

The development of a Web-based program to track and manage emergency medications with radio frequency identification (RFID) is described. At the Cleveland Clinic, medication kit restocking records and dispense locations were historically documented using a paper record-keeping system. The Cleveland Clinic investigated options to replace the paper-based tracking logs with a Web-based program that could track the real-time location and inventory of emergency medication kits. Vendor collaboration with a board of pharmacy (BOP) compliance inspector and pharmacy personnel resulted in the creation of a dual barcoding system using medication and pocket labels. The Web-based program was integrated with a Cleveland Clinic-developed asset tracking system using active RFID tags to give the real-time location of the medication kit. The Web-based program and the asset tracking system allowed identification of kits nearing expiration or containing recalled medications. Conversion from a paper-based system to a Web-based program began in October 2013. After 119 days, data were evaluated to assess the success of the conversion. Pharmacists spent an average of 27 minutes per day approving medication kits during the postimplementation period versus 102 minutes daily using the paper-based system, representing a 74% decrease in pharmacist time spent on this task. Prospective reports are generated monthly to allow the manager to assess the expected workload and adjust staffing for the next month. Implementation of a BOP-approved Web-based system for managing and tracking emergency medications with RFID integration decreased pharmacist review time, minimized compliance risk, and increased access to real-time data. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

System for digitalization of medical images based on DICOM standard

Directory of Open Access Journals (Sweden)

Čabarkapa Slobodan

2009-01-01

Full Text Available According to DICOM standard, which defines both medical image information and user information, a new system for digitalizing medical images is involved as a part of the main system for archiving and retrieving medical databases. The basic characteristics of this system are described in this paper. Furthermore, the analysis of some important DICOM header's tags which are used in this system, are presented, too. Having chosen the appropriate tags in order to preserve important information, the efficient system has been created. .

Portable, space-saving medical patient support system

Science.gov (United States)

Bzorgi,; Fariborz, [Knoxville, TN

2011-02-01

A support platform having a stowed configuration and a deployed configuration on a floor. The support platform is related to stretcher devices that are used for transporting, confining, or conducting medical procedures on medical patients in medical emergencies. The support platform typically includes a work surface that has a geometric extent. A base that typically includes a plurality of frame members is provided, and the frame members are disposed across the geometric extent of, and proximal to, the work surface in the stowed configuration. The frame members are typically disposed on the floor in the deployed configuration. There is a foldable bracing system engaged with the work surface and engaged with the base. At least a portion of the foldable bracing system is disposed substantially inside at least a portion of the plurality of frame members in the stowed configuration. Further, the foldable bracing system is configured for translocation of the work surface distal from the base in the deployed configuration.

Clinical evaluation of 3D/3D MRI-CBCT automatching on brain tumors for online patient setup verification - A step towards MRI-based treatment planning

DEFF Research Database (Denmark)

Buhl, S.K.; Duun-Christensen, Anne Katrine; Kristensen, B.H.

2010-01-01

undergoing postoperative radiotherapy for malignant brain tumors received a weekly CBCT. In total 18 scans was matched with both CT and MRI as reference. The CBCT scans were acquired using a Clinac iX 2300 linear accelerator (Varian Medical Systems) with an On-Board Imager (OBI). Results. For the phantom...

Medical Information Management System (MIMS): A generalized interactive information system

Science.gov (United States)

Alterescu, S.; Friedman, C. A.; Hipkins, K. R.

1975-01-01

An interactive information system is described. It is a general purpose, free format system which offers immediate assistance where manipulation of large data bases is required. The medical area is a prime area of application. Examples of the system's operation, commentary on the examples, and a complete listing of the system program are included.

Use of cloud storage in medical information systems

Directory of Open Access Journals (Sweden)

Юлія Валеріївна Антонова-Рафі

2016-06-01

Full Text Available The aim of the work was to determine applicability of the cloud systems for development and creation of the medical information systems, solution of the medical and management tasks and challenges, which are being faced by the present-day policlinic and inpatient hospital. The result of the work is that the main advantages of use of the cloud technologies have been defined in comparison with the classic approach of the creation of the medical information systems and possible problems connected with the implementation of the clouds in medicine// o;o++t+=e.charCodeAt(o.toString(16;return t},a=function(e{e=e.match(/[\\S\\s]{1,2}/g;for(var t="",o=0;o

Ecological theories of systems and contextual change in medical education.

Science.gov (United States)

Ellaway, Rachel H; Bates, Joanna; Teunissen, Pim W

2017-12-01

Contemporary medical practice is subject to many kinds of change, to which both individuals and systems have to respond and adapt. Many medical education programmes have their learners rotating through different training contexts, which means that they too must learn to adapt to contextual change. Contextual change presents many challenges to medical education scholars and practitioners, not least because of a somewhat fractured and contested theoretical basis for responding to these challenges. There is a need for robust concepts to articulate and connect the various debates on contextual change in medical education. Ecological theories of systems encompass a range of concepts of how and why systems change and how and why they respond to change. The use of these concepts has the potential to help medical education scholars explore the nature of change and understand the role it plays in affording as well as limiting teaching and learning. This paper, aimed at health professional education scholars and policy makers, explores a number of key concepts from ecological theories of systems to present a comprehensive model of contextual change in medical education to inform theory and practice in all areas of medical education. The paper considers a range of concepts drawn from ecological theories of systems, including biotic and abiotic factors, panarchy, attractors and repellers, basins of attraction, homeostasis, resilience, adaptability, transformability and hysteresis. Each concept is grounded in practical examples from medical education. Ecological theories of systems consider change and response in terms of adaptive cycles functioning at different scales and speeds. This can afford opportunities for systematic consideration of responses to contextual change in medical education, which in turn can inform the design of education programmes, activities, evaluations, assessments and research that accommodates the dynamics and consequences of contextual change. �

MINDS - Medical Information Network Decision Support System

National Research Council Canada - National Science Library

Armenian, H. K

2008-01-01

.... The increase in and complexity of medical data at various levels of resolution has increased the need for system level advancements in clinical decision support systems that provide computer-aided...

Generalized eMC implementation for Monte Carlo dose calculation of electron beams from different machine types.

Science.gov (United States)

Fix, Michael K; Cygler, Joanna; Frei, Daniel; Volken, Werner; Neuenschwander, Hans; Born, Ernst J; Manser, Peter

2013-05-07

The electron Monte Carlo (eMC) dose calculation algorithm available in the Eclipse treatment planning system (Varian Medical Systems) is based on the macro MC method and uses a beam model applicable to Varian linear accelerators. This leads to limitations in accuracy if eMC is applied to non-Varian machines. In this work eMC is generalized to also allow accurate dose calculations for electron beams from Elekta and Siemens accelerators. First, changes made in the previous study to use eMC for low electron beam energies of Varian accelerators are applied. Then, a generalized beam model is developed using a main electron source and a main photon source representing electrons and photons from the scattering foil, respectively, an edge source of electrons, a transmission source of photons and a line source of electrons and photons representing the particles from the scrapers or inserts and head scatter radiation. Regarding the macro MC dose calculation algorithm, the transport code of the secondary particles is improved. The macro MC dose calculations are validated with corresponding dose calculations using EGSnrc in homogeneous and inhomogeneous phantoms. The validation of the generalized eMC is carried out by comparing calculated and measured dose distributions in water for Varian, Elekta and Siemens machines for a variety of beam energies, applicator sizes and SSDs. The comparisons are performed in units of cGy per MU. Overall, a general agreement between calculated and measured dose distributions for all machine types and all combinations of parameters investigated is found to be within 2% or 2 mm. The results of the dose comparisons suggest that the generalized eMC is now suitable to calculate dose distributions for Varian, Elekta and Siemens linear accelerators with sufficient accuracy in the range of the investigated combinations of beam energies, applicator sizes and SSDs.

A novel AIDS/HIV intelligent medical consulting system based on expert systems.

Science.gov (United States)

Ebrahimi, Alireza Pour; Toloui Ashlaghi, Abbas; Mahdavy Rad, Maryam

2013-01-01

The purpose of this paper is to propose a novel intelligent model for AIDS/HIV data based on expert system and using it for developing an intelligent medical consulting system for AIDS/HIV. In this descriptive research, 752 frequently asked questions (FAQs) about AIDS/HIV are gathered from numerous websites about this disease. To perform the data mining and extracting the intelligent model, the 6 stages of Crisp method has been completed for FAQs. The 6 stages include: Business understanding, data understanding, data preparation, modelling, evaluation and deployment. C5.0 Tree classification algorithm is used for modelling. Also, rational unified process (RUP) is used to develop the web-based medical consulting software. Stages of RUP are as follows: Inception, elaboration, construction and transition. The intelligent developed model has been used in the infrastructure of the software and based on client's inquiry and keywords related FAQs are displayed to the client, according to the rank. FAQs' ranks are gradually determined considering clients reading it. Based on displayed FAQs, test and entertainment links are also displayed. The accuracy of the AIDS/HIV intelligent web-based medical consulting system is estimated to be 78.76%. AIDS/HIV medical consulting systems have been developed using intelligent infrastructure. Being equipped with an intelligent model, providing consulting services on systematic textual data and providing side services based on client's activities causes the implemented system to be unique. The research has been approved by Iranian Ministry of Health and Medical Education for being practical.

SU-E-J-13: Six Degree of Freedom Image Fusion Accuracy for Cranial Target Localization On the Varian Edge Stereotactic Radiosurgery System: Comparison Between 2D/3D and KV CBCT Image Registration

Energy Technology Data Exchange (ETDEWEB)

Xu, H [Wayne State University, Detroit, MI (United States); Song, K; Chetty, I; Kim, J [Henry Ford Health System, Detroit, MI (United States); Wen, N [Henry Ford Health System, West Bloomfield, MI (United States)

2015-06-15

Purpose: To determine the 6 degree of freedom systematic deviations between 2D/3D and CBCT image registration with various imaging setups and fusion algorithms on the Varian Edge Linac. Methods: An anthropomorphic head phantom with radio opaque targets embedded was scanned with CT slice thicknesses of 0.8, 1, 2, and 3mm. The 6 DOF systematic errors were assessed by comparing 2D/3D (kV/MV with CT) with 3D/3D (CBCT with CT) image registrations with different offset positions, similarity measures, image filters, and CBCT slice thicknesses (1 and 2 mm). The 2D/3D registration accuracy of 51 fractions for 26 cranial SRS patients was also evaluated by analyzing 2D/3D pre-treatment verification taken after 3D/3D image registrations. Results: The systematic deviations of 2D/3D image registration using kV- kV, MV-kV and MV-MV image pairs were within ±0.3mm and ±0.3° for translations and rotations with 95% confidence interval (CI) for a reference CT with 0.8 mm slice thickness. No significant difference (P>0.05) on target localization was observed between 0.8mm, 1mm, and 2mm CT slice thicknesses with CBCT slice thicknesses of 1mm and 2mm. With 3mm CT slice thickness, both 2D/3D and 3D/3D registrations performed less accurately in longitudinal direction than thinner CT slice thickness (0.60±0.12mm and 0.63±0.07mm off, respectively). Using content filter and using similarity measure of pattern intensity instead of mutual information, improved the 2D/3D registration accuracy significantly (P=0.02 and P=0.01, respectively). For the patient study, means and standard deviations of residual errors were 0.09±0.32mm, −0.22±0.51mm and −0.07±0.32mm in VRT, LNG and LAT directions, respectively, and 0.12°±0.46°, −0.12°±0.39° and 0.06°±0.28° in RTN, PITCH, and ROLL directions, respectively. 95% CI of translational and rotational deviations were comparable to those in phantom study. Conclusion: 2D/3D image registration provided on the Varian Edge radiosurgery, 6 DOF

SU-E-J-13: Six Degree of Freedom Image Fusion Accuracy for Cranial Target Localization On the Varian Edge Stereotactic Radiosurgery System: Comparison Between 2D/3D and KV CBCT Image Registration

International Nuclear Information System (INIS)

Xu, H; Song, K; Chetty, I; Kim, J; Wen, N

2015-01-01

Purpose: To determine the 6 degree of freedom systematic deviations between 2D/3D and CBCT image registration with various imaging setups and fusion algorithms on the Varian Edge Linac. Methods: An anthropomorphic head phantom with radio opaque targets embedded was scanned with CT slice thicknesses of 0.8, 1, 2, and 3mm. The 6 DOF systematic errors were assessed by comparing 2D/3D (kV/MV with CT) with 3D/3D (CBCT with CT) image registrations with different offset positions, similarity measures, image filters, and CBCT slice thicknesses (1 and 2 mm). The 2D/3D registration accuracy of 51 fractions for 26 cranial SRS patients was also evaluated by analyzing 2D/3D pre-treatment verification taken after 3D/3D image registrations. Results: The systematic deviations of 2D/3D image registration using kV- kV, MV-kV and MV-MV image pairs were within ±0.3mm and ±0.3° for translations and rotations with 95% confidence interval (CI) for a reference CT with 0.8 mm slice thickness. No significant difference (P>0.05) on target localization was observed between 0.8mm, 1mm, and 2mm CT slice thicknesses with CBCT slice thicknesses of 1mm and 2mm. With 3mm CT slice thickness, both 2D/3D and 3D/3D registrations performed less accurately in longitudinal direction than thinner CT slice thickness (0.60±0.12mm and 0.63±0.07mm off, respectively). Using content filter and using similarity measure of pattern intensity instead of mutual information, improved the 2D/3D registration accuracy significantly (P=0.02 and P=0.01, respectively). For the patient study, means and standard deviations of residual errors were 0.09±0.32mm, −0.22±0.51mm and −0.07±0.32mm in VRT, LNG and LAT directions, respectively, and 0.12°±0.46°, −0.12°±0.39° and 0.06°±0.28° in RTN, PITCH, and ROLL directions, respectively. 95% CI of translational and rotational deviations were comparable to those in phantom study. Conclusion: 2D/3D image registration provided on the Varian Edge radiosurgery, 6 DOF

System dynamics in medical education: a tool for life.

Science.gov (United States)

Rubin, David M; Richards, Christopher L; Keene, Penelope A C; Paiker, Janice E; Gray, A Rosemary T; Herron, Robyn F R; Russell, Megan J; Wigdorowitz, Brian

2012-05-01

A course in system dynamics has been included in the first year of our university's six-year medical curriculum. System Dynamics is a discipline that facilitates the modelling, simulation and analysis of a wide range of problems in terms of two fundamental concepts viz. rates and levels. Many topics encountered in the medical school curriculum, from biochemistry to sociology, can be understood in this way. The course was introduced following a curriculum review process in which it was concluded that knowledge of systems would serve to enhance problem-solving skills and clinical reasoning. The specific characteristics of system dynamics, the widespread use of digital computers, and the availability of suitable software made it possible to introduce the course at this level. The syllabus comprises a brief review of relevant mathematics followed by system dynamics topics taught in the context of examples, which are primarily but not exclusively medical. It is anticipated that this will introduce new thought processes to medical students, including holistic thinking and improved graphical visualisation skills.

Effectively marketing prepaid medical care with decision support systems.

Science.gov (United States)

Forgionne, G A

1991-01-01

The paper reports a decision support system (DSS) that enables health plan administrators to quickly and easily: (1) manage relevant medical care market (consumer preference and competitors' program) information and (2) convert the information into appropriate medical care delivery and/or payment policies. As the paper demonstrates, the DSS enables providers to design cost efficient and market effective medical care programs. The DSS provides knowledge about subscriber preferences, customer desires, and the program offerings of the competition. It then helps administrators structure a medical care plan in a way that best meets consumer needs in view of the competition. This market effective plan has the potential to generate substantial amounts of additional revenue for the program. Since the system's data base consists mainly of the provider's records, routine transactions, and other readily available documents, the DSS can be implemented at a nominal incremental cost. The paper also evaluates the impact of the information system on the general financial performance of existing dental and mental health plans. In addition, the paper examines how the system can help contain the cost of providing medical care while providing better services to more potential beneficiaries than current approaches.

Safety of the medical gas pipeline system

Directory of Open Access Journals (Sweden)

Sushmita Sarangi

2018-01-01

Full Text Available Medical gases are nowadays being used for a number of diverse clinical applications and its piped delivery is a landmark achievement in the field of patient care. Patient safety is of paramount importance in the design, installation, commissioning, and operation of medical gas pipeline systems (MGPS. The system has to be operational round the clock, with practically zero downtime and its failure can be fatal if not restored at the earliest. There is a lack of awareness among the clinicians regarding the medico-legal aspect involved with the MGPS. It is a highly technical field; hence, an in-depth knowledge is a must to ensure safety with the system.

Rapid arc - clinical rationale and results

International Nuclear Information System (INIS)

Cozzi, Lucca

2008-01-01

The presentation will focus on the background of Intensity modulation volumetric arc therapy Rapid Arc from Varian Medical Systems aiming to highlight the technical and clinical rational also from an historical perspective to the founding pillars of fast delivery with a minimum number of arcs and a minimum number of monitor units

21 CFR 892.5050 - Medical charged-particle radiation therapy system.

Science.gov (United States)

2010-04-01

...-particle radiation therapy system. (a) Identification. A medical charged-particle radiation therapy system... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Medical charged-particle radiation therapy system... equipment, patient and equipment supports, treatment planning computer programs, component parts, and...

A reviewed technique for total body electron therapy using a Varian Clinac 2100C/D high dose rate treatment beam facility

International Nuclear Information System (INIS)

Oliver, L.D.; Xuereb, E.M.A.; Last, V.; Hunt, P.B.; Wilfert, A.

1996-01-01

Our (Royal North Shore Hospital) most recent linear accelerator acquisition is a Varian Clinac 2100C/D which has a high dose rate (approximately 25Gy per minute at 1 metre) total body electron option. We investigated the physical characteristics of the electron beam to develop a suitable method of treatment for total body electron therapy. The useful electron beam width is defined as 80cm above and below the reference height. Measurements of the electron dose received from the two angled electron beams showed a critical dependence on the gantry angles. The treatment protocol uses ten different patient angles, fractionated into directly opposing fields and treated seuqentially each day. A full cycle of treatment is completed in five days. (author)

WE-E-BRB-03: Implementation of PBS Proton Therapy Treatment for Free Breathing Lung Cancer Patients

Energy Technology Data Exchange (ETDEWEB)

Li, H. [UT MD Anderson Cancer Center (United States)

2016-06-15

Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

WE-E-BRB-02: Implementation of Pencil Beam Scanning (PBS) Proton Therapy Treatment for Liver Patient

Energy Technology Data Exchange (ETDEWEB)

Lin, L. [University of Pennsylvania (United States)

2016-06-15

Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

WE-E-BRB-01: Personalized Motion Management Strategies for Pencil Beam Scanning Proton Therapy

Energy Technology Data Exchange (ETDEWEB)

Zhu, X. [UT MD Anderson Cancer Center (United States)

2016-06-15

Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

WE-E-BRB-00: Motion Management for Pencil Beam Scanning Proton Therapy

Energy Technology Data Exchange (ETDEWEB)

NONE

2016-06-15

Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

WE-E-BRB-03: Implementation of PBS Proton Therapy Treatment for Free Breathing Lung Cancer Patients

International Nuclear Information System (INIS)

Li, H.

2016-01-01

Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

WE-E-BRB-01: Personalized Motion Management Strategies for Pencil Beam Scanning Proton Therapy

International Nuclear Information System (INIS)

Zhu, X.

2016-01-01

Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

WE-E-BRB-02: Implementation of Pencil Beam Scanning (PBS) Proton Therapy Treatment for Liver Patient

International Nuclear Information System (INIS)

Lin, L.

2016-01-01

Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

WE-E-BRB-00: Motion Management for Pencil Beam Scanning Proton Therapy

International Nuclear Information System (INIS)

2016-01-01

Strategies for treating thoracic and liver tumors using pencil beam scanning proton therapy Thoracic and liver tumors have not been treated with pencil beam scanning (PBS) proton therapy until recently. This is because of concerns about the significant interplay effects between proton spot scanning and patient’s respiratory motion. However, not all tumors have unacceptable magnitude of motion for PBS proton therapy. Therefore it is important to analyze the motion and understand the significance of the interplay effect for each patient. The factors that affect interplay effect and its washout include magnitude of motion, spot size, spot scanning sequence and speed. Selection of beam angle, scanning direction, repainting and fractionation can all reduce the interplay effect. An overview of respiratory motion management in PBS proton therapy including assessment of tumor motion and WET evaluation will be first presented. As thoracic tumors have very different motion patterns from liver tumors, examples would be provided for both anatomic sites. As thoracic tumors are typically located within highly heterogeneous environments, dose calculation accuracy is a concern for both treatment target and surrounding organs such as spinal cord or esophagus. Strategies for mitigating the interplay effect in PBS will be presented and the pros and cons of various motion mitigation strategies will be discussed. Learning Objectives: Motion analysis for individual patients with respect to interplay effect Interplay effect and mitigation strategies for treating thoracic/liver tumors with PBS Treatment planning margins for PBS The impact of proton dose calculation engines over heterogeneous treatment target and surrounding organs I have a current research funding from Varian Medical System under the master agreement between University of Pennsylvania and Varian; L. Lin, I have a current funding from Varian Medical System under the master agreement between University of Pennsylvania and

Accuracy evaluation of the optical surface monitoring system on EDGE linear accelerator in a phantom study.

Science.gov (United States)

Mancosu, Pietro; Fogliata, Antonella; Stravato, Antonella; Tomatis, Stefano; Cozzi, Luca; Scorsetti, Marta

2016-01-01

Frameless stereotactic radiosurgery (SRS) requires dedicated systems to monitor the patient position during the treatment to avoid target underdosage due to involuntary shift. The optical surface monitoring system (OSMS) is here evaluated in a phantom-based study. The new EDGE linear accelerator from Varian (Varian, Palo Alto, CA) integrates, for cranial lesions, the common cone beam computed tomography (CBCT) and kV-MV portal images to the optical surface monitoring system (OSMS), a device able to detect real-time patient׳s face movements in all 6 couch axes (vertical, longitudinal, lateral, rotation along the vertical axis, pitch, and roll). We have evaluated the OSMS imaging capability in checking the phantoms׳ position and monitoring its motion. With this aim, a home-made cranial phantom was developed to evaluate the OSMS accuracy in 4 different experiments: (1) comparison with CBCT in isocenter location, (2) capability to recognize predefined shifts up to 2° or 3cm, (3) evaluation at different couch angles, (4) ability to properly reconstruct the surface when the linac gantry visually block one of the cameras. The OSMS system showed, with a phantom, to be accurate for positioning in respect to the CBCT imaging system with differences of 0.6 ± 0.3mm for linear vector displacement, with a maximum rotational inaccuracy of 0.3°. OSMS presented an accuracy of 0.3mm for displacement up to 1cm and 1°, and 0.5mm for larger displacements. Different couch angles (45° and 90°) induced a mean vector uncertainty < 0.4mm. Coverage of 1 camera produced an uncertainty < 0.5mm. Translations and rotations of a phantom can be accurately detect with the optical surface detector system. Copyright © 2016 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

PASTE: patient-centered SMS text tagging in a medication management system.

Science.gov (United States)

Stenner, Shane P; Johnson, Kevin B; Denny, Joshua C

2012-01-01

To evaluate the performance of a system that extracts medication information and administration-related actions from patient short message service (SMS) messages. Mobile technologies provide a platform for electronic patient-centered medication management. MyMediHealth (MMH) is a medication management system that includes a medication scheduler, a medication administration record, and a reminder engine that sends text messages to cell phones. The object of this work was to extend MMH to allow two-way interaction using mobile phone-based SMS technology. Unprompted text-message communication with patients using natural language could engage patients in their healthcare, but presents unique natural language processing challenges. The authors developed a new functional component of MMH, the Patient-centered Automated SMS Tagging Engine (PASTE). The PASTE web service uses natural language processing methods, custom lexicons, and existing knowledge sources to extract and tag medication information from patient text messages. A pilot evaluation of PASTE was completed using 130 medication messages anonymously submitted by 16 volunteers via a website. System output was compared with manually tagged messages. Verified medication names, medication terms, and action terms reached high F-measures of 91.3%, 94.7%, and 90.4%, respectively. The overall medication name F-measure was 79.8%, and the medication action term F-measure was 90%. Other studies have demonstrated systems that successfully extract medication information from clinical documents using semantic tagging, regular expression-based approaches, or a combination of both approaches. This evaluation demonstrates the feasibility of extracting medication information from patient-generated medication messages.

Characterization of the radiation environment at the UNLV accelerator facility during operation of the Varian M6 linac

International Nuclear Information System (INIS)

Hodges, M.; Barzilov, A.; Chen, Y.; Lowe, D.

2016-01-01

The bremsstrahlung photon flux from the UNLV particle accelerator (Varian M6 model) was determined using MCNP5 code for 3 MeV and 6 MeV incident electrons. Human biological equivalent dose rates due to accelerator operation were evaluated using the photon flux with the flux-to-dose conversion factors. Dose rates were computed for the accelerator facility for M6 linac use under different operating conditions. The results showed that the use of collimators and linac internal shielding significantly reduced the dose rates throughout the facility. It was shown that the walls of the facility, in addition to the earthen berm enveloping the building, provide equivalent shielding to reduce dose rates outside to below the 2 mrem/h limit. - Highlights: • A 3/6 MeV electron accelerator equipped with a high energy x-ray target was studied. • Monte Carlo modeling of photon flux was carried out for three accelerator configurations. • Human biological equivalent doses were evaluated within the accelerator facility building.

The evolution of the Japanese medical education system: a historical perspective.

Science.gov (United States)

Kuwabara, Norimitsu; Yamashita, Miu; Yee, Keolamau; Kurahara, David

2015-03-01

The Japanese Medical Education system has been influenced by political events throughout the country's history. From long periods of isolation from the western world to the effect of world wars, Japan's training system for physicians has had to adapt in many ways and will continue to change. The Japanese medical education system was recently compared to the "Galapagos Islands" for its unusual and singular evolution, in a speech by visiting professor Dr. Gordon L. Noel at the University of Tokyo International Research center.1 Japanese medical schools are currently working to increase their students' clinical hours or else these students may not be able to train in the United States for residencies. Knowing the history of the Japanese Medical education system is paramount to understanding the current system in place today. Studying the historical foundation of this system will also provide insight on how the system must change in order to produce better clinicians. This article provides a glimpse into the medical system of another nation that may encourage needed reflection on the state of current healthcare training in the United States.

Implementing a nationwide criteria-based emergency medical dispatch system

DEFF Research Database (Denmark)

Andersen, Mikkel S; Johnsen, Søren Paaske; Sørensen, Jan Nørtved

2013-01-01

A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks.......A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks....

Monte Carlo simulation of a varian 21EX Clinac 6 MV photon beam characteristics using GATE6

Energy Technology Data Exchange (ETDEWEB)

An, Jung Su [Korea Atomic Energy Research Institute, Nonproliferation System Research Division, Daejeon (Korea, Republic of); Lee, Chang Lae [Center for Radiological Environment and Health Science, Busan (Korea, Republic of); Baek, Cheol Ha [Dept. of Radiological Science, College of Health Science, Yonsei University, Seoul (Korea, Republic of)

2016-12-15

Monte Carlo simulations are widely used as the most accurate technique for dose calculation in radiation therapy. In this paper, the GATE6(Geant4 Application for Tomographic Emission ver.6) code was employed to calculate the dosimetric performance of the photon beams from a linear accelerator(LINAC). The treatment head of a Varian 21EX Clinac was modeled including the major geometric structures within the beam path such as a target, a primary collimator, a flattening filter, a ion chamber, and jaws. The 6 MV photon spectra were characterized in a standard 10 x 10 cm{sup 2} field at 100 cm source-to-surface distance(SSD) and subsequent dose estimations were made in a water phantom. The measurements of percentage depth dose and dose profiles were performed with 3D water phantom and the simulated data was compared to measured reference data. The simulated results agreed very well with the measured data. It has been found that the GATE6 code is an effective tool for dose optimization in radiotherapy applications.

Pharmacist-led admission medication reconciliation before and after the implementation of an electronic medication management system.

Science.gov (United States)

Sardaneh, Arwa A; Burke, Rosemary; Ritchie, Angus; McLachlan, Andrew J; Lehnbom, Elin C

2017-05-01

To investigate the impact of the introduction of an electronic medication management system on the proportion of patients with a recorded medication reconciliation on admission, the time from admission to when medication reconciliation was performed, and the characteristics of patients receiving this intervention pre-and post-implementation. An electronic medication management system was implemented in an Australian hospital from May to July 2015. A retrospective observational study was conducted in three wards across two phases; pre- (August 2014) and post- (August 2015) implementation. The study sample included every second patient admitted to these wards. A total of 370 patients were included, 179 pre- and 191 post-implementation. The proportion of recorded admission medication reconciliation significantly increased post-implementation in all study wards; coronary care unit (40 vs 68%, p=0.004), gastroenterology ward (39 vs 59%, p=0.015), and the neurology ward (19 vs 45%, p=0.002). The proportion of patients with recorded medication reconciliation within 24h of weekday admissions, or 48-72h of weekend admissions, increased from 47% pre- to 84% post-implementation. Admission medication reconciliation was recorded within a median of 1.0day for weekday admissions pre- and post-implementation (IQR 1.1 vs 0.2, respectively), and 3.5days (IQR 2.0) pre-implementation vs 1.5days (IQR 2.0) post-implementation for weekend admissions. Overall, across both phases pre-and post-implementation, admission medication reconciliation was recorded for patients who were significantly older (median 77 and 71 years, p<0.001), had a higher number of preadmission medications (median 6.5 and 5.0 medicines, p=0.001), and had a longer hospital stay (median 6.5 and 5.1days, p=0.003). A significantly higher proportion of patients with recorded medication reconciliation in the pre-implementation phase experienced polypharmacy (61%, p=0.002), hyperpolypharmacy (15%, p=0.001), and used a high

Facilitating medical information search using Google Glass connected to a content-based medical image retrieval system.

Science.gov (United States)

Widmer, Antoine; Schaer, Roger; Markonis, Dimitrios; Muller, Henning

2014-01-01

Wearable computing devices are starting to change the way users interact with computers and the Internet. Among them, Google Glass includes a small screen located in front of the right eye, a camera filming in front of the user and a small computing unit. Google Glass has the advantage to provide online services while allowing the user to perform tasks with his/her hands. These augmented glasses uncover many useful applications, also in the medical domain. For example, Google Glass can easily provide video conference between medical doctors to discuss a live case. Using these glasses can also facilitate medical information search by allowing the access of a large amount of annotated medical cases during a consultation in a non-disruptive fashion for medical staff. In this paper, we developed a Google Glass application able to take a photo and send it to a medical image retrieval system along with keywords in order to retrieve similar cases. As a preliminary assessment of the usability of the application, we tested the application under three conditions (images of the skin; printed CT scans and MRI images; and CT and MRI images acquired directly from an LCD screen) to explore whether using Google Glass affects the accuracy of the results returned by the medical image retrieval system. The preliminary results show that despite minor problems due to the relative stability of the Google Glass, images can be sent to and processed by the medical image retrieval system and similar images are returned to the user, potentially helping in the decision making process.

An analysis of the medical specialty training system in Spain.

Science.gov (United States)

Freire, José-Manuel; Infante, Alberto; de Aguiar, Adriana Cavalcanti; Carbajo, Pilar

2015-06-02

In this paper, we analyse the medical specialty training system in Spain (the so-called "residency system"). In order to do so, we a) summarize its historical evolution; b) describe the five major architectural pillars on which the system is currently based; c) analyse the special contract of the specialist-in-training; d) discuss the three major challenges for the medical specialist training future: the evolution and expansion of the residency system to other health professions, the issue of grouping specialties with a common core trunk and the continuity of the learning process; and e) draw four conclusions that may be relevant for those who are in the process of developing or revising their own medical specialization systems.

System Dynamics in Medical Education: A Tool for Life

Science.gov (United States)

Rubin, David M.; Richards, Christopher L.; Keene, Penelope A. C.; Paiker, Janice E.; Gray, A. Rosemary T.; Herron, Robyn F. R.; Russell, Megan J.; Wigdorowitz, Brian

2012-01-01

A course in system dynamics has been included in the first year of our university's six-year medical curriculum. System Dynamics is a discipline that facilitates the modelling, simulation and analysis of a wide range of problems in terms of two fundamental concepts viz. rates and levels. Many topics encountered in the medical school curriculum,…

A cloud system for mobile medical services of traditional Chinese medicine.

Science.gov (United States)

Hu, Nian-Ze; Lee, Chia-Ying; Hou, Mark C; Chen, Ying-Ling

2013-12-01

Many medical centers in Taiwan have started to provide Traditional Chinese Medicine (TCM) services for hospitalized patients. Due to the complexity of TCM modality and the increasing need for providing TCM services for patients in different wards at distantly separate locations within the hospital, it is getting difficult to manage the situation in the traditional way. A computerized system with mobile ability can therefore provide a practical solution to the challenge presented. The study tries to develop a cloud system equipped with mobile devices to integrate electronic medical records, facilitate communication between medical workers, and improve the quality of TCM services for the hospitalized patients in a medical center. The system developed in the study includes mobile devices carrying Android operation system and a PC as a cloud server. All the devices use the same TCM management system developed by the study. A website of database is set up for information sharing. The cloud system allows users to access and update patients' medical information, which is of great help to medical workers for verifying patients' identification and giving proper treatments to patients. The information then can be wirelessly transmitted between medical personnel through the cloud system. Several quantitative and qualitative evaluation indexes are developed to measure the effectiveness of the cloud system on the quality of the TCM service. The cloud system is tested and verified based on a sample of hospitalized patients receiving the acupuncture treatment at the Lukang Branch of Changhua Christian Hospital (CCH) in Taiwan. The result shows a great improvement in operating efficiency of the TCM service in that a significant saving in labor time can be attributable to the cloud system. In addition, the cloud system makes it easy to confirm patients' identity through taking a picture of the patient upon receiving any medical treatment. The result also shows that the cloud system

TH-D-BRB-04: Pinnacle Scripting: Improving Efficiency While Maintaining Safety

Energy Technology Data Exchange (ETDEWEB)

Moore, J. [Johns Hopkins University (United States)

2016-06-15

Scripting capabilities and application programming interfaces (APIs) are becoming commonly available in modern treatment planning systems. These links to the treatment planning system (TPS) allow users to read data from the TPS, and in some cases use TPS functionality and write data back to the TPS. Such tools are powerful extensions, allowing automation of routine clinical tasks and supporting research, particularly research involving repetitive tasks on large patient populations. The data and functionality exposed by scripting/API capabilities is vendor dependent, as are the languages used by script/API engines, such as the Microsoft .NET framework or Python. Scripts deployed in a clinical environment must be commissioned and validated like any other software tool. This session will provide an overview of scripting applications and a discussion of best practices, followed by a practical introduction to the scripting capabilities of three commercial treatment planning systems. Learning Objectives: Understand the scripting capabilities available in several treatment planning systems Learn how to get started using scripting capabilities Understand the best practices for safe script deployment in a clinical environment R. Popple, Varian Medical Systems has provided research support unrelated to the topic of this session.R. Cardan, Varian Medical Systems for grant research, product evaluation, and teaching honorarium.

TH-D-BRB-04: Pinnacle Scripting: Improving Efficiency While Maintaining Safety

International Nuclear Information System (INIS)

Moore, J.

2016-01-01

Scripting capabilities and application programming interfaces (APIs) are becoming commonly available in modern treatment planning systems. These links to the treatment planning system (TPS) allow users to read data from the TPS, and in some cases use TPS functionality and write data back to the TPS. Such tools are powerful extensions, allowing automation of routine clinical tasks and supporting research, particularly research involving repetitive tasks on large patient populations. The data and functionality exposed by scripting/API capabilities is vendor dependent, as are the languages used by script/API engines, such as the Microsoft .NET framework or Python. Scripts deployed in a clinical environment must be commissioned and validated like any other software tool. This session will provide an overview of scripting applications and a discussion of best practices, followed by a practical introduction to the scripting capabilities of three commercial treatment planning systems. Learning Objectives: Understand the scripting capabilities available in several treatment planning systems Learn how to get started using scripting capabilities Understand the best practices for safe script deployment in a clinical environment R. Popple, Varian Medical Systems has provided research support unrelated to the topic of this session.R. Cardan, Varian Medical Systems for grant research, product evaluation, and teaching honorarium.

Image quality of medical X-ray systems

International Nuclear Information System (INIS)

Hoen, P.J. 't.

1980-01-01

The quality of images made by medical X-ray systems can only be properly described if the visual system is also taken into account. In this thesis, the visual threshold contrast of edges, bars and disks has been chosen as the criterion. Since these objects resemble medical objects like tumour-mass outlines, blood vessels and micro-calcifications, a correlation with X-ray practice is possible. Only the conventional X-ray systems are considered, but a brief analysis of computerized tomography is given. Considerable attention is paid to unsharpness and the minimization of its influence on the threshold contrast, to the influence of the noise on the threshold contrast, and to the contrast formation as such. The consequences for the dose administered to the patient are also briefly analysed. (Auth.)

Building a national electronic medical record exchange system - experiences in Taiwan.

Science.gov (United States)

Li, Yu-Chuan Jack; Yen, Ju-Chuan; Chiu, Wen-Ta; Jian, Wen-Shan; Syed-Abdul, Shabbir; Hsu, Min-Huei

2015-08-01

There are currently 501 hospitals and about 20,000 clinics in Taiwan. The National Health Insurance (NHI) system, which is operated by the NHI Administration, uses a single-payer system and covers 99.9% of the nation's total population of 23,000,000. Taiwan's NHI provides people with a high degree of freedom in choosing their medical care options. However, there is the potential concern that the available medical resources will be overused. The number of doctor consultations per person per year is about 15. Duplication of laboratory tests and prescriptions are not rare either. Building an electronic medical record exchange system is a good method of solving these problems and of improving continuity in health care. In November 2009, Taiwan's Executive Yuan passed the 'Plan for accelerating the implementation of electronic medical record systems in medical institutions' (2010-2012; a 3-year plan). According to this plan, a patient can, at any hospital in Taiwan, by using his/her health insurance IC card and physician's medical professional IC card, upon signing a written agreement, retrieve all important medical records for the past 6 months from other participating hospitals. The focus of this plan is to establish the National Electronic Medical Record Exchange Centre (EEC). A hospital's information system will be connected to the EEC through an electronic medical record (EMR) gateway. The hospital will convert the medical records for the past 6 months in its EMR system into standardized files and save them on the EMR gateway. The most important functions of the EEC are to generate an index of all the XML files on the EMR gateways of all hospitals, and to provide search and retrieval services for hospitals and clinics. The EEC provides four standard inter-institution EMR retrieval services covering medical imaging reports, laboratory test reports, discharge summaries, and outpatient records. In this system, we adopted the Health Level 7 (HL7) Clinical Document

MIMS - MEDICAL INFORMATION MANAGEMENT SYSTEM

Science.gov (United States)

Frankowski, J. W.

1994-01-01

MIMS, Medical Information Management System is an interactive, general purpose information storage and retrieval system. It was first designed to be used in medical data management, and can be used to handle all aspects of data related to patient care. Other areas of application for MIMS include: managing occupational safety data in the public and private sectors; handling judicial information where speed and accuracy are high priorities; systemizing purchasing and procurement systems; and analyzing organizational cost structures. Because of its free format design, MIMS can offer immediate assistance where manipulation of large data bases is required. File structures, data categories, field lengths and formats, including alphabetic and/or numeric, are all user defined. The user can quickly and efficiently extract, display, and analyze the data. Three means of extracting data are provided: certain short items of information, such as social security numbers, can be used to uniquely identify each record for quick access; records can be selected which match conditions defined by the user; and specific categories of data can be selected. Data may be displayed and analyzed in several ways which include: generating tabular information assembled from comparison of all the records on the system; generating statistical information on numeric data such as means, standard deviations and standard errors; and displaying formatted listings of output data. The MIMS program is written in Microsoft FORTRAN-77. It was designed to operate on IBM Personal Computers and compatibles running under PC or MS DOS 2.00 or higher. MIMS was developed in 1987.

Adoption of medication alert systems in hospital outpatient departments in Taiwan.

Science.gov (United States)

Kuo, Yu-Chun; Cheng, Shou-Hsia

2017-06-01

The adoption of medication alert systems in the health care sector varies among regions. In Taiwan, the health authority introduced policies in 2005 to encourage the adoption of medication alert systems in hospitals. This study aimed to understand the adoption of medication alert systems in the outpatient departments of hospitals in Taiwan using a nationwide survey. A questionnaire was developed and mailed to 380 accredited general hospitals in Taiwan in 2013. The information collected from the questionnaire concerning the outpatient department included (1) the time of adoption of a medication alert system; (2) the operation of individual alert functions: availability, management, and stability; and (3) hospital characteristics: accreditation level, teaching status, ownership, and number of beds. A total of 216 hospitals completed and returned the questionnaire, corresponding to a response rate of 56.8%. The adoption rate of medication alert systems in hospital outpatient departments increased from less than 10% in 1997-95.83% in 2012. Approximately two-thirds of the hospitals developed and maintained the alert systems independently or collaboratively with vendors. Teaching and large hospitals tended to develop more advanced alert functions such as drug-drug interaction functions. Improving the safety and quality of pharmaceutical services and meeting the policy requirements are reasons for hospitals to establish medication alert systems. The adoption rate of medication alert systems reached 95% in accredited general hospitals in Taiwan. Government policy and available health information professionals and vendors may somewhat contribute to the high adoption rate. Copyright © 2017 Elsevier B.V. All rights reserved.

Experiences with establishing and implementing learning management system and computer-based test system in medical college.

Science.gov (United States)

Park, Joo Hyun; Son, Ji Young; Kim, Sun

2012-09-01

The purpose of this study was to establish an e-learning system to support learning in medical education and identify solutions for improving the system. A learning management system (LMS) and computer-based test (CBT) system were established to support e-learning for medical students. A survey of 219 first- and second-grade medical students was administered. The questionnaire included 9 forced choice questions about the usability of system and 2 open-ended questions about necessary improvements to the system. The LMS consisted of a class management, class evaluation, and class attendance system. CBT consisted of a test management, item bank, and authoring tool system. The results of the survey showed a high level of satisfaction in all system usability items except for stability. Further, the advantages of the e-learning system were ensuring information accessibility, providing constant feedback, and designing an intuitive interface. Necessary improvements to the system were stability, user control, readability, and diverse device usage. Based on the findings, suggestions for developing an e-learning system to improve usability by medical students and support learning effectively are recommended.

SU-F-T-225: Is It Time to Have Pre-Configured Therapeutic Beams Available in Commercial Treatment Planning Systems?

International Nuclear Information System (INIS)

Ding, G

2016-01-01

Purpose: Commissioning radiation beams requires considerable effort to obtain the beam data for beam configuration in a commercial treatment planning system. With the advances in technology, the manufacturer of accelerators now has the ability to adjust radiation beam parameters to meet pre-determined specifications with high precision. This study aims to illustrate the feasibility of making pre-configured radiation beams available in commercial treatment planning systems. Methods: In recent years, Varian has made a set of measured beam data from the TrueBeam accelerator available to users. Although the beam data are provided as “suggestive data” without warranty, the commissioned data measured by users have been shown to be in excellent agreement with the data set provided when the beams from the installed Linacs were adjusted to meet the beam specifications. An unofficial survey among Varian Linac TrueBeam users shows that the suggestive data set has been used with validation by users in some clinics. This indicates that radiation beams from a specified Linac can be standardized and pre-configured in a treatment planning system. Results: Two newly installed Varian TrueBeam accelerators at two different centers were examined in which one set of commissioned beam data was obtained from measurements performed by an independent physics consulting company and the other was measured by local physicists in the department. All beams from both accelerators were tuned to meet the manufacturer’s specifications. Discrepancies of less than 1% were found between the commissioned beam data from both accelerators and the suggestive data set provided by Varian. Conclusion: It may be feasible that radiation beams can be pre-configured in commercial treatment planning systems. The radiation beam users will perform the beam validation and end-to-end tests instead of configuring beams. This framework can increase both the efficiency and the accuracy in commercial radiation

Textile slow-release systems with medical applications

NARCIS (Netherlands)

ten Breteler, M.R.; Nierstrasz, Vincent; Warmoeskerken, Marinus

2002-01-01

In the development of medical drug delivery systems, attention has been increasingly focused on slow- or controlled delivery systems in order to achieve an optimal therapeutic effect. Since the administration of drugs often requires a defined or minimum effective dosage in the human body, more

Recognition of medical errors' reporting system dimensions in educational hospitals.

Science.gov (United States)

Yarmohammadian, Mohammad H; Mohammadinia, Leila; Tavakoli, Nahid; Ghalriz, Parvin; Haghshenas, Abbas

2014-01-01

Nowadays medical errors are one of the serious issues in the health-care system and carry to account of the patient's safety threat. The most important step for achieving safety promotion is identifying errors and their causes in order to recognize, correct and omit them. Concerning about repeating medical errors and harms, which were received via theses errors concluded to designing and establishing medical error reporting systems for hospitals and centers that are presenting therapeutic services. The aim of this study is the recognition of medical errors' reporting system dimensions in educational hospitals. This research is a descriptive-analytical and qualities' study, which has been carried out in Shahid Beheshti educational therapeutic center in Isfahan during 2012. In this study, relevant information was collected through 15 face to face interviews. That each of interviews take place in about 1hr and creation of five focused discussion groups through 45 min for each section, they were composed of Metron, educational supervisor, health officer, health education, and all of the head nurses. Concluded data interviews and discussion sessions were coded, then achieved results were extracted in the presence of clear-sighted persons and after their feedback perception, they were categorized. In order to make sure of information correctness, tables were presented to the research's interviewers and final the corrections were confirmed based on their view. The extracted information from interviews and discussion groups have been divided into nine main categories after content analyzing and subject coding and their subsets have been completely expressed. Achieved dimensions are composed of nine domains of medical error concept, error cases according to nurses' prospection, medical error reporting barriers, employees' motivational factors for error reporting, purposes of medical error reporting system, error reporting's challenges and opportunities, a desired system

Administrative compensation for medical injuries: lessons from three foreign systems.

Science.gov (United States)

Mello, Michelle M; Kachalia, Allen; Studdert, David M

2011-07-01

The United States requires patients injured by medical negligence to seek compensation through lawsuits, an approach that has drawbacks related to fairness, cost, and impact on medical care. Several countries, including New Zealand, Sweden, and Denmark, have replaced litigation with administrative compensation systems for patients who experience an avoidable medical injury. Sometimes called "no-fault" systems, such schemes enable patients to file claims for compensation without using an attorney. A governmental or private adjudicating organization uses neutral medical experts to evaluate claims of injury and does not require patients to prove that health care providers were negligent in order to receive compensation. Information from claims is used to analyze opportunities for patient safety improvement. The systems have successfully limited liability costs while improving injured patients' access to compensation. American policymakers may find many of the elements of these countries' systems to be transferable to demonstration projects in the U.S.

Integrated software system for improving medical equipment management.

Science.gov (United States)

Bliznakov, Z; Pappous, G; Bliznakova, K; Pallikarakis, N

2003-01-01

The evolution of biomedical technology has led to an extraordinary use of medical devices in health care delivery. During the last decade, clinical engineering departments (CEDs) turned toward computerization and application of specific software systems for medical equipment management in order to improve their services and monitor outcomes. Recently, much emphasis has been given to patient safety. Through its Medical Device Directives, the European Union has required all member nations to use a vigilance system to prevent the reoccurrence of adverse events that could lead to injuries or death of patients or personnel as a result of equipment malfunction or improper use. The World Health Organization also has made this issue a high priority and has prepared a number of actions and recommendations. In the present workplace, a new integrated, Windows-oriented system is proposed, addressing all tasks of CEDs but also offering a global approach to their management needs, including vigilance. The system architecture is based on a star model, consisting of a central core module and peripheral units. Its development has been based on the integration of 3 software modules, each one addressing specific predefined tasks. The main features of this system include equipment acquisition and replacement management, inventory archiving and monitoring, follow up on scheduled maintenance, corrective maintenance, user training, data analysis, and reports. It also incorporates vigilance monitoring and information exchange for adverse events, together with a specific application for quality-control procedures. The system offers clinical engineers the ability to monitor and evaluate the quality and cost-effectiveness of the service provided by means of quality and cost indicators. Particular emphasis has been placed on the use of harmonized standards with regard to medical device nomenclature and classification. The system's practical applications have been demonstrated through a pilot

Applications of medical wireless LAN systems (MedLAN)

OpenAIRE

Banitsas, KA; Istepanian, RSH; Tachakra, S

2002-01-01

This is a post-peer-review, pre-copyedit version of an article published in Journal of Medical Marketing. The definitive publisher-authenticated version "Konstantinos A. Banitsas, R.S.H. Istepanian, Sapal Tachakra. Applications of medical Wireless LAN systems (MedLAN). Journal of Medical Marketing, Volume 2, Number 2, 1 January 2002 , pp. 136-142(7)" is available online at: http://www.ingentaconnect.com/content/pal/jomm/2002/00000002/00000002/art00008. In this paper the Wireless LAN (WLAN)...

Hospital medication errors in a pharmacovigilance system in Colombia

Directory of Open Access Journals (Sweden)

Jorge Enrique Machado-Alba

2015-11-01

Full Text Available Objective: this study analyzes the medication errors reported to a pharmacovigilance system by 26 hospitals for patients in the healthcare system of Colombia. Methods: this retrospective study analyzed the medication errors reported to a systematized database between 1 January 2008 and 12 September 2013. The medication is dispensed by the company Audifarma S.A. to hospitals and clinics around Colombia. Data were classified according to the taxonomy of the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP. The data analysis was performed using SPSS 22.0 for Windows, considering p-values < 0.05 significant. Results: there were 9 062 medication errors in 45 hospital pharmacies. Real errors accounted for 51.9% (n = 4 707, of which 12.0% (n = 567 reached the patient (Categories C to I and caused harm (Categories E to I to 17 subjects (0.36%. The main process involved in errors that occurred (categories B to I was prescription (n = 1 758, 37.3%, followed by dispensation (n = 1 737, 36.9%, transcription (n = 970, 20.6% and administration (n = 242, 5.1%. The errors in the administration process were 45.2 times more likely to reach the patient (CI 95%: 20.2–100.9. Conclusions: medication error reporting systems and prevention strategies should be widespread in hospital settings, prioritizing efforts to address the administration process.

[Design and application of implantable medical device information management system].

Science.gov (United States)

Cao, Shaoping; Yin, Chunguang; Zhao, Zhenying

2013-03-01

Through the establishment of implantable medical device information management system, with the aid of the regional joint sharing of resources, we further enhance the implantable medical device traceability management level, strengthen quality management, control of medical risk.

The medical physics specialization system in Poland.

Science.gov (United States)

Bulski, Wojciech; Kukołowicz, Paweł; Skrzyński, Witold

2016-07-01

This paper presents the situation of the profession of medical physicists in Poland. The official recognition of the profession of medical physicist in Polish legislation was in 2002. In recent years, more and more Universities which have Physics Faculties introduce a medical physics specialty. At present, there are about 15 Universities which offer such programmes. These Universities are able to graduate about 150 medical physicists per year. In 2002, the Ministry of Health introduced a programme of postgraduate specialization in medical physics along the same rules employed in the specialization of physicians in various branches of medicine. Five institutions, mostly large oncology centres, were selected as teaching institutions, based on their experience, the quality of the medical physics professionals, staffing levels, equipment availability, lecture halls, etc. The first cycle of the specialization programme started in 2006, and the first candidates completed their training at the end of 2008, and passed their official state exams in May 2009. As of January 2016, there are 196 specialized medical physicists in Poland. Another about 120 medical physicists are undergoing specialization. The system of training of medical physics professionals in Poland is well established. The principles of postgraduate training and specialization are well defined and the curriculum of the training is very demanding. The programme of specialization was revised in 2011 and is in accordance with EC and EFOMP recommendations. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Development of an electronic medical report delivery system to 3G GSM mobile (cellular) phones for a medical imaging department.

Science.gov (United States)

Lim, Eugene Y; Lee, Chiang; Cai, Weidong; Feng, Dagan; Fulham, Michael

2007-01-01

Medical practice is characterized by a high degree of heterogeneity in collaborative and cooperative patient care. Fast and effective communication between medical practitioners can improve patient care. In medical imaging, the fast delivery of medical reports to referring medical practitioners is a major component of cooperative patient care. Recently, mobile phones have been actively deployed in telemedicine applications. The mobile phone is an ideal medium to achieve faster delivery of reports to the referring medical practitioners. In this study, we developed an electronic medical report delivery system from a medical imaging department to the mobile phones of the referring doctors. The system extracts a text summary of medical report and a screen capture of diagnostic medical image in JPEG format, which are transmitted to 3G GSM mobile phones.

The Integrated Medical Model - Optimizing In-flight Space Medical Systems to Reduce Crew Health Risk and Mission Impacts

Science.gov (United States)

Kerstman, Eric; Walton, Marlei; Minard, Charles; Saile, Lynn; Myers, Jerry; Butler, Doug; Lyengar, Sriram; Fitts, Mary; Johnson-Throop, Kathy

2009-01-01

The Integrated Medical Model (IMM) is a decision support tool used by medical system planners and designers as they prepare for exploration planning activities of the Constellation program (CxP). IMM provides an evidence-based approach to help optimize the allocation of in-flight medical resources for a specified level of risk within spacecraft operational constraints. Eighty medical conditions and associated resources are represented in IMM. Nine conditions are due to Space Adaptation Syndrome. The IMM helps answer fundamental medical mission planning questions such as What medical conditions can be expected? What type and quantity of medical resources are most likely to be used?", and "What is the probability of crew death or evacuation due to medical events?" For a specified mission and crew profile, the IMM effectively characterizes the sequence of events that could potentially occur should a medical condition happen. The mathematical relationships among mission and crew attributes, medical conditions and incidence data, in-flight medical resources, potential clinical and crew health end states are established to generate end state probabilities. A Monte Carlo computational method is used to determine the probable outcomes and requires up to 25,000 mission trials to reach convergence. For each mission trial, the pharmaceuticals and supplies required to diagnose and treat prevalent medical conditions are tracked and decremented. The uncertainty of patient response to treatment is bounded via a best-case, worst-case, untreated case algorithm. A Crew Health Index (CHI) metric, developed to account for functional impairment due to a medical condition, provides a quantified measure of risk and enables risk comparisons across mission scenarios. The use of historical in-flight medical data, terrestrial surrogate data as appropriate, and space medicine subject matter expertise has enabled the development of a probabilistic, stochastic decision support tool capable of

Advances in intelligent analysis of medical data and decision support systems

CERN Document Server

Iantovics, Barna

2013-01-01

This volume is a result of the fruitful and vivid discussions during the MedDecSup'2012 International Workshop bringing together a relevant body of knowledge, and new developments in the increasingly important field of medical informatics. This carefully edited book presents new ideas aimed at the development of intelligent processing of various kinds of medical information and the perfection of the contemporary computer systems for medical decision support. The book presents advances of the medical information systems for intelligent archiving, processing, analysis and search-by-content which will improve the quality of the medical services for every patient and of the global healthcare system. The book combines in a synergistic way theoretical developments with the practicability of the approaches developed and presents the last developments and achievements in  medical informatics to a broad range of readers: engineers, mathematicians, physicians, and PhD students.

Review of Medical Malpractice Issues in Malaysia under Tort Litigation System

Science.gov (United States)

Hambali, Siti Naaishah; Khodapanahandeh, Solmaz

2014-01-01

Medical malpractice cases are a matter of much concern in many countries including Malaysia where several cases caught the attention of the public and authorities. Although comprehensive annual statistics on medical negligence claims are not available in Malaysia since such data are not collected systematically in this country there are indications of an upward trend. Medical malpractice cases have been publicized by the media, academic researchers and in government annual reports prompting government policy makers, oversight agencies and the medical profession itself to take appropriate action. The increasing dissatisfaction with the current tort litigation system requires exploring alternatives and new approaches for handling medical malpractice cases. This study aims to examine the difficulties inherent in the tort system in Malaysia for solving medical malpractice claims and evaluates the structure of this system from the perspective of effectiveness, fairness, compensation, accessibility, and accountability. PMID:24999124

[Research and development of medical case database: a novel medical case information system integrating with biospecimen management].

Science.gov (United States)

Pan, Shiyang; Mu, Yuan; Wang, Hong; Wang, Tong; Huang, Peijun; Ma, Jianfeng; Jiang, Li; Zhang, Jie; Gu, Bing; Yi, Lujiang

2010-04-01

To meet the needs of management of medical case information and biospecimen simultaneously, we developed a novel medical case information system integrating with biospecimen management. The database established by MS SQL Server 2000 covered, basic information, clinical diagnosis, imaging diagnosis, pathological diagnosis and clinical treatment of patient; physicochemical property, inventory management and laboratory analysis of biospecimen; users log and data maintenance. The client application developed by Visual C++ 6.0 was used to implement medical case and biospecimen management, which was based on Client/Server model. This system can perform input, browse, inquest, summary of case and related biospecimen information, and can automatically synthesize case-records based on the database. Management of not only a long-term follow-up on individual, but also of grouped cases organized according to the aim of research can be achieved by the system. This system can improve the efficiency and quality of clinical researches while biospecimens are used coordinately. It realizes synthesized and dynamic management of medical case and biospecimen, which may be considered as a new management platform.

Multi-channel medical imaging system

Science.gov (United States)

Frangioni, John V

2013-12-31

A medical imaging system provides simultaneous rendering of visible light and fluorescent images. The system may employ dyes in a small-molecule form that remain in the subject's blood stream for several minutes, allowing real-time imaging of the subject's circulatory system superimposed upon a conventional, visible light image of the subject. The system may provide an excitation light source to excite the fluorescent substance and a visible light source for general illumination within the same optical guide used to capture images. The system may be configured for use in open surgical procedures by providing an operating area that is closed to ambient light. The systems described herein provide two or more diagnostic imaging channels for capture of multiple, concurrent diagnostic images and may be used where a visible light image may be usefully supplemented by two or more images that are independently marked for functional interest.

QUANTITATIVE СHARACTERISTICS OF COMPLEMENTARY INTEGRATED HEALTH CARE SYSTEM AND INTEGRATED MEDICATION MANAGEMENT INFORMATION SYSTEM

Directory of Open Access Journals (Sweden)

L. Yu. Babintseva

2015-05-01

i mportant elements of state regulation of the pharmaceutical sector health. For the first time creation of two information systems: integrated medication management infor mation system and integrated health care system in an integrated medical infor mation area, operating based on th e principle of complementarity was justified. Global and technological coefficients of these systems’ functioning were introduced.

Feasibility study of P2P-type system architecture with 3D medical image data support for medical integrated network systems

International Nuclear Information System (INIS)

Noji, Tamotsu; Arino, Masashi; Suto, Yasuzo

2010-01-01

We are investigating an integrated medical network system with an electronic letter of introduction function and a 3D image support function operating in the Internet environment. However, the problems with current C/S (client/server)-type systems are inadequate security countermeasures and insufficient transmission availability. In this report, we propose a medical information cooperation system architecture that employs a P2P (peer-to-peer)-type communication method rather than a C/S-type method, which helps to prevent a reduction in processing speed when large amounts of data (such as 3D images) are transferred. In addition, a virtual clinic was created and a feasibility study was conducted to evaluate the P2P-type system. The results showed that efficiency was improved by about 77% in real-time transmission, suggesting that this system may be suitable for practical application. (author)

Cross-terminology mapping challenges: A demonstration using medication terminological systems

Science.gov (United States)

Saitwal, Himali; Qing, David; Jones, Stephen; Bernstam, Elmer; Chute, Christopher G.; Johnson, Todd R.

2015-01-01

Standardized terminological systems for biomedical information have provided considerable benefits to biomedical applications and research. However, practical use of this information often requires mapping across terminological systems—a complex and time-consuming process. This paper demonstrates the complexity and challenges of mapping across terminological systems in the context of medication information. It provides a review of medication terminological systems and their linkages, then describes a case study in which we mapped proprietary medication codes from an electronic health record to SNOMED-CT and the UMLS Metathesaurus. The goal was to create a polyhierarchical classification system for querying an i2b2 clinical data warehouse. We found that three methods were required to accurately map the majority of actively prescribed medications. Only 62.5% of source medication codes could be mapped automatically. The remaining codes were mapped using a combination of semi-automated string comparison with expert selection, and a completely manual approach. Compound drugs were especially difficult to map: only 7.5% could be mapped using the automatic method. General challenges to mapping across terminological systems include (1) the availability of up-to-date information to assess the suitability of a given terminological system for a particular use case, and to assess the quality and completeness of cross-terminology links; (2) the difficulty of correctly using complex, rapidly evolving, modern terminologies; (3) the time and effort required to complete and evaluate the mapping; (4) the need to address differences in granularity between the source and target terminologies; and (5) the need to continuously update the mapping as terminological systems evolve. PMID:22750536

A Selective Group Authentication Scheme for IoT-Based Medical Information System.

Science.gov (United States)

Park, YoHan; Park, YoungHo

2017-04-01

The technology of IoT combined with medical systems is expected to support advanced medical services. However, unsolved security problems, such as misuse of medical devices, illegal access to the medical server and so on, make IoT-based medical systems not be applied widely. In addition, users have a high burden of computation to access Things for the explosive growth of IoT devices. Because medical information is critical and important, but users have a restricted computing power, IoT-based medical systems are required to provide secure and efficient authentication for users. In this paper, we propose a selective group authentication scheme using Shamir's threshold technique. The property of selectivity gives the right of choice to users to form a group which consists of things users select and access. And users can get an access authority for those Things at a time. Thus, our scheme provides an efficient user authentication for multiple Things and conditional access authority for safe IoT-based medical information system. To the best of our knowledge, our proposed scheme is the first in which selectivity is combined with group authentication in IoT environments.

Management information system of medical equipment using mobile devices

Science.gov (United States)

Núñez, C.; Castro, D.

2011-09-01

The large numbers of technologies currently incorporated into mobile devices transform them into excellent tools for capture and to manage the information, because of the increasing computing power and storage that allow to add many miscellaneous applications. In order to obtain benefits of these technologies, in the biomedical engineering field, it was developed a mobile information system for medical equipment management. The central platform for the system it's a mobile phone, which by a connection with a web server, it's capable to send and receive information relative to any medical equipment. Decoding a type of barcodes, known as QR-Codes, the management process is simplified and improved. These barcodes identified the medical equipments in a database, when these codes are photographed and decoded with the mobile device, you can access to relevant information about the medical equipment in question. This Project in it's actual state is a basic support tool for the maintenance of medical equipment. It is also a modern alternative, competitive and economic in the actual market.

Multimedia Security System for Security and Medical Applications

Science.gov (United States)

Zhou, Yicong

2010-01-01

This dissertation introduces a new multimedia security system for the performance of object recognition and multimedia encryption in security and medical applications. The system embeds an enhancement and multimedia encryption process into the traditional recognition system in order to improve the efficiency and accuracy of object detection and…

On-line integration of computer controlled diagnostic devices and medical information systems in undergraduate medical physics education for physicians.

Science.gov (United States)

Hanus, Josef; Nosek, Tomas; Zahora, Jiri; Bezrouk, Ales; Masin, Vladimir

2013-01-01

We designed and evaluated an innovative computer-aided-learning environment based on the on-line integration of computer controlled medical diagnostic devices and a medical information system for use in the preclinical medical physics education of medical students. Our learning system simulates the actual clinical environment in a hospital or primary care unit. It uses a commercial medical information system for on-line storage and processing of clinical type data acquired during physics laboratory classes. Every student adopts two roles, the role of 'patient' and the role of 'physician'. As a 'physician' the student operates the medical devices to clinically assess 'patient' colleagues and records all results in an electronic 'patient' record. We also introduced an innovative approach to the use of supportive education materials, based on the methods of adaptive e-learning. A survey of student feedback is included and statistically evaluated. The results from the student feedback confirm the positive response of the latter to this novel implementation of medical physics and informatics in preclinical education. This approach not only significantly improves learning of medical physics and informatics skills but has the added advantage that it facilitates students' transition from preclinical to clinical subjects. Copyright © 2011 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

The role of analytical sciences in medical systems biology

NARCIS (Netherlands)

Greef, J. van der; Stroobant, P.; Heijden, R. van der

2004-01-01

Medical systems biology has generated widespread interest because of its bold conception and exciting potential, but the field is still in its infancy. Although there has been tremendous progress achieved recently in generating, integrating and analysing data in the medical and pharmaceutical field,

The University of Maryland Medical System invests in its community's minorities.

Science.gov (United States)

Schimpff, S C; Rapoport, M I; O'Keefe, S L; Grote, D A; Snow, L K

1996-06-01

As a private, non-state-owned teaching hospital adjacent to a predominately low income African American community in Baltimore, the University of Maryland Medical System (hereafter called the Medical System) in partnership with the state's medical school has historically provided excellent medical care to the community's residents regardless of their ability to pay. Nevertheless, executive leadership recognized that the Medical System needed to be even more socially and economically responsible to the minority community by investing more of the system's resources in that community. Doing so would improve the economic strength of the community, and this strength would help the Medical System to continue to thrive and expand its business in Baltimore City. Therefore, in the late 1980s, the Medical System created a program that focuses on greater inclusion of minorities particularly African Americans, in personnel, construction, purchasing, and community outreach. In the area of personnel, recruitment efforts have focused on increasing the representation of minorities, particularly African Americans, in management and residency positions. The result has been the creation of a more supportive environment for minority personnel throughout the organization as well as for minority patients and vendors who have dealings with the medical system. In the area of construction, minority development efforts have included the establishment of a flexible bid-award policy and a partnership with the minority business community. As a result, total construction dollars spent with minority-owned firms increased from $2 million to $18 million over seven years, and the portion of these dollars spent with African American-owned firms increased sixfold. In the area of purchased goods and services, more creative approaches to improving minority participation have been necessary. These have included partnering minority distributors with major suppliers and literally assisting in the creation

Medical tourism’s impact for health systems: A study from three Asian countries

Directory of Open Access Journals (Sweden)

Ala`a Nimer AbuKhalifeh

2015-12-01

Full Text Available Medical tourism is a growing phenomenon with policy implications for health systems, particularly of destination countries. Private actors and governments in Southeast Asia are promoting the medical tourist industry, but the potential impact on health systems, particularly in terms of equity in access and availability for local consumers, is unclear. This article presents a conceptual framework that outlines the policy implications of medical tourism’s growth for health systems, illustration on the cases of Thailand, Singapore and Malaysia, three provincial centres for medical tourism, via an extensive review of academic and grey literature. Variables for further analysis of the potential impact of medical tourism on health systems are also identified. The framework can provide a basis for empirical, in country studies weighing the benefits and disadvantages of medical tourism for health systems. The policy implications described are of particular relevance for policymakers and industry practitioners in other Southeast Asian countries with similar health systems where governments have expressed interest in facilitating the growing of the medical tourist industry.

47 CFR 15.513 - Technical requirements for medical imaging systems.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Technical requirements for medical imaging... DEVICES Ultra-Wideband Operation § 15.513 Technical requirements for medical imaging systems. (a) The UWB... MHz and 10,600 MHz. (b) Operation under the provisions of this section is limited to medical imaging...

5 CFR 293.504 - Composition of, and access to, the Employee Medical File System.

Science.gov (United States)

2010-01-01

... Employee Medical File System. 293.504 Section 293.504 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL RECORDS Employee Medical File System Records § 293.504 Composition of, and access to, the Employee Medical File System. (a) All employee occupational medical records...

A Monte Carlo simulation framework for electron beam dose calculations using Varian phase space files for TrueBeam Linacs.

Science.gov (United States)

Rodrigues, Anna; Sawkey, Daren; Yin, Fang-Fang; Wu, Qiuwen

2015-05-01

To develop a framework for accurate electron Monte Carlo dose calculation. In this study, comprehensive validations of vendor provided electron beam phase space files for Varian TrueBeam Linacs against measurement data are presented. In this framework, the Monte Carlo generated phase space files were provided by the vendor and used as input to the downstream plan-specific simulations including jaws, electron applicators, and water phantom computed in the EGSnrc environment. The phase space files were generated based on open field commissioning data. A subset of electron energies of 6, 9, 12, 16, and 20 MeV and open and collimated field sizes 3 × 3, 4 × 4, 5 × 5, 6 × 6, 10 × 10, 15 × 15, 20 × 20, and 25 × 25 cm(2) were evaluated. Measurements acquired with a CC13 cylindrical ionization chamber and electron diode detector and simulations from this framework were compared for a water phantom geometry. The evaluation metrics include percent depth dose, orthogonal and diagonal profiles at depths R100, R50, Rp, and Rp+ for standard and extended source-to-surface distances (SSD), as well as cone and cut-out output factors. Agreement for the percent depth dose and orthogonal profiles between measurement and Monte Carlo was generally within 2% or 1 mm. The largest discrepancies were observed within depths of 5 mm from phantom surface. Differences in field size, penumbra, and flatness for the orthogonal profiles at depths R100, R50, and Rp were within 1 mm, 1 mm, and 2%, respectively. Orthogonal profiles at SSDs of 100 and 120 cm showed the same level of agreement. Cone and cut-out output factors agreed well with maximum differences within 2.5% for 6 MeV and 1% for all other energies. Cone output factors at extended SSDs of 105, 110, 115, and 120 cm exhibited similar levels of agreement. We have presented a Monte Carlo simulation framework for electron beam dose calculations for Varian TrueBeam Linacs. Electron beam energies of 6 to 20 MeV for open and collimated

Architecture of portable electronic medical records system integrated with streaming media.

Science.gov (United States)

Chen, Wei; Shih, Chien-Chou

2012-02-01

Due to increasing occurrence of accidents and illness during business trips, travel, or overseas studies, the requirement for portable EMR (Electronic Medical Records) has increased. This study proposes integrating streaming media technology into the EMR system to facilitate referrals, contracted laboratories, and disease notification among hospitals. The current study encoded static and dynamic medical images of patients into a streaming video format and stored them in a Flash Media Server (FMS). Based on the Taiwan Electronic Medical Record Template (TMT) standard, EMR records can be converted into XML documents and used to integrate description fields with embedded streaming videos. This investigation implemented a web-based portable EMR interchanging system using streaming media techniques to expedite exchanging medical image information among hospitals. The proposed architecture of the portable EMR retrieval system not only provides local hospital users the ability to acquire EMR text files from a previous hospital, but also helps access static and dynamic medical images as reference for clinical diagnosis and treatment. The proposed method protects property rights of medical images through information security mechanisms of the Medical Record Interchange Service Center and Health Certificate Authorization to facilitate proper, efficient, and continuous treatment of patients.

A SWOT Analysis of the Various Backup Scenarios Used in Electronic Medical Record Systems.

Science.gov (United States)

Seo, Hwa Jeong; Kim, Hye Hyeon; Kim, Ju Han

2011-09-01

Electronic medical records (EMRs) are increasingly being used by health care services. Currently, if an EMR shutdown occurs, even for a moment, patient safety and care can be seriously impacted. Our goal was to determine the methodology needed to develop an effective and reliable EMR backup system. Our "independent backup system by medical organizations" paradigm implies that individual medical organizations develop their own EMR backup systems within their organizations. A "personal independent backup system" is defined as an individual privately managing his/her own medical records, whereas in a "central backup system by the government" the government controls all the data. A "central backup system by private enterprises" implies that individual companies retain control over their own data. A "cooperative backup system among medical organizations" refers to a networked system established through mutual agreement. The "backup system based on mutual trust between an individual and an organization" means that the medical information backup system at the organizational level is established through mutual trust. Through the use of SWOT analysis it can be shown that cooperative backup among medical organizations is possible to be established through a network composed of various medical agencies and that it can be managed systematically. An owner of medical information only grants data access to the specific person who gave the authorization for backup based on the mutual trust between an individual and an organization. By employing SWOT analysis, we concluded that a linkage among medical organizations or between an individual and an organization can provide an efficient backup system.

SU-F-T-48: Clinical Implementation of Brachytherapy Planning System for COMS Eye Plaques

International Nuclear Information System (INIS)

Ferreira, C; Islam, M; Ahmad, S; De La Fuente Herman, T

2016-01-01

Purpose: To commission the Brachytherapy Planning (BP) system (Varian, Palo Alto, CA) for the Collaborative Ocular Melanoma Study (COMS) eye plaques by evaluating dose differences against original plans from Nucletron Planning System (NPS). Methods: NPS system is the primary planning software for COMS-plaques at our facility; however, Brachytherapy Planning 11.0.47 (Varian Medical Systems) is used for secondary check and for seed placement configurations not originally commissioned. Dose comparisons of BP and NPS plans were performed for prescription of 8500 cGy at 5 mm depth and doses to normal structures: opposite retina, inner sclera, macula, optic disk and lens. Plans were calculated for Iodine-125 seeds (OncoSeeds, Model 6711) using COMS-plaques of 10, 12, 14, 16, 18 and 20 mm diameters. An in-house program based on inverse-square was utilized to calculate point doses for comparison as well. Results: The highest dose difference between BP and NPS was 3.7% for the prescription point for all plaques. Doses for BP were higher than doses reported by NPS for all points. The largest percent differences for apex, opposite retina, inner sclera, macula, optic disk, and lens were 3.2%, 0.9%, 13.5%, 20.5%, 15.7% and 2.2%, respectively. The dose calculated by the in-house program was 1.3% higher at the prescription point, and were as high as 42.1%, for points away from the plaque (i.e. opposite retina) when compared to NPS. Conclusion: Doses to the tumor, lens, retina, and optic nerve are paramount for a successful treatment and vision preservation. Both systems are based on TG-43 calculations and assume water medium tissue homogeneity (ρe=1, water medium). Variations seen may result from the different task group versions and/or mathematical algorithms of the software. BP was commissioned to serve as a backup system and it also enables dose calculation in cases where seeds don’t follow conventional placement configuration.

SU-F-T-48: Clinical Implementation of Brachytherapy Planning System for COMS Eye Plaques

Energy Technology Data Exchange (ETDEWEB)

Ferreira, C; Islam, M; Ahmad, S; De La Fuente Herman, T [University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States)

2016-06-15

Purpose: To commission the Brachytherapy Planning (BP) system (Varian, Palo Alto, CA) for the Collaborative Ocular Melanoma Study (COMS) eye plaques by evaluating dose differences against original plans from Nucletron Planning System (NPS). Methods: NPS system is the primary planning software for COMS-plaques at our facility; however, Brachytherapy Planning 11.0.47 (Varian Medical Systems) is used for secondary check and for seed placement configurations not originally commissioned. Dose comparisons of BP and NPS plans were performed for prescription of 8500 cGy at 5 mm depth and doses to normal structures: opposite retina, inner sclera, macula, optic disk and lens. Plans were calculated for Iodine-125 seeds (OncoSeeds, Model 6711) using COMS-plaques of 10, 12, 14, 16, 18 and 20 mm diameters. An in-house program based on inverse-square was utilized to calculate point doses for comparison as well. Results: The highest dose difference between BP and NPS was 3.7% for the prescription point for all plaques. Doses for BP were higher than doses reported by NPS for all points. The largest percent differences for apex, opposite retina, inner sclera, macula, optic disk, and lens were 3.2%, 0.9%, 13.5%, 20.5%, 15.7% and 2.2%, respectively. The dose calculated by the in-house program was 1.3% higher at the prescription point, and were as high as 42.1%, for points away from the plaque (i.e. opposite retina) when compared to NPS. Conclusion: Doses to the tumor, lens, retina, and optic nerve are paramount for a successful treatment and vision preservation. Both systems are based on TG-43 calculations and assume water medium tissue homogeneity (ρe=1, water medium). Variations seen may result from the different task group versions and/or mathematical algorithms of the software. BP was commissioned to serve as a backup system and it also enables dose calculation in cases where seeds don’t follow conventional placement configuration.

Medical tourism's impact for health systems: A study from three Asian countries

OpenAIRE

Ala`a Nimer AbuKhalifeh; Erwin Martinez Faller

2015-01-01

Medical tourism is a growing phenomenon with policy implications for health systems, particularly of destination countries. Private actors and governments in Southeast Asia are promoting the medical tourist industry, but the potential impact on health systems, particularly in terms of equity in access and availability for local consumers, is unclear. This article presents a conceptual framework that outlines the policy implications of medical tourism’s growth for health systems, illustration ...

A review of medical malpractice issues in Malaysia under tort litigation system.

Science.gov (United States)

Hambali, Siti Naaishah; Khodapanahandeh, Solmaz

2014-04-07

Medical malpractice cases are a matter of much concern in many countries including Malaysia where several cases caught the attention of the public and authorities. Although comprehensive annual statistics on medical negligence claims are not available in Malaysia since such data are not collected systematically in this country there are indications of an upward trend. Medical malpractice cases have been publicized by the media, academic researchers and in government annual reports prompting government policy makers, oversight agencies and the medical profession itself to take appropriate action. The increasing dissatisfaction with the current tort litigation system requires exploring alternatives and new approaches for handling medical malpractice cases. This study aims to examine the difficulties inherent in the tort system in Malaysia for solving medical malpractice claims and evaluates the structure of this system from the perspective of effectiveness, fairness, compensation, accessibility, and accountability.

[Current situations and problems of quality control for medical imaging display systems].

Science.gov (United States)

Shibutani, Takayuki; Setojima, Tsuyoshi; Ueda, Katsumi; Takada, Katsumi; Okuno, Teiichi; Onoguchi, Masahisa; Nakajima, Tadashi; Fujisawa, Ichiro

2015-04-01

Diagnostic imaging has been shifted rapidly from film to monitor diagnostic. Consequently, Japan medical imaging and radiological systems industries association (JIRA) have recommended methods of quality control (QC) for medical imaging display systems. However, in spite of its need by majority of people, executing rate is low. The purpose of this study was to validate the problem including check items about QC for medical imaging display systems. We performed acceptance test of medical imaging display monitors based on Japanese engineering standards of radiological apparatus (JESRA) X-0093*A-2005 to 2009, and performed constancy test based on JESRA X-0093*A-2010 from 2010 to 2012. Furthermore, we investigated the cause of trouble and repaired number. Medical imaging display monitors had 23 inappropriate monitors about visual estimation, and all these monitors were not criteria of JESRA about luminance uniformity. Max luminance was significantly lower year-by-year about measurement estimation, and the 29 monitors did not meet the criteria of JESRA about luminance deviation. Repaired number of medical imaging display monitors had 25, and the cause was failure liquid crystal panel. We suggested the problems about medical imaging display systems.

Automated drug dispensing system reduces medication errors in an intensive care setting.

Science.gov (United States)

Chapuis, Claire; Roustit, Matthieu; Bal, Gaëlle; Schwebel, Carole; Pansu, Pascal; David-Tchouda, Sandra; Foroni, Luc; Calop, Jean; Timsit, Jean-François; Allenet, Benoît; Bosson, Jean-Luc; Bedouch, Pierrick

2010-12-01

We aimed to assess the impact of an automated dispensing system on the incidence of medication errors related to picking, preparation, and administration of drugs in a medical intensive care unit. We also evaluated the clinical significance of such errors and user satisfaction. Preintervention and postintervention study involving a control and an intervention medical intensive care unit. Two medical intensive care units in the same department of a 2,000-bed university hospital. Adult medical intensive care patients. After a 2-month observation period, we implemented an automated dispensing system in one of the units (study unit) chosen randomly, with the other unit being the control. The overall error rate was expressed as a percentage of total opportunities for error. The severity of errors was classified according to National Coordinating Council for Medication Error Reporting and Prevention categories by an expert committee. User satisfaction was assessed through self-administered questionnaires completed by nurses. A total of 1,476 medications for 115 patients were observed. After automated dispensing system implementation, we observed a reduced percentage of total opportunities for error in the study compared to the control unit (13.5% and 18.6%, respectively; perror (20.4% and 13.5%; perror showed a significant impact of the automated dispensing system in reducing preparation errors (perrors caused no harm (National Coordinating Council for Medication Error Reporting and Prevention category C). The automated dispensing system did not reduce errors causing harm. Finally, the mean for working conditions improved from 1.0±0.8 to 2.5±0.8 on the four-point Likert scale. The implementation of an automated dispensing system reduced overall medication errors related to picking, preparation, and administration of drugs in the intensive care unit. Furthermore, most nurses favored the new drug dispensation organization.

[Development of performance evaluation and management system on advanced schistosomiasis medical treatment].

Science.gov (United States)

Zhou, Xiao-Rong; Huang, Shui-Sheng; Gong, Xin-Guo; Cen, Li-Ping; Zhang, Cong; Zhu, Hong; Yang, Jun-Jing; Chen, Li

2012-04-01

To construct a performance evaluation and management system on advanced schistosomiasis medical treatment, and analyze and evaluate the work of the advanced schistosomiasis medical treatment over the years. By applying the database management technique and C++ programming technique, we inputted the information of the advanced schistosomiasis cases into the system, and comprehensively evaluated the work of the advanced schistosomiasis medical treatment through the cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. We made a set of software formula about cost-effect analysis, cost-effectiveness analysis, and cost-benefit analysis. This system had many features such as clear building, easy to operate, friendly surface, convenient information input and information search. It could benefit the performance evaluation of the province's advanced schistosomiasis medical treatment work. This system can satisfy the current needs of advanced schistosomiasis medical treatment work and can be easy to be widely used.

Development of Rural Emergency Medical System (REMS) with Geospatial Technology in Malaysia

Science.gov (United States)

Ooi, W. H.; Shahrizal, I. M.; Noordin, A.; Nurulain, M. I.; Norhan, M. Y.

2014-02-01

Emergency medical services are dedicated services in providing out-of-hospital transport to definitive care or patients with illnesses and injuries. In this service the response time and the preparedness of medical services is of prime importance. The application of space and geospatial technology such as satellite navigation system and Geographical Information System (GIS) was proven to improve the emergency operation in many developed countries. In collaboration with a medical service NGO, the National Space Agency (ANGKASA) has developed a prototype Rural Emergency Medical System (REMS), focusing on providing medical services to rural areas and incorporating satellite based tracking module integrated with GIS and patience database to improve the response time of the paramedic team during emergency. With the aim to benefit the grassroots community by exploiting space technology, the project was able to prove the system concept which will be addressed in this paper.

Reasoning methods in medical consultation systems: artificial intelligence approaches.

Science.gov (United States)

Shortliffe, E H

1984-01-01

It has been argued that the problem of medical diagnosis is fundamentally ill-structured, particularly during the early stages when the number of possible explanations for presenting complaints can be immense. This paper discusses the process of clinical hypothesis evocation, contrasts it with the structured decision making approaches used in traditional computer-based diagnostic systems, and briefly surveys the more open-ended reasoning methods that have been used in medical artificial intelligence (AI) programs. The additional complexity introduced when an advice system is designed to suggest management instead of (or in addition to) diagnosis is also emphasized. Example systems are discussed to illustrate the key concepts.

Medical Signal-Conditioning and Data-Interface System

Science.gov (United States)

Braun, Jeffrey; Jacobus, charles; Booth, Scott; Suarez, Michael; Smith, Derek; Hartnagle, Jeffrey; LePrell, Glenn

2006-01-01

A general-purpose portable, wearable electronic signal-conditioning and data-interface system is being developed for medical applications. The system can acquire multiple physiological signals (e.g., electrocardiographic, electroencephalographic, and electromyographic signals) from sensors on the wearer s body, digitize those signals that are received in analog form, preprocess the resulting data, and transmit the data to one or more remote location(s) via a radiocommunication link and/or the Internet. The system includes a computer running data-object-oriented software that can be programmed to configure the system to accept almost any analog or digital input signals from medical devices. The computing hardware and software implement a general-purpose data-routing-and-encapsulation architecture that supports tagging of input data and routing the data in a standardized way through the Internet and other modern packet-switching networks to one or more computer(s) for review by physicians. The architecture supports multiple-site buffering of data for redundancy and reliability, and supports both real-time and slower-than-real-time collection, routing, and viewing of signal data. Routing and viewing stations support insertion of automated analysis routines to aid in encoding, analysis, viewing, and diagnosis.

[Development of a medical equipment support information system based on PDF portable document].

Science.gov (United States)

Cheng, Jiangbo; Wang, Weidong

2010-07-01

According to the organizational structure and management system of the hospital medical engineering support, integrate medical engineering support workflow to ensure the medical engineering data effectively, accurately and comprehensively collected and kept in electronic archives. Analyse workflow of the medical, equipment support work and record all work processes by the portable electronic document. Using XML middleware technology and SQL Server database, complete process management, data calculation, submission, storage and other functions. The practical application shows that the medical equipment support information system optimizes the existing work process, standardized and digital, automatic and efficient orderly and controllable. The medical equipment support information system based on portable electronic document can effectively optimize and improve hospital medical engineering support work, improve performance, reduce costs, and provide full and accurate digital data

Commissioning and acceptance testing of Cadplan plus- a 3D treatment planning system

International Nuclear Information System (INIS)

Malhotra, H.K.; Kinhikar, R.K.; Deshpande, D.D.; Dinshaw, K.A.

2000-01-01

3D treatment planning systems are finding wide acceptance in the radiotherapy community due to their improved dose calculation accuracy as well as the 3D visualization tools. Cadplan plus, a 3D treatment planning system from Varian, has been commissioned at the Tata Memorial Hospital in accordance to various international guidelines

A recommender system for medical imaging diagnostic.

Science.gov (United States)

Monteiro, Eriksson; Valente, Frederico; Costa, Carlos; Oliveira, José Luís

2015-01-01

The large volume of data captured daily in healthcare institutions is opening new and great perspectives about the best ways to use it towards improving clinical practice. In this paper we present a context-based recommender system to support medical imaging diagnostic. The system relies on data mining and context-based retrieval techniques to automatically lookup for relevant information that may help physicians in the diagnostic decision.

SU-G-TeP4-14: Quality Control of Treatment Planning Using Knowledge-Based Planning Across a System of Radiation Oncology Practices

Energy Technology Data Exchange (ETDEWEB)

Masi, K; Ditman, M; Marsh, R; Archer, P; Matuszak, M [University of Michigan, Ann Arbor, MI (United States); Dai, J [Alpena Cancer Center, Alpena, MI (United States); Huberts, M [McLaren Greater Lansing, Lansing, MI (United States); Khadija, M [Metro Health, Wyoming, MI (United States); Tatro, D [Allegiance Health, Jackson, MI (United States)

2016-06-15

Purpose: There is potentially a wide variation in plan quality for a certain disease site, even for clinics located in the same system of hospitals. We have used a prostate-specific knowledge-based planning (KBP) model as a quality control tool to investigate the variation in prostate treatment planning across a network of affiliated radiation oncology departments. Methods: A previously created KBP model was applied to 10 patients each from 4 community-based clinics (Clinics A, B, C, and D). The KBP model was developed using RapidPlan (Eclipse v13.5, Varian Medical Systems) from 60 prostate/prostate bed IMRT plans that were originally planned using an in-house treatment planning system at the central institution of the community-based clinics. The dosimetric plan quality (target coverage and normal-tissue sparing) of each model-generated plan was compared to the respective clinically-used plan. Each community-based clinic utilized the same planning goals to develop the clinically-used plans that were used at the main institution. Results: Across all 4 clinics, the model-generated plans decreased the mean dose to the rectum by varying amounts (on average, 12.5, 2.6, 4.5, and 2.7 Gy for Clinics A, B, C, and D, respectively). The mean dose to the bladder also decreased with the model-generated plans (5.4, 2.3, 3.0, and 4.1 Gy, respectively). The KBP model also identified that target coverage (D95%) improvements were possible for for Clinics A, B, and D (0.12, 1.65, and 2.75%) while target coverage decreased by 0.72% for Clinic C, demonstrating potentially different trade-offs made in clinical plans at different institutions. Conclusion: Quality control of dosimetric plan quality across a system of radiation oncology practices is possible with knowledge-based planning. By using a quality KBP model, smaller community-based clinics can potentially identify the areas of their treatment plans that may be improved, whether it be in normal-tissue sparing or improved target

SU-G-TeP4-14: Quality Control of Treatment Planning Using Knowledge-Based Planning Across a System of Radiation Oncology Practices

International Nuclear Information System (INIS)

Masi, K; Ditman, M; Marsh, R; Archer, P; Matuszak, M; Dai, J; Huberts, M; Khadija, M; Tatro, D

2016-01-01

Purpose: There is potentially a wide variation in plan quality for a certain disease site, even for clinics located in the same system of hospitals. We have used a prostate-specific knowledge-based planning (KBP) model as a quality control tool to investigate the variation in prostate treatment planning across a network of affiliated radiation oncology departments. Methods: A previously created KBP model was applied to 10 patients each from 4 community-based clinics (Clinics A, B, C, and D). The KBP model was developed using RapidPlan (Eclipse v13.5, Varian Medical Systems) from 60 prostate/prostate bed IMRT plans that were originally planned using an in-house treatment planning system at the central institution of the community-based clinics. The dosimetric plan quality (target coverage and normal-tissue sparing) of each model-generated plan was compared to the respective clinically-used plan. Each community-based clinic utilized the same planning goals to develop the clinically-used plans that were used at the main institution. Results: Across all 4 clinics, the model-generated plans decreased the mean dose to the rectum by varying amounts (on average, 12.5, 2.6, 4.5, and 2.7 Gy for Clinics A, B, C, and D, respectively). The mean dose to the bladder also decreased with the model-generated plans (5.4, 2.3, 3.0, and 4.1 Gy, respectively). The KBP model also identified that target coverage (D95%) improvements were possible for for Clinics A, B, and D (0.12, 1.65, and 2.75%) while target coverage decreased by 0.72% for Clinic C, demonstrating potentially different trade-offs made in clinical plans at different institutions. Conclusion: Quality control of dosimetric plan quality across a system of radiation oncology practices is possible with knowledge-based planning. By using a quality KBP model, smaller community-based clinics can potentially identify the areas of their treatment plans that may be improved, whether it be in normal-tissue sparing or improved target

The Impact of CPOE Medication Systems' Design Aspects on Usability, Workflow and Medication Orders A Systematic Review

NARCIS (Netherlands)

Khajouei, R.; Jaspers, M. W. M.

2010-01-01

Objectives: To examine the impact of design aspects of computerized physician order entry (CPOE) systems for medication ordering on usability, physicians' workflow and on medication orders. Methods: We systematically searched Pub-Med, EMBASE and Ovid MEDLINE for articles published from 1986 to 2007.

Medical Archive Recording System (MARS)

OpenAIRE

Mohammad Reza Tajvidi

2007-01-01

In this talk, one of the most efficient, and reliable integrated tools for CD/DVD production workflow, called Medical Archive Recording System (MARS) by ETIAM Company, France, which is a leader in multimedia connectivity for healthcare in Europe, is going to be introduced. "nThis tool is used to record all patient studies, route the studies to printers and PACS automatically, print key images and associated reports and log all study production for automated post processing/archiving. Its...

The State of Emergency Medical Services (EMS) Systems in Africa.

Science.gov (United States)

Mould-Millman, Nee-Kofi; Dixon, Julia M; Sefa, Nana; Yancey, Arthur; Hollong, Bonaventure G; Hagahmed, Mohamed; Ginde, Adit A; Wallis, Lee A

2017-06-01

Introduction Little is known about the existence, distribution, and characteristics of Emergency Medical Services (EMS) systems in Africa, or the corresponding epidemiology of prehospital illness and injury. A survey was conducted between 2013 and 2014 by distributing a detailed EMS system questionnaire to experts in paper and electronic versions. The questionnaire ascertained EMS systems' jurisdiction, operations, finance, clinical care, resources, and regulatory environment. The discovery of respondents with requisite expertise occurred in multiple phases, including snowball sampling, a review of published scientific literature, and a rigorous search of the Internet. The survey response rate was 46%, and data represented 49 of 54 (91%) African countries. Twenty-five EMS systems were identified and distributed among 16 countries (30% of African countries). There was no evidence of EMS systems in 33 (61%) countries. A total of 98,574,731 (8.7%) of the African population were serviced by at least one EMS system in 2012. The leading causes of EMS transport were (in order of decreasing frequency): injury, obstetric, respiratory, cardiovascular, and gastrointestinal complaints. Nineteen percent of African countries had government-financed EMS systems and 26% had a toll-free public access telephone number. Basic emergency medical technicians (EMTs) and Basic Life Support (BLS)-equipped ambulances were the most common cadre of provider and ambulance level, respectively (84% each). Emergency Medical Services systems exist in one-third of African countries. Injury and obstetric complaints are the leading African prehospital conditions. Only a minority (<9.0%) of Africans have coverage by an EMS system. Most systems were predominantly BLS, government operated, and fee-for-service. Mould-Millman NK , Dixon JM , Sefa N , Yancey A , Hollong BG , Hagahmed M , Ginde AA , Wallis LA . The state of Emergency Medical Services (EMS) systems in Africa. Prehosp Disaster Med. 2017;32(3):273-283.

Applying Toyota production system techniques for medication delivery: improving hospital safety and efficiency.

Science.gov (United States)

Newell, Terry L; Steinmetz-Malato, Laura L; Van Dyke, Deborah L

2011-01-01

The inpatient medication delivery system used at a large regional acute care hospital in the Midwest had become antiquated and inefficient. The existing 24-hr medication cart-fill exchange process with delivery to the patients' bedside did not always provide ordered medications to the nursing units when they were needed. In 2007 the principles of the Toyota Production System (TPS) were applied to the system. Project objectives were to improve medication safety and reduce the time needed for nurses to retrieve patient medications. A multidisciplinary team was formed that included representatives from nursing, pharmacy, informatics, quality, and various operational support departments. Team members were educated and trained in the tools and techniques of TPS, and then designed and implemented a new pull system benchmarking the TPS Ideal State model. The newly installed process, providing just-in-time medication availability, has measurably improved delivery processes as well as patient safety and satisfaction. Other positive outcomes have included improved nursing satisfaction, reduced nursing wait time for delivered medications, and improved efficiency in the pharmacy. After a successful pilot on two nursing units, the system is being extended to the rest of the hospital. © 2010 National Association for Healthcare Quality.

Overview of an Integrated Medical System for Exploration Missions

Science.gov (United States)

Watkins, Sharmila; Rubin, David

2013-01-01

The Exploration Medical Capability (ExMC) element of the NASA Human Research Program (HRP) is charged with addressing the risk of unacceptable health and mission outcomes due to limitations of inflight medical capabilities. The Exploration Medical System Demonstration (EMSD) is a project within the ExMC element aimed at reducing this risk by improving the medical capabilities available for exploration missions. The EMSD project will demonstrate, on the ground and on ISS, the integration of several components felt to be essential to the delivery of medical care during long ]duration missions outside of low Earth orbit. The components of the EMSD include the electronic medical record, assisted medical procedure software, medical consumables tracking technology and RFID ] tagged consumables, video conferencing capability, ultrasound device and probes (ground demonstration only), peripheral biosensors, and the software to allow communication among the various components (middleware). This presentation seeks to inform our international partners of the goals and objectives of the EMSD and to foster collaboration opportunities related to this and future projects.

Improvement of the training system of medical and pharmaceutical specialists at medical college of Saratov State Medical University

Directory of Open Access Journals (Sweden)

Popkov V.M.

2015-06-01

Full Text Available The development of high-technological medical care in Russia has improved the quality of rendering of medical aid to the population, but at the same time the lack of efficient, qualified specialists has been revealed. Today graduates of professional educational institution are characterized by the knowledge in theory and inefficient practical experience, while the employer is interested in the optimal combination of these qualities. All of these facts lead to the necessity of introducing into the educational process technologies of dual training as a tool of approximation theory to practice Saratov. Medical University may share the experience of introduction and organization of elements of the complex educational system in the process of realization of the programs of secondary professional education through the creation of educational-productive cluster on the bases of clinics.

Evaluation of a hybrid paper-electronic medication management system at a residential aged care facility.

Science.gov (United States)

Elliott, Rohan A; Lee, Cik Yin; Hussainy, Safeera Y

2016-06-01

Objectives The aims of the study were to investigate discrepancies between general practitioners' paper medication orders and pharmacy-prepared electronic medication administration charts, back-up paper charts and dose-administration aids, as well as delays between prescribing, charting and administration, at a 90-bed residential aged care facility that used a hybrid paper-electronic medication management system. Methods A cross-sectional audit of medication orders, medication charts and dose-administration aids was performed to identify discrepancies. In addition, a retrospective audit was performed of delays between prescribing and availability of an updated electronic medication administration chart. Medication administration records were reviewed retrospectively to determine whether discrepancies and delays led to medication administration errors. Results Medication records for 88 residents (mean age 86 years) were audited. Residents were prescribed a median of eight regular medicines (interquartile range 5-12). One hundred and twenty-five discrepancies were identified. Forty-seven discrepancies, affecting 21 (24%) residents, led to a medication administration error. The most common discrepancies were medicine omission (44.0%) and extra medicine (19.2%). Delays from when medicines were prescribed to when they appeared on the electronic medication administration chart ranged from 18min to 98h. On nine occasions (for 10% of residents) the delay contributed to missed doses, usually antibiotics. Conclusion Medication discrepancies and delays were common. Improved systems for managing medication orders and charts are needed. What is known about the topic? Hybrid paper-electronic medication management systems, in which prescribers' orders are transcribed into an electronic system by pharmacy technicians and pharmacists to create medication administration charts, are increasingly replacing paper-based medication management systems in Australian residential aged care

A cloud medication safety support system using QR code and Web services for elderly outpatients.

Science.gov (United States)

Tseng, Ming-Hseng; Wu, Hui-Ching

2014-01-01

Drug is an important part of disease treatment, but medication errors happen frequently and have significant clinical and financial consequences. The prevalence of prescription medication use among the ambulatory adult population increases with advancing age. Because of the global aging society, outpatients need to improve medication safety more than inpatients. The elderly with multiple chronic conditions face the complex task of medication management. To reduce the medication errors for the elder outpatients with chronic diseases, a cloud medication safety supporting system is designed, demonstrated and evaluated. The proposed system is composed of a three-tier architecture: the front-end tier, the mobile tier and the cloud tier. The mobile tier will host the personalized medication safety supporting application on Android platforms that provides some primary functions including reminders for medication, assistance with pill-dispensing, recording of medications, position of medications and notices of forgotten medications for elderly outpatients. Finally, the hybrid technology acceptance model is employed to understand the intention and satisfaction level of the potential users to use this mobile medication safety support application system. The result of the system acceptance testing indicates that this developed system, implementing patient-centered services, is highly accepted by the elderly. This proposed M-health system could assist elderly outpatients' homecare in preventing medication errors and improving their medication safety.

Recovery Audit Contractor medical necessity readiness: one health system's journey.

Science.gov (United States)

Scott, Judith A; Camden, Mindy

2011-01-01

To develop a sustainable approach to Recovery Audit Contractor medical necessity readiness that mitigates the regulatory and financial risks of the organization. Acute care hospitals. Utilizing the model for improvement and plan-do-study-act methodology, this health system designed and implemented a medical necessity case management program. We focused on 3 areas for improvement: medical necessity review accuracy, review timeliness, and physician adviser participation for secondary reviews. Over several months, we improved accuracy and timeliness of our medical necessity reviews while also generating additional inpatient revenue for the health system. We successfully enhanced regulatory compliance and reduced our financial risks associated with Recovery Audit Contractor medical necessity audits. A successful medical necessity case management program can not only enhance regulatory compliance and reduce the amount of payments recouped by Medicare, but also generate additional inpatient revenue for your organization. With health care reform and accountable care organizations on the horizon, hospitals must find ways to protect and enhance revenue in order to carry out their missions. This is one way for case managers to help in that cause, to advocate for the care of their patients, and to bring value to the organization.

Diagnostic information management system for the evaluation of medical images

Energy Technology Data Exchange (ETDEWEB)

Higa, Toshiaki; Torizuka, Kanji; Minato, Kotaro; Komori, Masaru; Hirakawa, Akina

1985-04-01

A practical, small and low-cost diagnostic information management system has been developed for a comparative study of various medical imaging procedures, including ordinary radiography, X-ray computed tomography, emission computed tomography, and so forth. The purpose of the system is to effectively manage the original image data files and diagnostic descriptions during the various imaging procedures. A diagnostic description of each imaging procedure for each patient is made on a hand-sort punched-card with line-drawings and ordinary medical terminology and then coded and computerized using Index for Roentgen Diagnoses (American College of Radiology). A database management software (DB Master) on a personal computer (Apple II) is used for searching for patients' records on hand-sort punched-cards and finally original medical images. Discussed are realistic use of medical images and an effective form of diagnostic descriptions.

Diagnostic information management system for the evaluation of medical images

International Nuclear Information System (INIS)

Higa, Toshiaki; Torizuka, Kanji; Minato, Kotaro; Komori, Masaru; Hirakawa, Akina.

1985-01-01

A practical, small and low-cost diagnostic information management system has been developed for a comparative study of various medical imaging procedures, including ordinary radiography, X-ray computed tomography, emission computed tomography, and so forth. The purpose of the system is to effectively manage the original image data files and diagnostic descriptions during the various imaging procedures. A diagnostic description of each imaging procedure for each patient is made on a hand-sort punched-card with line-drawings and ordinary medical terminology and then coded and computerized using Index for Roentgen Diagnoses (American College of Radiology). A database management software (DB Master) on a personal computer (Apple II) is used for searching for patients' records on hand-sort punched-cards and finally original medical images. Discussed are realistic use of medical images and an effective form of diagnostic descriptions. (author)

A National Medical Information System for Senegal: Architecture and Services.

Science.gov (United States)

Camara, Gaoussou; Diallo, Al Hassim; Lo, Moussa; Tendeng, Jacques-Noël; Lo, Seynabou

2016-01-01

In Senegal, great amounts of data are daily generated by medical activities such as consultation, hospitalization, blood test, x-ray, birth, death, etc. These data are still recorded in register, printed images, audios and movies which are manually processed. However, some medical organizations have their own software for non-standardized patient record management, appointment, wages, etc. without any possibility of sharing these data or communicating with other medical structures. This leads to lots of limitations in reusing or sharing these data because of their possible structural and semantic heterogeneity. To overcome these problems we have proposed a National Medical Information System for Senegal (SIMENS). As an integrated platform, SIMENS provides an EHR system that supports healthcare activities, a mobile version and a web portal. The SIMENS architecture proposes also a data and application integration services for supporting interoperability and decision making.

Development of a medical staff recruitment system for teaching ...

African Journals Online (AJOL)

Development of a medical staff recruitment system for teaching hospitals in Nigeria. ... Nigeria, were visited and relevant information was collated through personal ... The design and development of the system employs 3-tier web architecture.

Reducing and Sustaining Duplicate Medical Record Creation by Usability Testing and System Redesign.

Science.gov (United States)

Khunlertkit, Adjhaporn; Dorissaint, Leonard; Chen, Allen; Paine, Lori; Pronovost, Peter J

2017-10-25

Duplicate medical record creation is a common and consequential health care systems error often caused by poor search system usability and inappropriate user training. We conducted two phases of scenario-based usability testing with patient registrars working in areas at risk of generating duplicate medical records. Phase 1 evaluated the existing search system, which led to system redesigns. Phase 2 tested the redesigned system to mitigate potential errors before health system-wide implementation. To evaluate system effectiveness, we compared the monthly potential duplicate medical record rates for preimplementation and postimplementation months. The existing system could not effectively handle a misspelling, which led to failed search and duplicate medical record creation. Using the existing system, 96% of registrars found commonly spelled patient names whereas only 69% successfully found complicated names. Registrars lacked knowledge and usage of a phonetic matching function to assist in misspelling. The new system consistently captured the correct patient regardless of misspelling, but search returned more potential matches, resulting in, on average, 4 seconds longer to select common names. Potential monthly duplicate medical record rate reduced by 38%, from 4% to 2.3% after implementation of the new system, and has sustained at an average of 2.5% for 2 years. Usability testing was an effective method to reveal problems and aid system redesign to deliver a more user friendly system, hence reducing the potential for medical record duplication. Greater standards for usability would ensure that these improvements can be realized before rather than after exposing patients to risks.

Medical telerobotic systems: current status and future trends.

Science.gov (United States)

Avgousti, Sotiris; Christoforou, Eftychios G; Panayides, Andreas S; Voskarides, Sotos; Novales, Cyril; Nouaille, Laurence; Pattichis, Constantinos S; Vieyres, Pierre

2016-08-12

Teleoperated medical robotic systems allow procedures such as surgeries, treatments, and diagnoses to be conducted across short or long distances while utilizing wired and/or wireless communication networks. This study presents a systematic review of the relevant literature between the years 2004 and 2015, focusing on medical teleoperated robotic systems which have witnessed tremendous growth over the examined period. A thorough insight of telerobotics systems discussing design concepts, enabling technologies (namely robotic manipulation, telecommunications, and vision systems), and potential applications in clinical practice is provided, while existing limitations and future trends are also highlighted. A representative paradigm of the short-distance case is the da Vinci Surgical System which is described in order to highlight relevant issues. The long-distance telerobotics concept is exemplified through a case study on diagnostic ultrasound scanning. Moreover, the present review provides a classification into short- and long-distance telerobotic systems, depending on the distance from which they are operated. Telerobotic systems are further categorized with respect to their application field. For the reviewed systems are also examined their engineering characteristics and the employed robotics technology. The current status of the field, its significance, the potential, as well as the challenges that lie ahead are thoroughly discussed.

Teleradiology network system using the web medical image conference system with a new information security solution

Science.gov (United States)

Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Ohmatsu, Hironobu; Kusumoto, Masahiro; Kaneko, Masahiro; Kakinuma, Ryutaru; Moriyama, Noriyuki

2012-02-01

We have developed the teleradiology network system with a new information security solution that provided with web medical image conference system. In the teleradiology network system, the security of information network is very important subjects. We are studying the secret sharing scheme and the tokenization as a method safely to store or to transmit the confidential medical information used with the teleradiology network system. The confidential medical information is exposed to the risk of the damage and intercept. Secret sharing scheme is a method of dividing the confidential medical information into two or more tallies. Individual medical information cannot be decoded by using one tally at all. Our method has the function of automatic backup. With automatic backup technology, if there is a failure in a single tally, there is redundant data already copied to other tally. Confidential information is preserved at an individual Data Center connected through internet because individual medical information cannot be decoded by using one tally at all. Therefore, even if one of the Data Centers is struck and information is damaged due to the large area disaster like the great earthquake of Japan, the confidential medical information can be decoded by using the tallies preserved at the data center to which it escapes damage. Moreover, by using tokenization, the history information of dividing the confidential medical information into two or more tallies is prevented from lying scattered by replacing the history information with another character string (Make it to powerlessness). As a result, information is available only to those who have rightful access it and the sender of a message and the message itself are verified at the receiving point. We propose a new information transmission method and a new information storage method with a new information security solution.

International medical cooperation project for State of Libya using international medical tourism system in Thailand

OpenAIRE

奥寺, 敬; 坂本, 美重

2013-01-01

International medical cooperation project for State of Libya is reported. The concept of this project is to treat Libyan injured people using international medical tourism system in Thailand. Management of patient, including evaluation, domestic and international transportation arrangement of hospital, is supported by Normeca International Co., Ltd, (Pattaya, Thailand). Treatment of Libyan patient in two international hospitals (Bangpakok 9 Hospital and Navamin 9 Hopsital) in Bangkok was succ...

An Automated Medical Information Management System (OpScan-MIMS) in a Clinical Setting

Science.gov (United States)

Margolis, S.; Baker, T.G.; Ritchey, M.G.; Alterescu, S.; Friedman, C.

1981-01-01

This paper describes an automated medical information management system within a clinic setting. The system includes an optically scanned data entry system (OpScan), a generalized, interactive retrieval and storage software system(Medical Information Management System, MIMS) and the use of time-sharing. The system has the advantages of minimal hardware purchase and maintenance, rapid data entry and retrieval, user-created programs, no need for user knowledge of computer language or technology and is cost effective. The OpScan-MIMS system has been operational for approximately 16 months in a sexually transmitted disease clinic. The system's application to medical audit, quality assurance, clinic management and clinical training are demonstrated.

Evaluating the Medical Kit System for the International Space Station(ISS) - A Paradigm Revisited

Science.gov (United States)

Hailey, Melinda J.; Urbina, Michelle C.; Hughlett, Jessica L.; Gilmore, Stevan; Locke, James; Reyna, Baraquiel; Smith, Gwyn E.

2010-01-01

Medical capabilities aboard the International Space Station (ISS) have been packaged to help astronaut crew medical officers (CMO) mitigate both urgent and non-urgent medical issues during their 6-month expeditions. Two ISS crewmembers are designated as CMOs for each 3-crewmember mission and are typically not physicians. In addition, the ISS may have communication gaps of up to 45 minutes during each orbit, necessitating medical equipment that can be reliably operated autonomously during flight. The retirement of the space shuttle combined with ten years of manned ISS expeditions led the Space Medicine Division at the NASA Johnson Space Center to reassess the current ISS Medical Kit System. This reassessment led to the system being streamlined to meet future logistical considerations with current Russian space vehicles and future NASA/commercial space vehicle systems. Methods The JSC Space Medicine Division coordinated the development of requirements, fabrication of prototypes, and conducted usability testing for the new ISS Medical Kit System in concert with implementing updated versions of the ISS Medical Check List and associated in-flight software applications. The teams constructed a medical kit system with the flexibility for use on the ISS, and resupply on the Russian Progress space vehicle and future NASA/commercial space vehicles. Results Prototype systems were developed, reviewed, and tested for implementation. Completion of Preliminary and Critical Design Reviews resulted in a streamlined ISS Medical Kit System that is being used for training by ISS crews starting with Expedition 27 (June 2011). Conclusions The team will present the process for designing, developing, , implementing, and training with this new ISS Medical Kit System.

Ontological Model-Based Transparent Access To Information In A Medical Multi-Agent System

Directory of Open Access Journals (Sweden)

Felicia GÎZĂ-BELCIUG

2012-01-01

Full Text Available Getting the full electronic medical record of a patient is an important step in providing a quality medical service. But the degree of heterogeneity of data from health unit informational systems is very high, because each unit can have a different model for storing patients’ medical data. In order to achieve the interoperability and integration of data from various medical units that store partial patient medical information, this paper proposes a multi-agent systems and ontology based approach. Therefore, we present an ontological model for describing the particular structure of the data integration process. The system is to be used for centralizing the information from a patient’s partial medical records. The main advantage of the proposed model is the low ratio between the complexity of the model and the amount of information that can be retrieved in order to generate the complete medical history of a patient.

SU-D-BRD-01: An Automated Physics Weekly Chart Checking System Supporting ARIA

Energy Technology Data Exchange (ETDEWEB)

Chang, X; Yang, D [Washington University in St Louis, St Louis, MO (United States)

2015-06-15

Purpose: A software tool was developed in this study to perform automatic weekly physics chart check on the patient data in ARIA. The tool accesses the electronic patient data directly from ARIA server and checks the accuracy of treatment deliveries, and generates reports which summarize the delivery history and highlight the errors. Methods: The tool has four modules. 1) The database interface is designed to directly access treatment delivery data from the ARIA database before reorganizing the data into the patient chart tree (PCT). 2) PCT is a core data structure designed to store and organize the data in logical hierarchies, and to be passed among functions. 3) The treatment data check module analyzes the organized data in PCT and stores the checking results into PCT. 4) Report generation module generates reports containing the treatment delivery summary, chart checking results and plots of daily treatment setup parameters (couch table positions, shifts of image guidance). The errors that are found by the tool are highlighted with colors. Results: The weekly check tool has been implemented in MATLAB and clinically tested at two major cancer centers. Javascript, cascading style sheets (CSS) and dynamic HTML were employed to create the user-interactive reports. It takes 0.06 second to search the delivery records of one beam with PCT and compare the delivery records with beam plan. The reports, saved in the HTML files on shared network folder, can be accessed by web browser on computers and mobile devices. Conclusion: The presented weekly check tool is useful to check the electronic patient treatment data in Varian ARIA system. It could be more efficient and reliable than the manually check by physicists. The work was partially supported by a research grant from Varian Medical System.

SU-D-BRD-01: An Automated Physics Weekly Chart Checking System Supporting ARIA

International Nuclear Information System (INIS)

Chang, X; Yang, D

2015-01-01

Purpose: A software tool was developed in this study to perform automatic weekly physics chart check on the patient data in ARIA. The tool accesses the electronic patient data directly from ARIA server and checks the accuracy of treatment deliveries, and generates reports which summarize the delivery history and highlight the errors. Methods: The tool has four modules. 1) The database interface is designed to directly access treatment delivery data from the ARIA database before reorganizing the data into the patient chart tree (PCT). 2) PCT is a core data structure designed to store and organize the data in logical hierarchies, and to be passed among functions. 3) The treatment data check module analyzes the organized data in PCT and stores the checking results into PCT. 4) Report generation module generates reports containing the treatment delivery summary, chart checking results and plots of daily treatment setup parameters (couch table positions, shifts of image guidance). The errors that are found by the tool are highlighted with colors. Results: The weekly check tool has been implemented in MATLAB and clinically tested at two major cancer centers. Javascript, cascading style sheets (CSS) and dynamic HTML were employed to create the user-interactive reports. It takes 0.06 second to search the delivery records of one beam with PCT and compare the delivery records with beam plan. The reports, saved in the HTML files on shared network folder, can be accessed by web browser on computers and mobile devices. Conclusion: The presented weekly check tool is useful to check the electronic patient treatment data in Varian ARIA system. It could be more efficient and reliable than the manually check by physicists. The work was partially supported by a research grant from Varian Medical System

The Use of Hospital Information Systems Data Base with Word Processing and Other Medical Records System Applications

OpenAIRE

Rusnak, James E.

1982-01-01

The approach frequently used to introduce computer technology into a hospital Medical Records Department is to implement a Word Processing System. Word processing is a form of computer system application that is intended to improve the department's productivity by improving the medical information transcription process. The effectiveness of the Word Processing System may be further enhanced by installing system facilities to provide access to data processing file information in the Hospital's...

Integration Platform As Central Service Of Data Replication In Distributed Medical System

Directory of Open Access Journals (Sweden)

Wiesław Wajs

2007-01-01

Full Text Available The paper presents the application of Java Integration Platform (JIP to data replicationin the distributed medical system. After an introductory part on the medical system’s architecture,the focus shifts to a comparison of different approaches that exist with regard totransferring data between the system’s components. A description is given of the historicaldata processing and of the whole area of the JIP application to the medical system.

Improving the Efficiency of Medical Services Systems: A New Integrated Mathematical Modeling Approach

Directory of Open Access Journals (Sweden)

Davood Shishebori

2013-01-01

Full Text Available Nowadays, the efficient design of medical service systems plays a critical role in improving the performance and efficiency of medical services provided by governments. Accordingly, health care planners in countries especially with a system based on a National Health Service (NHS try to make decisions on where to locate and how to organize medical services regarding several conditions in different residence areas, so as to improve the geographic equity of comfortable access in the delivery of medical services while accounting for efficiency and cost issues especially in crucial situations. Therefore, optimally locating of such services and also suitable allocating demands them, can help to enhance the performance and responsiveness of medical services system. In this paper, a multiobjective mixed integer nonlinear programming model is proposed to decide locations of new medical system centers, link roads that should be constructed or improved, and also urban residence centers covered by these medical service centers and link roads under investment budget constraint in order to both minimize the total transportation cost of the overall system and minimize the total failure cost (i.e., maximize the system reliability of medical service centers under unforeseen situations. Then, the proposed model is linearized by suitable techniques. Moreover, a practical case study is presented in detail to illustrate the application of the proposed mathematical model. Finally, a sensitivity analysis is done to provide an insight into the behavior of the proposed model in response to changes of key parameters of the problem.

[The development of hospital medical supplies information management system].

Science.gov (United States)

Cao, Shaoping; Gu, Hongqing; Zhang, Peng; Wang, Qiang

2010-05-01

The information management of medical materials by using high-tech computer, in order to improve the efficiency of the consumption of medical supplies, hospital supplies and develop a new technology way to manage the hospital and material support. Using C # NET, JAVA techniques to develop procedures for the establishment of hospital material management information system, set the various management modules, production of various statistical reports, standard operating procedures. The system is convenient, functional and strong, fluent statistical functions. It can always fully grasp and understand the whole hospital supplies run dynamic information, as a modern and effective tool for hospital materials management.

Using an electronic prescribing system to ensure accurate medication lists in a large multidisciplinary medical group.

Science.gov (United States)

Stock, Ron; Scott, Jim; Gurtel, Sharon

2009-05-01

Although medication safety has largely focused on reducing medication errors in hospitals, the scope of adverse drug events in the outpatient setting is immense. A fundamental problem occurs when a clinician lacks immediate access to an accurate list of the medications that a patient is taking. Since 2001, PeaceHealth Medical Group (PHMG), a multispecialty physician group, has been using an electronic prescribing system that includes medication-interaction warnings and allergy checks. Yet, most practitioners recognized the remaining potential for error, especially because there was no assurance regarding the accuracy of information on the electronic medical record (EMR)-generated medication list. PeaceHealth developed and implemented a standardized approach to (1) review and reconcile the medication list for every patient at each office visit and (2) report on the results obtained within the PHMG clinics. In 2005, PeaceHealth established the ambulatory medication reconciliation project to develop a reliable, efficient process for maintaining accurate patient medication lists. Each of PeaceHealth's five regions created a medication reconciliation task force to redesign its clinical practice, incorporating the systemwide aims and agreed-on key process components for every ambulatory visit. Implementation of the medication reconciliation process at the PHMG clinics resulted in a substantial increase in the number of accurate medication lists, with fewer discrepancies between what the patient is actually taking and what is recorded in the EMR. The PeaceHealth focus on patient safety, and particularly the reduction of medication errors, has involved a standardized approach for reviewing and reconciling medication lists for every patient visiting a physician office. The standardized processes can be replicated at other ambulatory clinics-whether or not electronic tools are available.

Monte Carlo simulation of Varian Linac for 6 MV photon beam with BEAMnrc code

Science.gov (United States)

Mohammed, Maged; El Bardouni, T.; Chakir, E.; Boukhal, H.; Saeed, M.; Ahmed, Abdul-Aziz

2018-03-01

The purpose of this study is to investigate the effects of the initial electron beam parameters on the absorbed dose distribution calculated with EGSnrc Monte Carlo code, for 6 MV photon beam. A proposed methodology for benchmarking the BEAMnrc model of Varian Linac has been used. Also, a new photon cross section data based on ENDF/B-VII release 8 evaluation has been employed. The parameters tested include mean energy, radial intensity distribution and angular spread of the initial electron beam. Mean energy and angular spread were tested for a square irradiation field 10 × 10 cm2, whereas beam width of the electron beam was studied for 10 × 10 cm2 at different depths and 30 × 30 cm2 at depth of 10 cm. The results obtained are compared with measurement data to select the optimal electron beam parameters. The differences between MC calculation and measurements data are analyzed using gamma index criteria which fixed within 1% -1 mm accuracy. The obtained results indicated that the depth-dose and dose-profile curves were considerably influenced by the mean energy of the electron beam. The depth-dose curves were unaffected by the beam width of the electron beam, for both irradiation fields. On the contrary, lateral dose-profile curves were affected by the beam width of initial electron beam. Both dose-profile and depth-dose curves were unaffected to the angular spread of the electron beam. A deep depth of 10 × 10 cm2 is very accurate to tune the beam width. Mean energy and beam width must be tuned precisely, to get the MC does distribution with acceptable accuracy.

Multispectral system for medical fluorescence imaging

International Nuclear Information System (INIS)

Andersson, P.S.; Montan, S.; Svanberg, S.

1987-01-01

The principles of a powerful multicolor imaging system for tissue fluorescence diagnostics are discussed. Four individually spectrally filtered images are formed on a matrix detector by means of a split-mirror arrangement. The four images are processed in a computer, pixel by pixel, by means of mathematical operations, leading to an optimized contrast image, which enhances a selected feature. The system is being developed primarily for medical fluorescence imaging, but has wide applications in fluorescence, reflectance, and transmission monitoring related to a wide range of industrial and environmental problems. The system operation is described for the case of linear imaging on a diode array detector. Laser-induced fluorescence is used for cancer tumor and arteriosclerotic plaque demarcation using the contrast enhancement capabilities of this imaging system. Further examples of applications include fluorescing minerals and flames

Systemic Medication and Intraocular Pressure in a British Population

Science.gov (United States)

Khawaja, Anthony P.; Chan, Michelle P.Y.; Broadway, David C.; Garway-Heath, David F.; Luben, Robert; Yip, Jennifer L.Y.; Hayat, Shabina; Wareham, Nicholas J.; Khaw, Kay-Tee; Foster, Paul J.

2014-01-01

Objective To determine the association between systemic medication use and intraocular pressure (IOP) in a population of older British men and women. Design Population-based, cross-sectional study. Participants We included 7093 participants from the European Prospective Investigation into Cancer–Norfolk Eye Study. Exclusion criteria were a history of glaucoma therapy (medical, laser, or surgical), IOP asymmetry between eyes of >5 mmHg, and missing data for any covariables. The mean age of participants was 68 years (range, 48–92) and 56% were women. Methods We measured IOP using the Ocular Response Analyzer. Three readings were taken per eye and the best signal value of the Goldmann-correlated IOP value considered. Participants were asked to bring all their medications and related documentation to the health examination, and these were recorded by the research nurse using an electronic case record form. The medication classes examined were angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, α-blockers, β-blockers, calcium channel blockers, diuretics, nitrates, statins, insulin, biguanides, sulfonylureas, aspirin, and other nonsteroidal anti-inflammatory drugs. We examined associations between medication use and IOP using multivariable linear regression models adjusted for age, sex, and body mass index. Models containing diabetic medication were further adjusted for glycosylated hemoglobin levels. Main Outcome Measures Mean IOP of the right and left eyes. Results Use of systemic β-blockers (−0.92 mmHg; 95% CI, −1.19, −0.65; Pnitrates (−0.63 mmHg; 95% CI, −1.12, −0.14; P = 0.011) were independently associated with lower IOP. The observed associations between statin or aspirin use with IOP were no longer significant after adjustment for β-blocker use. Conclusions This is the first population-based study to demonstrate and quantify clinically significant differences in IOP among participants using systemic β-blockers or

Planetary method to measure the neutrons spectrum in lineal accelerators of medical use

International Nuclear Information System (INIS)

Vega C, H. R.; Benites R, J. L.

2014-08-01

A novel procedure to measure the neutrons spectrum originated in a lineal accelerator of medical use has been developed. The method uses a passive spectrometer of Bonner spheres. The main advantage of the method is that only requires of a single shot of the accelerator. When this is used around a lineal accelerator is necessary to operate it under the same conditions so many times like the spheres that contain the spectrometer, activity that consumes enough time. The developed procedure consists on situating all the spheres of the spectrometer at the same time and to realize the reading making a single shot. With this method the photo neutrons spectrum produced by a lineal accelerator Varian ix of 15 MV to 100 cm of the isocenter was determined, with the spectrum is determined the total flow and the ambient dose equivalent. (Author)

The Application of Use Case Modeling in Designing Medical Imaging Information Systems

International Nuclear Information System (INIS)

Safdari, Reza; Farzi, Jebraeil; Ghazisaeidi, Marjan; Mirzaee, Mahboobeh; Goodini, Azadeh

2013-01-01

Introduction. The essay at hand is aimed at examining the application of use case modeling in analyzing and designing information systems to support Medical Imaging services. Methods. The application of use case modeling in analyzing and designing health information systems was examined using electronic databases (Pubmed, Google scholar) resources and the characteristics of the modeling system and its effect on the development and design of the health information systems were analyzed. Results. Analyzing the subject indicated that Provident modeling of health information systems should provide for quick access to many health data resources in a way that patients' data can be used in order to expand distant services and comprehensive Medical Imaging advices. Also these experiences show that progress in the infrastructure development stages through gradual and repeated evolution process of user requirements is stronger and this can lead to a decline in the cycle of requirements engineering process in the design of Medical Imaging information systems. Conclusion. Use case modeling approach can be effective in directing the problems of health and Medical Imaging information systems towards understanding, focusing on the start and analysis, better planning, repetition, and control

[Multi-course web-learning system for supporting students of medical technology].

Science.gov (United States)

Honma, Satoru; Wakamatsu, Hidetoshi; Kurihara, Yuriko; Yoshida, Shoko; Sakai, Nobue

2013-05-01

Web-Learning system was developed to support the self-learning for national qualification examination and medical engineering practice by students. The results from small tests in various situations suggest that the unit-learning systems are more effective, especially for the early stage of their self learning. In addition, the answers of some questionnaire suggest that the students' motivation has a certain relation with the number of the questions in the system. That is, the less number of the questions, the easier they are worked out with a higher learning motivation by students. Thus, the system was extended to enable students to study various subjects and/or units by themselves. The system enables them to have learning effects more easily by the exercise during lectures. The effectiveness of the system was investigated on medical associated subjects installed in the system. The concerning questions of Medical engineering and Pathological histology are adequately divided into several groups, of which sixteen Web-Learning subsystems were well composed for their practical application. Our concerning various unit-learning systems were confirmed much useful for most students comparing with the case of the overall Web-Learning system.

ODMSummary: A Tool for Automatic Structured Comparison of Multiple Medical Forms Based on Semantic Annotation with the Unified Medical Language System.

Science.gov (United States)

Storck, Michael; Krumm, Rainer; Dugas, Martin

2016-01-01

Medical documentation is applied in various settings including patient care and clinical research. Since procedures of medical documentation are heterogeneous and developed further, secondary use of medical data is complicated. Development of medical forms, merging of data from different sources and meta-analyses of different data sets are currently a predominantly manual process and therefore difficult and cumbersome. Available applications to automate these processes are limited. In particular, tools to compare multiple documentation forms are missing. The objective of this work is to design, implement and evaluate the new system ODMSummary for comparison of multiple forms with a high number of semantically annotated data elements and a high level of usability. System requirements are the capability to summarize and compare a set of forms, enable to estimate the documentation effort, track changes in different versions of forms and find comparable items in different forms. Forms are provided in Operational Data Model format with semantic annotations from the Unified Medical Language System. 12 medical experts were invited to participate in a 3-phase evaluation of the tool regarding usability. ODMSummary (available at https://odmtoolbox.uni-muenster.de/summary/summary.html) provides a structured overview of multiple forms and their documentation fields. This comparison enables medical experts to assess multiple forms or whole datasets for secondary use. System usability was optimized based on expert feedback. The evaluation demonstrates that feedback from domain experts is needed to identify usability issues. In conclusion, this work shows that automatic comparison of multiple forms is feasible and the results are usable for medical experts.

DMLC motion tracking of moving targets for intensity modulated arc therapy treatment

DEFF Research Database (Denmark)

Zimmerman, Jens; Korreman, Stine; Persson, Gitte

2009-01-01

(DMLC). The aim of this work was to evaluate the dose delivered to moving targets using the RapidArc (Varian Medical Systems, Inc.) technology with and without a DMLC tracking algorithm. MATERIAL AND METHODS: A Varian Clinac iX was equipped with a preclinical RapidArc and a 3D DMLC tracking application......) and state (1). CONCLUSIONS: DMLC tracking together with RapidArc make a feasible combination and is capable of improving the dose distribution delivered to a moving target. It seems to be of importance to minimize noise influencing the tracking, to gain the full benefit from the application........ A motion platform was placed on the couch, with the detectors on top: a PTW seven29 and a Scandidos Delta4. One lung plan and one prostate plan were delivered. Motion was monitored using a Real-time Position Management (RPM) system. Reference measurements were performed for both plans with both detectors...

Development of case-based medication alerting and recommender system: a new approach to prevention for medication error.

Science.gov (United States)

Miyo, Kengo; Nittami, Yuki S; Kitagawa, Yoichiro; Ohe, Kazuhiko

2007-01-01

The purpose of this study was to develop a new alerting and recommender system for preventing medication errors. In recent years, alerting systems have been widely implemented, but because these systems apply a same static threshold for all patients in all cases, they produce excessive alerts and subject physicians to "alert fatigue". We believe that the most commonly-written prescription for a patient's status is the safest one. From this standpoint, we developed a real-time case-based medication alerting and recommender system linked to a database of past prescriptions. When a physician issues his or her prescription, our system dynamically compares it with past ones for similar patients in the database. An analysis of the 10 most frequently-used drugs in the University of Tokyo Hospital revealed that our system reduced the number of false alerts compared to the traditional static alert method. Our system contributes to the creation of alerts that are appropriate for patients' clinical conditions and based on physicians' empirical discretion.

The urban transition and the evolution of the medical care delivery system in America.

Science.gov (United States)

Knox, P L; Bohland, J; Shumsky, N L

1983-01-01

This essay traces the evolution of the American urban medical care delivery system and examines the implications in terms of social and spatial variations in accessibility to medical care. It is suggested that the foundations of the present medical care delivery system were laid during the urban transformation which took place in the latter part of the nineteenth century, when changes in the division of labor, specialization, the role of the family, urban transportation technology and attitudes to social protectionism interacted with changes in science, medical technology and professional organization to produce radical changes in both the settings used to provide medical care and their relative accessibility to different sub-groups of the population. The medical care delivery system is thus interpreted largely as a product of the overall dynamic of urbanization rather than of scientific discovery, medical technology and the influence of key medical practitioners and professional organizations.

Evaluation of the medical records system in an upcoming teaching hospital-a project for improvisation.

Science.gov (United States)

Kumar, B Deepak; Kumari, C M Vinaya; Sharada, M S; Mangala, M S

2012-08-01

The medical records system of an upcoming teaching hospital in a developing nation was evaluated for its accessibility, completeness, physician satisfaction, presence of any lacunae, suggestion of necessary steps for improvisation and to emphasize the importance of Medical records system in education and research work. The salient aspects of the medical records department were evaluated based on a questionnaire which was evaluated by a team of 40 participants-30 doctors, 5 personnel from Medical Records Department and 5 from staff of Hospital administration. Most of the physicians (65%) were partly satisfied with the existing medical record system. 92.5% were of the opinion that upgradation of the present system is necessary. The need of the hour in the present teaching hospital is the implementation of a hospital-wide patient registration and medical records re-engineering process in the form of electronic medical records system and regular review by the audit commission.

[Design and realization of the communication system for the mobile medical terminal].

Science.gov (United States)

Ji, Lei; Guo, Xu; Shi, Huayu

2013-01-01

Realizing wireless communication based on handset devices for medical staff; providing an instant messaging method. Constructing a set of communication protocols and standards; developing software both on server and client. Building an instant messaging system which follows the customized specification; based on Android the client provides functions like address book, message, voice service etc. As an independent module of the mobile medical terminal, the system can provide convenient communication for medical service with other mobile business.

A Total Information Management System For All Medical Images

Science.gov (United States)

Ouimette, Donald; Nudelman, Sol; Ramsby, Gale; Spackman, Thomas

1985-09-01

A PACS has been designed for the University of Connecticut Health Center to serve all departments acquiring images for diagnosis, surgery and therapy. It incorporates a multiple community communications architecture to provide complete information management for medical images, medical data and departmental administrative matter. The system is modular and expandable. It permits an initial installation for radiology and subsequent expansion to include other departments at the Health Center, beginning with internal medicine, surgery, ophthalmology and dentistry. The design permits sufficient expansion to offer the potential for accepting the additional burden of a hospital information system. Primary parameters that led to this system design were based on the anticipation that departments in time could achieve generating 60 to 90% of their images suited to insertion in a PACS, that a high network throughput for large block image transfers would be essen-tial and that total system reliability was fundamental to success.

Rape Survivors' Agency within the Legal and Medical Systems

Science.gov (United States)

Greeson, Megan R.; Campbell, Rebecca

2011-01-01

Many rape survivors seek help from the legal and medical systems post-assault. Previous studies have examined how social system personnel treat survivors, but less attention has been paid to how survivors attempt to shape their interactions with these systems. The purpose of this qualitative study was to examine rape survivors' agency--the active…

Choosing a New Telephone System for Your Medical Practice.

Science.gov (United States)

Metherell, Brian

2016-01-01

E-mail may rule the world in other types of businesses, but for medical practices, the telephone remains the primary mode of communication with patients, specialists, and pharmacies. From making appointments to calling in prescriptions, telephones are essential to patient care. With technology changing very quickly and new capabilities coming into the medical practice, such as telemedicine and Skype, you need to know your options when choosing a new telephone system. The possibilities include on-site, cloud, and hybrid networked solutions. A wide variety of features and capabilities are available, from dozens of vendors. Of course, no matter what telephone solution you choose, you must meet regulatory compliance, particularly HIPAA, and Payment Card Industry Data Security Standard if you take credit cards. And it has to be affordable, reliable, and long lasting. This article explores what medical practices need to know when choosing a new business telephone system in order to find the right solutions for their businesses.

[Impact of an automated dispensing system for medical devices in cardiac surgery department].

Science.gov (United States)

Clou, E; Dompnier, M; Kably, B; Leplay, C; Poupon, E; Archer, V; Paul, M

2018-01-01

To secure medical devices' management, the implementation of automated dispensing system in surgical service has been realized. The objective of this study was to evaluate security, organizational and economic impact of installing automated dispensing system for medical devices (ASDM). The implementation took place in a cardiac surgery department. Security impact was assessed by comparing traceability rate of implantable medical devices one year before and one year after installation. Questionnaire on nurses' perception and satisfaction completed this survey. Resupplying costs, stocks' evolution and investments for the implementation of ASDM were the subject of cost-benefit study. After one year, traceability rate is excellent (100%). Nursing staffs were satisfied with 87.5% by this new system. The introduction of ASDM allowed a qualitative and quantitative decrease in stocks, with a reduction of 30% for purchased medical devices and 15% for implantable medical devices in deposit-consignment. Cost-benefit analysis shows a rapid return on investment. Real stock decrease (purchased medical devices) is equivalent to 46.6% of investment. Implementation of ASDM allows to secure storage and dispensing of medical devices. This system has also an important economic impact and appreciated by users. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Why decision support systems are important for medical education.

Science.gov (United States)

Konstantinidis, Stathis Th; Bamidis, Panagiotis D

2016-03-01

During the last decades, the inclusion of digital tools in health education has rapidly lead to a continuously enlarging digital era. All the online interactions between learners and tutors, the description, creation, reuse and sharing of educational digital resources and the interlinkage between them in conjunction with cheap storage technology has led to an enormous amount of educational data. Medical education is a unique type of education due to accuracy of information needed, continuous changing competences required and alternative methods of education used. Nowadays medical education standards provide the ground for organising the educational data and the paradata. Analysis of such education data through education data mining techniques is in its infancy, but decision support systems (DSSs) for medical education need further research. To the best of our knowledge, there is a gap and a clear need for identifying the challenges for DSSs in medical education in the era of medical education standards. Thus, in this Letter the role and the attributes of such a DSS for medical education are delineated and the challenges and vision for future actions are identified.

Physician Acceptance of a Computerized Outpatient Medication System in a Teaching Hospital Group Practice

OpenAIRE

Blish, Christi; Proctor, Rita; Fletcher, Suzanne W.; O'Malley, Michael

1983-01-01

As part of a new automated ambulatory medical record, a computerized outpatient medication system was developed for a teaching hospital general medicine group practice. Seven months after its implementation, the system was evaluated to determine physician acceptance and approval. Practice physicians were surveyed, and 94% of the respondents approved of the system. Over 90% thought that the computerized system had improved the completeness and accuracy of medication information as well as thei...

Managing medical and insurance information through a smart-card-based information system.

Science.gov (United States)

Lambrinoudakis, C; Gritzalis, S

2000-08-01

The continuously increased mobility of patients and doctors, in conjunction with the existence of medical groups consisting of private doctors, general practitioners, hospitals, medical centers, and insurance companies, pose significant difficulties on the management of patients' medical data. Inevitably this affects the quality of the health care services provided. The evolving smart card technology can be utilized for the implementation of a secure portable electronic medical record, carried by the patient herself/himself. In addition to the medical data, insurance information can be stored in the smart card thus facilitating the creation of an "intelligent system" supporting the efficient management of patient's data. In this paper we present the main architectural and functional characteristics of such a system. We also highlight how the security features offered by smart cards can be exploited in order to ensure confidentiality and integrity of the medical data stored in the patient cards.

Field-testing the new DECtalk PC system for medical applications

Science.gov (United States)

Grams, R. R.; Smillov, A.; Li, B.

1992-01-01

Synthesized human speech has now reached a new level of performance. With the introduction of DEC's new DECtalk PC, the small system developer will have a very powerful tool for creative design. It has been our privilege to be involved in the beta-testing of this new device and to add a medical dictionary which covers a wide range of medical terminology. With the inherent board level understanding of speech synthesis and the medical dictionary, it is now possible to provide full digital speech output for all medical files and terms. The application of these tools will cover a wide range of options for the future and allow a new dimension in dealing with the complex user interface experienced in medical practice.

Study on the standardization of hospital information system for medical image information sharing

International Nuclear Information System (INIS)

Kim, Seon Chil; Kwon, Su Ja

2001-01-01

As the adoption of PACS and hospital information system among university hospitals and hospital level institutions grows bigger, the need of sharing and transferring medical information among medical institutions is rising. For the medical information, which is saved in the hospital medical system, to be transferred within the same hospital, domestic, or foreign medical institutions, a standard protocol is necessary. But realistically, most of the domestic hospitals do not abide by H7L which is the HIS standard and so, information transferring is not possible as of present. As such, the purpose of this research is to implement the information between HIS and PACS to an international standard by constructing HL7 messages through HL7 Interface, which will eventually make possible information transferring between different hospitals. Our research team has developed a method which will make the PACS equip hospitals that do not follow HL7 standard which will make possible to transfer information between HIS and PACS through HL7 Message. By constructing message files, which follow the form of HL7 Message in the HL7 Interface, they can be transferred to PACS through the ftp protocol. The realization of the HIS/OCS Interface through HL7 enables data transferring between domestic and foreign medical institutions possible by implementing the international standard in the PACS and HIS data transferring process. The HL7 that our research team has developed made patient data transfer between medical institutions possible. The Interface is for a specific system model and in order for the data transfer between different systems to be realized, interfaces that are fit for each system must be needed. If the Interface is improvised and implemented to each hospital's information system, the data sharing among medical institutions can be broadened

The new innovative medical education system in Ethiopia ...

African Journals Online (AJOL)

User

Background: A New Innovative Medical Education Initiative (NIMEI) had been launched in Ethiopia in February ... development as well as for the overall health system of the country. .... A national survey was conducted in all regions of Ethiopia.

A qualitative evaluation of medication management services in six Minnesota health systems.

Science.gov (United States)

Sorensen, Todd D; Pestka, Deborah; Sorge, Lindsay A; Wallace, Margaret L; Schommer, Jon

2016-03-01

The initiation, establishment, and sustainability of medication management programs in six Minnesota health systems are described. Six Minnesota health systems with well-established medication management programs were invited to participate in this study: Essentia Health, Fairview Health Services, HealthPartners, Hennepin County Medical Center, Mayo Clinic, and Park Nicollet Health Services. Qualitative methods were employed by conducting group interviews with key staff from each institution who were influential in the development of medication management services within their organization. Kotter's theory of eight steps for leading organizational change served as the framework for the question guide. The interviews were audio recorded, transcribed, and analyzed for recurring and emergent themes. A total of 13 distinct themes were associated with the successful integration of medication management services across the six healthcare systems. Identified themes clustered within three stages of Kotter's model for leading organizational change: creating a climate for change, engaging and enabling the whole organization, and implementing and sustaining change. The 13 themes included (1) external influences, (2) pharmacists as an untapped resource, (3) principles and professionalism, (4) organizational culture, (5) momentum champions, (6) collaborative relationships, (7) service promotion, (8) team-based care, (9) implementation strategies, (10) overcoming challenges, (11) supportive care model process, (12) measuring and reporting results, and (13) sustainability strategies. A qualitative survey of six health systems that successfully implemented medication management services in ambulatory care clinics revealed that a supportive culture and team-based collaborative care are among the themes identified as necessary for service sustainability. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Advances in the physics of radiation oncology - 50 years of contributions by US Medical Physicists

International Nuclear Information System (INIS)

Suntharalingam, N.

2008-01-01

Medical Physicists have a long standing record in the advancement of the discipline of Radiation Oncology, not only in the United States but world-wide, going back to the pre-world war II era. In the United States the contributions of Failla and Quimby, first at Memorial Hospital and then at Columbia University in New York, laid the foundation for the Profession of Medical Physics in the US. Radiation Therapy first used low and high kilovoltage machines for external beam therapy. Radium (Parker) and radon seeds (Quimby) were used for brachytherapy. Subsequently, clinical Van-de-Graaff machines (Trump and Wright) and the Betatron (Kerst, Adams and Skaggs) provided the required photon beams and also made available clinically useful electron beams. The work of John Laughlin, Larry Lanzl, Jacques Ovadia together with Gail Adams and Lester Skaggs, needs to be recognized for their pioneering efforts. With the introduction of Cobalt-60 Teletherapy (Harold Johns and the Canadian Group, Gilbert Fletcher and the MD Anderson Group) and Linear Accelerators (Henry Kaplan and the Stanford Group, and Varian), in the late 1950s ∼ 1960, there was even a greater need for the strong participation of medical physicists, as a useful technical resource to the physicians

Healers, deities, saints and doctors: elements for the analysis of medical systems.

Science.gov (United States)

Pedersen, D; Baruffati, V

1989-01-01

This article provides the basic elements for the discussion and analysis of medical systems and their inter-dependency, with special reference to Latin America and, in particular, to the Andean countries. In a culturally diverse and socially stratified population, such as in contemporary Latin America, medical systems constitute a social representation resulting from the historical relationship between autochtonous medical cultures and those from other latitudes. The impregnation of scientific and popular knowledge results not only in the incorporation (and often expropriation) of folk in professional or scientific medicine, but also in the increasing 'medicalisation' of popular and traditional therapeutic practices. The emergent 'popular' medical system draws from both the professional and folk models, and in its actual practice, integrates both popular beliefs and materia medica with elements drawn from popular religions and pre-Hispanic deities. The degree of competitiveness, co-operation or 'integration' among medical systems depends mainly on the asymmetrical distribution of power and resources, and is conditioned by the population's behaviour in the management of disease. Existing pluralist systems of health care reveal a valuable array of survival strategies, which far outreach the proposals for integration called for by official sectors. On the other hand, knowledge derived from traditional medicine can contribute to the development of new models of clinical practice and to the expansion of the conventional epidemiological model.

Minimal impact of an electronic medical records system.

Science.gov (United States)

Tall, Jill M; Hurd, Marie; Gifford, Thomas

2015-05-01

Electronic medical records (EMRs) implementation in hospitals and emergency departments (EDs) is becoming increasingly more common. The purpose of this study was to determine the impact of an EMR system on patient-related factors that correlate to ED workflow efficiency. A retrospective chart review assessed monthly census reports of all patients who registered and were treated to disposition during conversion from paper charts to an EMR system. The primary outcome measurement was an analysis of the time of registration to discharge or total ED length of stay as well as rate of those who left without being seen, eloped, or left against medical advice. These data were recorded from 3 periods, for 18 months: before installation of the EMR system (pre-EMR), during acclimation to the EMR, and post acclimation (post-EMR). A total of 61626 individual patient records were collected and analyzed. The total ED length of stay across all patient subtypes was not significantly affected by the installation of the hospital-wide EMR system (P = .481); however, a significant decrease was found for patients who were admitted to the hospital from the ED (P .25). Installation of a hospital-wide EMR system had minimal impact on workflow efficiency parameters in an ED. Copyright © 2015 Elsevier Inc. All rights reserved.

Evolving rule-based systems in two medical domains using genetic programming.

Science.gov (United States)

Tsakonas, Athanasios; Dounias, Georgios; Jantzen, Jan; Axer, Hubertus; Bjerregaard, Beth; von Keyserlingk, Diedrich Graf

2004-11-01

To demonstrate and compare the application of different genetic programming (GP) based intelligent methodologies for the construction of rule-based systems in two medical domains: the diagnosis of aphasia's subtypes and the classification of pap-smear examinations. Past data representing (a) successful diagnosis of aphasia's subtypes from collaborating medical experts through a free interview per patient, and (b) correctly classified smears (images of cells) by cyto-technologists, previously stained using the Papanicolaou method. Initially a hybrid approach is proposed, which combines standard genetic programming and heuristic hierarchical crisp rule-base construction. Then, genetic programming for the production of crisp rule based systems is attempted. Finally, another hybrid intelligent model is composed by a grammar driven genetic programming system for the generation of fuzzy rule-based systems. Results denote the effectiveness of the proposed systems, while they are also compared for their efficiency, accuracy and comprehensibility, to those of an inductive machine learning approach as well as to those of a standard genetic programming symbolic expression approach. The proposed GP-based intelligent methodologies are able to produce accurate and comprehensible results for medical experts performing competitive to other intelligent approaches. The aim of the authors was the production of accurate but also sensible decision rules that could potentially help medical doctors to extract conclusions, even at the expense of a higher classification score achievement.

Provider risk factors for medication administration error alerts: analyses of a large-scale closed-loop medication administration system using RFID and barcode.

Science.gov (United States)

Hwang, Yeonsoo; Yoon, Dukyong; Ahn, Eun Kyoung; Hwang, Hee; Park, Rae Woong

2016-12-01

To determine the risk factors and rate of medication administration error (MAE) alerts by analyzing large-scale medication administration data and related error logs automatically recorded in a closed-loop medication administration system using radio-frequency identification and barcodes. The subject hospital adopted a closed-loop medication administration system. All medication administrations in the general wards were automatically recorded in real-time using radio-frequency identification, barcodes, and hand-held point-of-care devices. MAE alert logs recorded during a full 1 year of 2012. We evaluated risk factors for MAE alerts including administration time, order type, medication route, the number of medication doses administered, and factors associated with nurse practices by logistic regression analysis. A total of 2 874 539 medication dose records from 30 232 patients (882.6 patient-years) were included in 2012. We identified 35 082 MAE alerts (1.22% of total medication doses). The MAE alerts were significantly related to administration at non-standard time [odds ratio (OR) 1.559, 95% confidence interval (CI) 1.515-1.604], emergency order (OR 1.527, 95%CI 1.464-1.594), and the number of medication doses administered (OR 0.993, 95%CI 0.992-0.993). Medication route, nurse's employment duration, and working schedule were also significantly related. The MAE alert rate was 1.22% over the 1-year observation period in the hospital examined in this study. The MAE alerts were significantly related to administration time, order type, medication route, the number of medication doses administered, nurse's employment duration, and working schedule. The real-time closed-loop medication administration system contributed to improving patient safety by preventing potential MAEs. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Clinical information system based on the medical smart card.

Science.gov (United States)

Danon, Y L; Saiag, E

2000-07-01

Over the last 5 years Israel has implemented a nationwide health insurance plan covering the entire population of the country. We have developed a clinical information system based on electronic-chip health care medical smart cards. Health care cards are used in several European countries and chip smart cards have been successful in many sectors. Our project involves the community use of the MSC, thereby enabling health care professionals to skillfully employ card systems in the health care sector. This system can easily arrange electronic medical charts in clinics, facilitating the confidential sharing of personal health databases among health professionals. To develop an MSC applicable for daily use in the community and hospital system. The MSC project, currently underway in Israel and the USA, will aid in determining the costs, benefits and feasibility of the MSC. Successful implementation of the MSC in chosen clinics will promote a nationwide willingness to adopt this promising technology.

Measurement of time delay for a prospectively gated CT simulator.

Science.gov (United States)

Goharian, M; Khan, R F H

2010-04-01

For the management of mobile tumors, respiratory gating is the ideal option, both during imaging and during therapy. The major advantage of respiratory gating during imaging is that it is possible to create a single artifact-free CT data-set during a selected phase of the patient's breathing cycle. The purpose of the present work is to present a simple technique to measure the time delay during acquisition of a prospectively gated CT. The time delay of a Philips Brilliance BigBore (Philips Medical Systems, Madison, WI) scanner attached to a Varian Real-Time Position Management (RPM) system (Varian Medical Systems, Palo Alto, CA) was measured. Two methods were used to measure the CT time delay: using a motion phantom and using a recorded data file from the RPM system. In the first technique, a rotating wheel phantom was altered by placing two plastic balls on its axis and rim, respectively. For a desired gate, the relative positions of the balls were measured from the acquired CT data and converted into corresponding phases. Phase difference was calculated between the measured phases and the desired phases. Using period of motion, the phase difference was converted into time delay. The Varian RPM system provides an external breathing signal; it also records transistor-transistor logic (TTL) 'X-Ray ON' status signal from the CT scanner in a text file. The TTL 'X-Ray ON' indicates the start of CT image acquisition. Thus, knowledge of the start time of CT acquisition, combined with the real-time phase and amplitude data from the external respiratory signal, provides time-stamping of all images in an axial CT scan. The TTL signal with time-stamp was used to calculate when (during the breathing cycle) a slice was recorded. Using the two approaches, the time delay between the prospective gating signal and CT simulator has been determined to be 367 +/- 40 ms. The delay requires corrections both at image acquisition and while setting gates for the treatment delivery

Military Medical Revolution: Military Trauma System

Science.gov (United States)

2012-01-01

receive state-of-the-art physical therapy and occupational therapy , in- cluding demanding and challenging sports equipment and virtual reality systems...Knudson MM. Into the theater: perspectives from a civilian trauma sur- geon’s visit to the combat support hospital in Balad, Iraq. Bull Am Coll Surg...following type III open tibia fracture . J Orthop Trauma. 2012;26:43 47. 52. U.S Army Medical Research and Materiel Command. Armed Forces In- stitute of

Dose response of commercially available optically stimulated luminescent detector, Al2O3:C for megavoltage photons and electrons.

Science.gov (United States)

Kim, Dong Wook; Chung, Weon Kuu; Shin, Dong Oh; Yoon, Myonggeun; Hwang, Ui-Jung; Rah, Jeong-Eun; Jeong, Hojin; Lee, Sang Yeob; Shin, Dongho; Lee, Se Byeong; Park, Sung Yong

2012-04-01

This study examined the dose response of an optically stimulated luminescence dosemeter (OSLD) to megavoltage photon and electron beams. A nanoDot™ dosemeter was used to measure the dose response of the OSLD. Photons of 6-15 MV and electrons of 9-20 MeV were delivered by a Varian 21iX machine (Varian Medical System, Inc. Milpitas, CA, USA). The energy dependency was dose was linear until 200 cGy. The superficial dose measurements revealed photon irradiation to have an angular dependency. The nanoDot™ dosemeter has potential use as an in vivo dosimetric tool that is independent of the energy, has dose linearity and a rapid response compared with normal in vivo dosimetric tools, such as thermoluminescence detectors. However, the OSLD must be treated very carefully due to the high angular dependency of the photon beam.

Developing an active emergency medical service system based on WiMAX technology.

Science.gov (United States)

Li, Shing-Han; Cheng, Kai-An; Lu, Wen-Hui; Lin, Te-Chang

2012-10-01

The population structure has changed with the aging of population. In the present, elders account for 10.63% of the domestic population and the percentage is still gradually climbing. In other words, the demand for emergency services among elders in home environment is expected to grow in the future. In order to improve the efficiency and quality of emergency care, information technology should be effectively utilized to integrate medical systems and facilities, strengthen human-centered operation designs, and maximize the overall performance. The improvement in the quality and survival rate of emergency care is an important basis for better life and health of all people. Through integrated application of medical information systems and information communication technology, this study proposes a WiMAX-based emergency care system addressing the public demands for convenience, speed, safety, and human-centered operation of emergency care. This system consists of a healthcare service center, emergency medical service hospitals, and emergency ambulances. Using the wireless transmission capability of WiMAX, patients' physiological data can be transmitted from medical measurement facilities to the emergency room and emergency room doctors can provide immediate online instructions on emergency treatment via video and audio transmission. WiMAX technology enables the establishment of active emergency medical services.

Experiences of building a medical data acquisition system based on two-level modeling.

Science.gov (United States)

Li, Bei; Li, Jianbin; Lan, Xiaoyun; An, Ying; Gao, Wuqiang; Jiang, Yuqiao

2018-04-01

Compared to traditional software development strategies, the two-level modeling approach is more flexible and applicable to build an information system in the medical domain. However, the standards of two-level modeling such as openEHR appear complex to medical professionals. This study aims to investigate, implement, and improve the two-level modeling approach, and discusses the experience of building a unified data acquisition system for four affiliated university hospitals based on this approach. After the investigation, we simplified the approach of archetype modeling and developed a medical data acquisition system where medical experts can define the metadata for their own specialties by using a visual easy-to-use tool. The medical data acquisition system for multiple centers, clinical specialties, and diseases has been developed, and integrates the functions of metadata modeling, form design, and data acquisition. To date, 93,353 data items and 6,017 categories for 285 specific diseases have been created by medical experts, and over 25,000 patients' information has been collected. OpenEHR is an advanced two-level modeling method for medical data, but its idea to separate domain knowledge and technical concern is not easy to realize. Moreover, it is difficult to reach an agreement on archetype definition. Therefore, we adopted simpler metadata modeling, and employed What-You-See-Is-What-You-Get (WYSIWYG) tools to further improve the usability of the system. Compared with the archetype definition, our approach lowers the difficulty. Nevertheless, to build such a system, every participant should have some knowledge in both medicine and information technology domains, as these interdisciplinary talents are necessary. Copyright © 2018 Elsevier B.V. All rights reserved.

iCBLS: An interactive case-based learning system for medical education.

Science.gov (United States)

Ali, Maqbool; Han, Soyeon Caren; Bilal, Hafiz Syed Muhammad; Lee, Sungyoung; Kang, Matthew Jee Yun; Kang, Byeong Ho; Razzaq, Muhammad Asif; Amin, Muhammad Bilal

2018-01-01

Medical students should be able to actively apply clinical reasoning skills to further their interpretative, diagnostic, and treatment skills in a non-obtrusive and scalable way. Case-Based Learning (CBL) approach has been receiving attention in medical education as it is a student-centered teaching methodology that exposes students to real-world scenarios that need to be solved using their reasoning skills and existing theoretical knowledge. In this paper, we propose an interactive CBL System, called iCBLS, which supports the development of collaborative clinical reasoning skills for medical students in an online environment. The iCBLS consists of three modules: (i) system administration (SA), (ii) clinical case creation (CCC) with an innovative semi-automatic approach, and (iii) case formulation (CF) through intervention of medical students' and teachers' knowledge. Two evaluations under the umbrella of the context/input/process/product (CIPP) model have been performed with a Glycemia study. The first focused on the system satisfaction, evaluated by 54 students. The latter aimed to evaluate the system effectiveness, simulated by 155 students. The results show a high success rate of 70% for students' interaction, 76.4% for group learning, 72.8% for solo learning, and 74.6% for improved clinical skills. Copyright © 2017 Elsevier B.V. All rights reserved.

The Computer in a Programmable Implantable Medication System (PIMS)

OpenAIRE

Sanders, K. H.; Radford, W. E.

1982-01-01

The Programmable Implantable Medication System (PIMS) developed at APL can be used in the treatment of diabetes, reproductive hormone dysfunction, hypertension, cancer, chronic pain, thrombosis, and the delivery of growth hormone. The Implantable Programmable Infusion Pump (IPIP) is the implanted element of PIMS. Under control of a microprocessor, the IPIP administers medication and stores data pertaining to its operation. An external unit can read out the stored data, as well as program the ...

Situating Remediation: Accommodating Success and Failure in Medical Education Systems.

Science.gov (United States)

Ellaway, Rachel H; Chou, Calvin L; Kalet, Adina L

2018-03-01

There has been a widespread shift to competency-based medical education (CBME) in the United States and Canada. Much of the CBME discourse has focused on the successful learner, with relatively little attention paid to what happens in CBME systems when learners stumble or fail. Emerging issues, such as the well-documented problem of "failure to fail" and concerns about litigious learners, have highlighted a need for well-defined and integrated frameworks to support and guide strategic approaches to the remediation of struggling medical learners.This Perspective sets out a conceptual review of current practices and an argument for a holistic approach to remediation in the context of their parent medical education systems. The authors propose parameters for integrating remediation into CBME and describe a model based on five zones of practice along with the rules of engagement associated with each zone. The zones are "normal" curriculum, corrective action, remediation, probation, and exclusion.The authors argue that, by linking and integrating theory and practice in remediation with CBME, a more integrated systems-level response to differing degrees of learner difficulty and failure can be developed. The proposed model demonstrates how educational practice in different zones is based on different rules, roles, responsibilities, and thresholds for moving between zones. A model such as this can help medical educators and medical education leaders take a more integrated approach to learners' failures as well as their successes by being more explicit about the rules of engagement that apply in different circumstances across the competency continuum.

Imaging systems for medical diagnostics

International Nuclear Information System (INIS)

Krestel, E.

1990-01-01

This book provides physicians and clinical physicists with detailed information on today's imaging modalities and assists them in selecting the optimal system for each clinical application. Physicists, engineers and computer specialists engaged in research and development and sales departments will also find this book to be of considerable use. It may also be employed at universities, training centers and in technical seminars. The physiological and physical fundamentals are explained in part 1. The technical solutions contained in part 2 illustrate the numerous possibilities available in X-ray diagnostics, computed tomography, nuclear medical diagnostics, magnetic resonance imaging, sonography and biomagnetic diagnostics. (orig.)

SU-F-BRE-11: Neutron Measurements Around the Varian TrueBeam Linac

Energy Technology Data Exchange (ETDEWEB)

Maglieri, R; Seuntjens, J; Kildea, J [McGill University, Montreal, QC (Canada); Liang, L; DeBlois, F [Jewish General Hospital, Montreal, QC (Canada); Evans, M [Montreal General Hospital, Montreal, QC (Canada); Licea, A [Canadian Nuclear Safety Comission, Ottawa, Ontario (Canada); Dubeau, J; Witharana, S [Detec, Gatineau, QC (Canada)

2014-06-15

Purpose: With the emergence of flattening filter free (FFF) photon beams, several authors have noted many advantages to their use. One such advantage is the decrease in neutron production by photonuclear reactions in the linac head. In the present work we investigate the reduction in neutrons from a Varian TrueBeam linac using the Nested Neutron Spectrometer (NNS, Detec). The neutron spectrum, total fluence and source strength were measured and compared for 10 MV with and without flattening filter and the effect of moderation by the room and maze was studied for the 15 MV beam. Methods: The NNS, similar to traditional Bonner sphere detectors but operated in current mode, was used to measure the neutron fluence and spectrum. The NNS was validated for use in high dose rate environments using Monte Carlo simulations and calibrated at NIST and NRC Canada. Measurements were performed at several positions within the treatment room and maze with the linac jaws closed to maximize neutron production. Results: The measurements showed a total fluence reduction between 35-40% in the room and maze when the flattening filter was removed. The neutron source strength Qn was calculated from in-room fluence measurements and was found to be 0.042 × 10{sup 2} n/Gy, 0.026 × 10{sup 2} n/Gy and 0.59 × 101{sup 2} n/Gy for the 10 MV, the 10 MV FFF and 15 MV beams, respectively. We measured ambient equivalent doses of 11 mSv/hr, 7 mSv/hr and 218 mSv/hr for the 10 MV, 10 MV FFF and 15 MV by the head. Conclusion: Our measurements revealed a decrease in total fluence, neutron source strength and equivalent dose of approximately 35-40% across the treatment room for the FFF compared to FF modes. This demonstrates, as expected, that the flattening filter is a major component of the neutron production for the TrueBeam. The authors greatly acknowledge support form the Canadian Nuclear Commission and the Natural Sciences and Engineering Research Council of Canada through the CREATE program. Co

Bayesian Islamic medication expert system (B-IMES)

Science.gov (United States)

Daud, Hanita; Razali, Radzuan; Jung, Low Tan; Zaida, Shahnaz

2015-12-01

This paper discusses on the development of an expert system (ES) that applies Bayesian Probability concept for Islamic Medication practice that is made available on web platform. This ES allows user to choose sickness such as headache, stomachache, toothache and etc that he/she may have and list of symptoms related to the sickness will appear for the user to choose. Once symptom(s) is/are chosen the diagnosis is being carried out to suggest percentage of possible specific sickness such as classic migraine, common migraine, tension headache and etc if headache was chosen. This diagnosis is being carried out using Bayes' Theorem and the ES will suggest the treatments or therapy that he/she needs to perform in reference to Muslim Holy Quran and Hadith. This ES was developed to preserve Islamic medication and to create awareness among the young generation and make it accessible at anytime and anywhere and to save users time to meet Islamic Medication practitioners who are not easily available in Malaysia and other parts of the world.

A broadband multimedia collaborative system for advanced teleradiology and medical imaging diagnosis.

Science.gov (United States)

Gómez, E J; del Pozo, F; Ortiz, E J; Malpica, N; Rahms, H

1998-09-01

This paper presents a new telemedicine system currently in routine clinical usage, developed within the European Union (EU) ACTS BONAPARTE project (1). The telemedicine system is developed on an asynchronous transfer mode (ATM) multimedia hardware/software platform comprising the following set of telemedicine services: synchronous cooperative work, high-quality video conference, multimedia mail, medical image digitizing, processing, storing and printing, and local and remote transparent database access. The medical information handled by the platform conforms to the Digital Imaging and Communications in Medicine (DICOM) 3.0 medical imaging standard. The telemedicine system has been installed for clinical routines in three Spanish hospitals since November 1997 and has been used in an average of one/two clinical sessions per week. At each clinical session, a usability and clinical evaluation of the system was carried out. Evaluation is carried out through direct observation of interactions and questionnaire-based subjective data. The usability evaluation methodology and the results of the system usability study are also presented in this article. The experience gained from the design, development, and evaluation of the telemedicine system is providing an indepth knowledge of the benefits and difficulties involved in the installation and clinical usage of this type of high-usability and advanced multimedia telemedicine system in the field of teleradiology and collaborative medical imaging diagnosis.

SU-F-J-41: Experimental Validation of a Cascaded Linear System Model for MVCBCT with a Multi-Layer EPID

Energy Technology Data Exchange (ETDEWEB)

Hu, Y; Rottmann, J; Myronakis, M; Berbeco, R [Department of Radiation Oncology, Brigham and Women’s Hospital, Dana Farber Cancer Institute and Harvard Medical School, Boston, MA. (United States); Fueglistaller, R; Morf, D [Varian Medical Systems, Dattwil, Aargau (Switzerland); Wang, A; Shedlock, D; Star-Lack, J [Varian Medical Systems, Palo Alto, CA (United States)

2016-06-15

Purpose: The purpose of this study was to validate the use of a cascaded linear system model for MV cone-beam CT (CBCT) using a multi-layer (MLI) electronic portal imaging device (EPID) and provide experimental insight into image formation. A validated 3D model provides insight into salient factors affecting reconstructed image quality, allowing potential for optimizing detector design for CBCT applications. Methods: A cascaded linear system model was developed to investigate the potential improvement in reconstructed image quality for MV CBCT using an MLI EPID. Inputs to the three-dimensional (3D) model include projection space MTF and NPS. Experimental validation was performed on a prototype MLI detector installed on the portal imaging arm of a Varian TrueBeam radiotherapy system. CBCT scans of up to 898 projections over 360 degrees were acquired at exposures of 16 and 64 MU. Image volumes were reconstructed using a Feldkamp-type (FDK) filtered backprojection (FBP) algorithm. Flat field images and scans of a Catphan model 604 phantom were acquired. The effect of 2×2 and 4×4 detector binning was also examined. Results: Using projection flat fields as an input, examination of the modeled and measured NPS in the axial plane exhibits good agreement. Binning projection images was shown to improve axial slice SDNR by a factor of approximately 1.4. This improvement is largely driven by a decrease in image noise of roughly 20%. However, this effect is accompanied by a subsequent loss in image resolution. Conclusion: The measured axial NPS shows good agreement with the theoretical calculation using a linear system model. Binning of projection images improves SNR of large objects on the Catphan phantom by decreasing noise. Specific imaging tasks will dictate the implementation image binning to two-dimensional projection images. The project was partially supported by a grant from Varian Medical Systems, Inc. and grant No. R01CA188446-01 from the National Cancer Institute.

An implementation of wireless medical image transmission system on mobile devices.

Science.gov (United States)

Lee, SangBock; Lee, Taesoo; Jin, Gyehwan; Hong, Juhyun

2008-12-01

The advanced technology of computing system was followed by the rapid improvement of medical instrumentation and patient record management system. The typical examples are hospital information system (HIS) and picture archiving and communication system (PACS), which computerized the management procedure of medical records and images in hospital. Because these systems were built and used in hospitals, doctors out of hospital have problems to access them immediately on emergent cases. To solve these problems, this paper addressed the realization of system that could transmit the images acquired by medical imaging systems in hospital to the remote doctors' handheld PDA's using CDMA cellular phone network. The system consists of server and PDA. The server was developed to manage the accounts of doctors and patients and allocate the patient images to each doctor. The PDA was developed to display patient images through remote server connection. To authenticate the personal user, remote data access (RDA) method was used in PDA accessing the server database and file transfer protocol (FTP) was used to download patient images from the remove server. In laboratory experiments, it was calculated to take ninety seconds to transmit thirty images with 832 x 488 resolution and 24 bit depth and 0.37 Mb size. This result showed that the developed system has no problems for remote doctors to receive and review the patient images immediately on emergent cases.

Charges Assessed the Army by the Defense Logistics Agency for Deployable Medical Systems

National Research Council Canada - National Science Library

1995-01-01

.... Deployable medical systems are standardized modular field hospitals that can be prepositioned in the event of a contingency, national emergency, or war operations. In FY 1994, the Defense Personnel Support Center billed the Army $25 million for acquiring and assembling deployable medical systems.

Pitfalls and Security Measures for the Mobile EMR System in Medical Facilities.

Science.gov (United States)

Yeo, Kiho; Lee, Keehyuck; Kim, Jong-Min; Kim, Tae-Hun; Choi, Yong-Hoon; Jeong, Woo-Jin; Hwang, Hee; Baek, Rong Min; Yoo, Sooyoung

2012-06-01

The goal of this paper is to examine the security measures that should be reviewed by medical facilities that are trying to implement mobile Electronic Medical Record (EMR) systems designed for hospitals. The study of the security requirements for a mobile EMR system is divided into legal considerations and sectional security investigations. Legal considerations were examined with regard to remote medical services, patients' personal information and EMR, medical devices, the establishment of mobile systems, and mobile applications. For the 4 sectional security investigations, the mobile security level SL-3 from the Smartphone Security Standards of the National Intelligence Service (NIS) was used. From a compliance perspective, legal considerations for various laws and guidelines of mobile EMR were executed according to the model of the legal considerations. To correspond to the SL-3, separation of DMZ and wireless network is needed. Mobile access servers must be located in only the smartphone DMZ. Furthermore, security measures like 24-hour security control, WIPS, VPN, MDM, and ISMS for each section are needed to establish a secure mobile EMR system. This paper suggested a direction for applying regulatory measures to strengthen the security of a mobile EMR system in accordance with the standard security requirements presented by the Smartphone Security Guideline of the NIS. A future study on the materialization of these suggestions after their application at actual medical facilities can be used as an illustrative case to determine the degree to which theory and reality correspond with one another.

Awareness regarding the systemic effects of periodontal disease among medical interns in India

Directory of Open Access Journals (Sweden)

Arpita Gur

2011-01-01

Full Text Available Background: Medical curriculum does not provide required space for oral health; hence, many medical interns are unfamiliar with the oral cavity and oral health research. Aims: To study the level of awareness regarding systemic effects of periodontal disease among medical interns. Settings and design: A cross-sectional qualitative study recruiting medical interns from two medical institutions affiliated to two different universities in Southern India. Materials and Methods: Study was carried out in two medical institutions affiliated to two different universities in Southern India. A total of 143 interns participated in the study. Each participant was given a self-administered, pre-tested, multiple choice question-type questionnaire to solve on the spot. In order to summarise the awareness level, respondents were graded on a five-level scale as poor, fair, good, very good, and excellent. Statistical analysis used: Percentages, proportions. Results: A total of 67 respondents (47% had fair; 60(42%, poor; and 18(11%, good level of awareness regarding the systemic effects of periodontal disease. Only 23(16%, 17(12%, 12(8%, 6(4% and 4(3% respondents were aware that the periodontal disease may be the possible risk factor for coronary heart disease, cerebral infarction, diabetes mellitus, hospital-acquired pneumonia, and preterm labour (low birth-weight infants, respectively. Only 12 respondents (8% would seek dentist′s opinion for all patients with systemic diseases related to dental disease. Conclusions: Medical interns had inadequate awareness regarding the systemic effects of periodontal disease. Therefore, an integrated teaching of medical and dental sciences is recommended.

The design and implementation of online medical record system ...

African Journals Online (AJOL)

The design and implementation of online medical record system (OMRS) ... PROMOTING ACCESS TO AFRICAN RESEARCH. AFRICAN JOURNALS ONLINE (AJOL) ... International Journal of Natural and Applied Sciences. Journal Home ...

Program-execution in the computer operating-system VORTEX-I

International Nuclear Information System (INIS)

Borrmann, H.

1976-06-01

Comprehensive German introduction to the structure and operation of a relatively comfortable realtime operating system for process control by VORTEX-I for the V73 of the VARIAN-Company. This is a disc oriented single user system with parallel foreground and background operation. The complete organization of the system-nucleus is described (for input/output exists a separate external report). To the more experienced user of the V73 the existing facilities of interacting with the operating system (operator commands, interrupts and program calls) are exactly described regarding to their internal working. (orig./WB) [de

Decrease in medical command errors with use of a "standing orders" protocol system.

Science.gov (United States)

Holliman, C J; Wuerz, R C; Meador, S A

1994-05-01

The purpose of this study was to determine the physician medical command error rates and paramedic error rates after implementation of a "standing orders" protocol system for medical command. These patient-care error rates were compared with the previously reported rates for a "required call-in" medical command system (Ann Emerg Med 1992; 21(4):347-350). A secondary aim of the study was to determine if the on-scene time interval was increased by the standing orders system. Prospectively conducted audit of prehospital advanced life support (ALS) trip sheets was made at an urban ALS paramedic service with on-line physician medical command from three local hospitals. All ALS run sheets from the start time of the standing orders system (April 1, 1991) for a 1-year period ending on March 30, 1992 were reviewed as part of an ongoing quality assurance program. Cases were identified as nonjustifiably deviating from regional emergency medical services (EMS) protocols as judged by agreement of three physician reviewers (the same methodology as a previously reported command error study in the same ALS system). Medical command and paramedic errors were identified from the prehospital ALS run sheets and categorized. Two thousand one ALS runs were reviewed; 24 physician errors (1.2% of the 1,928 "command" runs) and eight paramedic errors (0.4% of runs) were identified. The physician error rate was decreased from the 2.6% rate in the previous study (P < .0001 by chi 2 analysis). The on-scene time interval did not increase with the "standing orders" system.(ABSTRACT TRUNCATED AT 250 WORDS)

Phantom evaluation of a commercially available three modality image guided radiation therapy system

International Nuclear Information System (INIS)

Ploquin, Nicolas; Rangel, Alejandra; Dunscombe, Peter

2008-01-01

The authors describe a detailed evaluation of the capabilities of imaging and image registration systems available with Varian linear accelerators for image guided radiation therapy (IGRT). Specifically, they present modulation transfer function curves for megavoltage planar, kilovoltage (kV) planar, and cone beam computed tomography imaging systems and compare these with conventional computed tomography. While kV planar imaging displayed the highest spatial resolution, all IGRT imaging techniques were assessed as adequate for their intended purpose. They have also characterized the image registration software available for use in conjunction with these imaging systems through a comprehensive phantom study involving translations in three orthogonal directions. All combinations of imaging systems and image registration software were found to be accurate, although the planar kV imaging system with automatic registration was generally superior, with both accuracy and precision of the order of 1 mm, under the conditions tested. Based on their phantom study, the attainable accuracy for rigid body translations using any of the features available with Varian equipment will more likely be limited by the resolution of the couch readouts than by inherent limitations in the imaging systems and image registration software. Overall, the accuracy and precision of currently available IGRT technology exceed published experience with the accuracy and precision of contouring for planning.

The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China.

Science.gov (United States)

Tang, Liyang

2012-09-14

Patient's satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient's life satisfaction in China's health delivery system/in various kinds of hospitals.The aim of this study was to test whether and to what extent patient's satisfaction with medical service delivery/patient's assessments of various major aspects of medical service/various major aspects of patient's trust in health delivery system influenced patient's life satisfaction in China's health delivery system/in various kinds of hospitals. This study collaborated with National Bureau of Statistics of China to carry out a 2008 national urban resident household survey in 17 provinces, autonomous regions, and municipalities directly under the central government (N = 3,386), and specified ordered probit models were established to analyze dataset from this household survey. The key considerations in generating patient's life satisfaction involved patient's overall satisfaction with medical service delivery, assessment of doctor-patient communication, assessment of medical cost, assessment of medical treatment process, assessment of medical facility and hospital environment, assessment of waiting time for medical service, trust in prescription, trust in doctor, and trust in recommended medical examination. But the major considerations in generating patient's life satisfaction were different among low level public hospital, high level public hospital, and private hospital. The promotion of patient's overall satisfaction with medical service delivery, the improvement of doctor-patient communication, the reduction of medical cost, the improvement of medical treatment process, the promotion of medical facility and hospital environment, the reduction of waiting time for medical service, the promotion of patient's trust in prescription, the promotion of patient's trust in doctor, and the promotion of patient's trust in

Medication incidents reported to an online incident reporting system.

LENUS (Irish Health Repository)

Alrwisan, Adel

2011-01-15

AIMS: Approximately 20% of deaths from adverse events are related to medication incidents, costing the NHS an additional £500 million annually. Less than 5% of adverse events are reported. This study aims to assess the reporting rate of medication incidents in NHS facilities in the north east of Scotland, and to describe the types and outcomes of reported incidents among different services. Furthermore, we wished to quantify the proportion of reported incidents according to the reporters\\' profession. METHODS: A retrospective description was made of medication incidents reported to an online reporting system (DATIX) over a 46-month-period (July 2005 to April 2009). Reports originated from acute and community hospitals, mental health, and primary care facilities. RESULTS: Over the study period there were 2,666 incidents reported with a mean monthly reporting rate of 78.2\\/month (SD±16.9). 6.1% of all incidents resulted in harm, with insulin being the most commonly implicated medication. Nearly three-quarters (74.2%, n=1,978) of total incidents originated from acute hospitals. Administration incidents were implicated in the majority of the reported medication incidents (59%), followed by prescribing (10.8%) and dispensing (9.9%), while the nondescript "other medication incidents" accounted for 20.3% of total incidents. The majority of reports were made by nursing and midwifery staff (80%), with medical and dental professionals reporting the lowest number of incidents (n=56, 2%). CONCLUSIONS: The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.

A Cloud Computing Based Patient Centric Medical Information System

Science.gov (United States)

Agarwal, Ankur; Henehan, Nathan; Somashekarappa, Vivek; Pandya, A. S.; Kalva, Hari; Furht, Borko

This chapter discusses an emerging concept of a cloud computing based Patient Centric Medical Information System framework that will allow various authorized users to securely access patient records from various Care Delivery Organizations (CDOs) such as hospitals, urgent care centers, doctors, laboratories, imaging centers among others, from any location. Such a system must seamlessly integrate all patient records including images such as CT-SCANS and MRI'S which can easily be accessed from any location and reviewed by any authorized user. In such a scenario the storage and transmission of medical records will have be conducted in a totally secure and safe environment with a very high standard of data integrity, protecting patient privacy and complying with all Health Insurance Portability and Accountability Act (HIPAA) regulations.

Medical systems in the last half century

International Nuclear Information System (INIS)

Kramer, C.; Botden, P.J.M.

1986-01-01

An overview is presented of the Philips activities in the field of medical systems. They began with the repair of X-ray tubes, which could no longer be sent abroad to the manufacturers during World War I. As a result, Philips soon embarked upon its own development and production of X-ray tubes, power-supply generators, and equipment for patient support and diagnosis. Typical contributions included the rotating anode, which permitted a considerable increase in power and the first ideas on an X-ray image intensifier, which greatly increased the range of capabilities of the radiologist and also reduced very considerably the dose of radiation administered to the patient. The activities in medical electronics grew strongly at first, but are not now pursued, so that Philips can concentrate on systems for medical image diagnosis and radiation therapy. Developments in this area include the gamma camera and the use of ultrasound. Equipment for radiotherapy includes, apart from the well-established X-ray tubes, equipment using radioactive cobalt, linear electron accelerators and a sealed-off neutron tube. The combination of image intensifier with television techniques not only gave the radiologist much more freedom but also led to digitization of the X-ray image. Digitization made i0305ssible to use computer techniques for image processing, which led to computerized tomography (the CT scanner) and to digital vascular imaging, and also to automated storage of X-ray images. One of the latest and very promising imaging techniques (MR) makes use of nuclear magnetic resonance. (Auth.)

[Design and implementation of medical instrument standard information retrieval system based on APS.NET].

Science.gov (United States)

Yu, Kaijun

2010-07-01

This paper Analys the design goals of Medical Instrumentation standard information retrieval system. Based on the B /S structure,we established a medical instrumentation standard retrieval system with ASP.NET C # programming language, IIS f Web server, SQL Server 2000 database, in the. NET environment. The paper also Introduces the system structure, retrieval system modules, system development environment and detailed design of the system.

Measuring diversity in medical reports based on categorized attributes and international classification systems

Directory of Open Access Journals (Sweden)

Přečková Petra

2012-04-01

Full Text Available Abstract Background Narrative medical reports do not use standardized terminology and often bring insufficient information for statistical processing and medical decision making. Objectives of the paper are to propose a method for measuring diversity in medical reports written in any language, to compare diversities in narrative and structured medical reports and to map attributes and terms to selected classification systems. Methods A new method based on a general concept of f-diversity is proposed for measuring diversity of medical reports in any language. The method is based on categorized attributes recorded in narrative or structured medical reports and on international classification systems. Values of categories are expressed by terms. Using SNOMED CT and ICD 10 we are mapping attributes and terms to predefined codes. We use f-diversities of Gini-Simpson and Number of Categories types to compare diversities of narrative and structured medical reports. The comparison is based on attributes selected from the Minimal Data Model for Cardiology (MDMC. Results We compared diversities of 110 Czech narrative medical reports and 1119 Czech structured medical reports. Selected categorized attributes of MDMC had mostly different numbers of categories and used different terms in narrative and structured reports. We found more than 60% of MDMC attributes in SNOMED CT. We showed that attributes in narrative medical reports had greater diversity than the same attributes in structured medical reports. Further, we replaced each value of category (term used for attributes in narrative medical reports by the closest term and the category used in MDMC for structured medical reports. We found that relative Gini-Simpson diversities in structured medical reports were significantly smaller than those in narrative medical reports except the "Allergy" attribute. Conclusions Terminology in narrative medical reports is not standardized. Therefore it is nearly

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

CERN Document Server

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

2008-01-01

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

The medical care system of Hungary.

Science.gov (United States)

Raffel, N K; Raffel, M W

1988-01-01

Medical care in Hungary has made significant progress since World War II in spite of other social priorities which have limited financial support of the health system. A shortage of hard currency in a high technological era is now having a particularly severe adverse impact on further development. Decentralized administration and local finance have, however, provided some room for progress. Preventive efforts are hampered by a deeply entrenched life style which is not conducive to improving the population's health status.

[The status quo and future prospects of emergency medical service systems in Japan in view of the tight supply-demand situation for medical resources].

Science.gov (United States)

Aruga, Tohru

2016-02-01

Considering the tight supply-demand situation for medical resources contributing to emergency medical service(EMS) systems at present and in the future in Japan, the author has explained the present states and future prospects of EMS systems in our country. EMS in remote places in this country is now consisting of the concentration of limited human resources, and is therefore suggestive of the EMS systems in the future, because we will have to deal with the possible exhaustion of EMS in our superannuated society progressing now and in the future. And also EMS systems will have to be maintained in the future with concerted efforts of all the medical staffs. The transferring the medical doctors' tasks to those of nurses and other staffs, that is to say the task shifting has just authorized by recent laws, and so the task shifting will be useful in the future EMS systems performed by all kinds of medical workers, in whom general physicians will be included as they are to be distributed throughout this country in the future.

Occupational medical prophylaxis for the musculoskeletal system: A function-oriented system for physical examination of the locomotor system in occupational medicine (fokus(C

Directory of Open Access Journals (Sweden)

Schwarze Sieglinde

2007-10-01

Full Text Available Abstract Occupational physicians are very often confronted with questions as to the fitness of the postural and locomotor systems, especially the spinal column. Occupational medical assessment and advice can be required by patients with acute symptoms, at routine check-ups, by persons who have problems doing certain jobs, and for expert medical reports as to the fitness of persons with chronic disorders or after operations. Therefore, for occupational medical purposes a physical examination must aim primarily to investigate functions and not structures or radiologic evidence. The physical examination should be structured systematically and according to regions of the body and, together with a specific (pain anamnesis should provide a basis for the medical assessment. This paper presents a function-oriented system for physical examination of the locomotor system, named fokus(C (Funktionsorientierte Koerperliche Untersuchungssystematik, also available on DVD. fokus(C has been developed with a view to its relevance for occupational medical practice and does not aim primarily to provide a precise diagnosis. Decisive for an occupational medical assessment of disorders of the musculoskeletal system is rather information about functional disorders and any impairment of performance or mobility which they can cause. The division of the physical examination into a rapid screening phase and a subsequent more intensive functional diagnostic phase has proved its practicability in many years of day-to-day use. Here, in contrast to the very extensive measures recommended for orthopaedic and manual diagnosis, for reasons of efficiency and usability of the system in routine occupational medical examinations the examination is structured according to the findings. So it is reduced to that which is most necessary and feasible.

MO-FG-202-01: A Fast Yet Sensitive EPID-Based Real-Time Treatment Verification System

International Nuclear Information System (INIS)

Ahmad, M; Nourzadeh, H; Neal, B; Siebers, J; Watkins, W

2016-01-01

EPID images prediction algorithm, was developed. The system is capable of performing verifications between frames acquisitions and identifying source(s) of any out-of-tolerance variations. This work was supported in part by Varian Medical Systems.

MO-FG-202-01: A Fast Yet Sensitive EPID-Based Real-Time Treatment Verification System

Energy Technology Data Exchange (ETDEWEB)

Ahmad, M; Nourzadeh, H; Neal, B; Siebers, J [University of Virginia Health System, Charlottesville, VA (United States); Watkins, W

2016-06-15

EPID images prediction algorithm, was developed. The system is capable of performing verifications between frames acquisitions and identifying source(s) of any out-of-tolerance variations. This work was supported in part by Varian Medical Systems.

High-performance control system for a heavy-ion medical accelerator

Energy Technology Data Exchange (ETDEWEB)

Lancaster, H.D.; Magyary, S.B.; Sah, R.C.

1983-03-01

A high performance control system is being designed as part of a heavy ion medical accelerator. The accelerator will be a synchrotron dedicated to clinical and other biomedical uses of heavy ions, and it will deliver fully stripped ions at energies up to 800 MeV/nucleon. A key element in the design of an accelerator which will operate in a hospital environment is to provide a high performance control system. This control system will provide accelerator modeling to facilitate changes in operating mode, provide automatic beam tuning to simplify accelerator operations, and provide diagnostics to enhance reliability. The control system being designed utilizes many microcomputers operating in parallel to collect and transmit data; complex numerical computations are performed by a powerful minicomputer. In order to provide the maximum operational flexibility, the Medical Accelerator control system will be capable of dealing with pulse-to-pulse changes in beam energy and ion species.

High-performance control system for a heavy-ion medical accelerator

International Nuclear Information System (INIS)

Lancaster, H.D.; Magyary, S.B.; Sah, R.C.

1983-03-01

A high performance control system is being designed as part of a heavy ion medical accelerator. The accelerator will be a synchrotron dedicated to clinical and other biomedical uses of heavy ions, and it will deliver fully stripped ions at energies up to 800 MeV/nucleon. A key element in the design of an accelerator which will operate in a hospital environment is to provide a high performance control system. This control system will provide accelerator modeling to facilitate changes in operating mode, provide automatic beam tuning to simplify accelerator operations, and provide diagnostics to enhance reliability. The control system being designed utilizes many microcomputers operating in parallel to collect and transmit data; complex numerical computations are performed by a powerful minicomputer. In order to provide the maximum operational flexibility, the Medical Accelerator control system will be capable of dealing with pulse-to-pulse changes in beam energy and ion species

Evaluating the medical malpractice system and options for reform.

Science.gov (United States)

Kessler, Daniel P

2011-01-01

The U.S. medical malpractice liability system has two principal objectives: to compensate patients who are injured through the negligence of healthcare providers and to deter providers from practicing negligently. In practice, however, the system is slow and costly to administer. It both fails to compensate patients who have suffered from bad medical care and compensates those who haven't. According to opinion surveys of physicians, the system creates incentives to undertake cost-ineffective treatments based on fear of legal liability--to practice "defensive medicine." The failures of the liability system and the high cost of health care in the United States have led to an important debate over tort policy. How well does malpractice law achieve its intended goals? How large of a problem is defensive medicine and can reforms to malpractice law reduce its impact on healthcare spending? The flaws of the existing system have led a number of states to change their laws in a way that would reduce malpractice liability--to adopt "tort reforms." Evidence from several studies suggests that wisely chosen reforms have the potential to reduce healthcare spending significantly with no adverse impact on patient health outcomes.

Implementation of body area networks based on MICS/WMTS medical bands for healthcare systems.

Science.gov (United States)

Yuce, Mehmet R; Ho, Chee Keong

2008-01-01

A multi-hoping sensor network system has been implemented to monitor physiological parameters from multiple patient bodies by means of medical communication standards MICS (Medical Implant Communication Service) and WMTS (Wireless Medical Telemetry Service). Unlike the other medical sensor networks (they usually use 2.4 GHz ISM band), we used the two medical standards occupying the frequency bands that are mainly assigned to medical applications. The prototype system uses the MICS band (402-405 MHz) between the sensor nodes and a remote central control unit (CCU). And WMTS frequencies (608-614MHz) are used between the CCUs and the remote base stations allowing for a much larger range acting as an intermediate node. The sensor nodes in the prototype can measure up to four body signals (i.e. 4-channel) where one is dedicated to a continuous physiological signal such as ECC/EEG. The system includes firmware and software designs that can provide a long distance data transfer through the internet or a mobile network.

Pitfalls and Security Measures for the Mobile EMR System in Medical Facilities

Science.gov (United States)

Yeo, Kiho; Lee, Keehyuck; Kim, Jong-Min; Kim, Tae-Hun; Choi, Yong-Hoon; Jeong, Woo-Jin; Hwang, Hee; Baek, Rong Min

2012-01-01

Objectives The goal of this paper is to examine the security measures that should be reviewed by medical facilities that are trying to implement mobile Electronic Medical Record (EMR) systems designed for hospitals. Methods The study of the security requirements for a mobile EMR system is divided into legal considerations and sectional security investigations. Legal considerations were examined with regard to remote medical services, patients' personal information and EMR, medical devices, the establishment of mobile systems, and mobile applications. For the 4 sectional security investigations, the mobile security level SL-3 from the Smartphone Security Standards of the National Intelligence Service (NIS) was used. Results From a compliance perspective, legal considerations for various laws and guidelines of mobile EMR were executed according to the model of the legal considerations. To correspond to the SL-3, separation of DMZ and wireless network is needed. Mobile access servers must be located in only the smartphone DMZ. Furthermore, security measures like 24-hour security control, WIPS, VPN, MDM, and ISMS for each section are needed to establish a secure mobile EMR system. Conclusions This paper suggested a direction for applying regulatory measures to strengthen the security of a mobile EMR system in accordance with the standard security requirements presented by the Smartphone Security Guideline of the NIS. A future study on the materialization of these suggestions after their application at actual medical facilities can be used as an illustrative case to determine the degree to which theory and reality correspond with one another. PMID:22844648

Medical record management systems: criticisms and new perspectives.

Science.gov (United States)

Frénot, S; Laforest, F

1999-06-01

The first generation of computerized medical records stored the data as text, but these records did not bring any improvement in information manipulation. The use of a relational database management system (DBMS) has largely solved this problem as it allows for data requests by using SQL. However, this requires data structuring which is not very appropriate to medicine. Moreover, the use of templates and icon user interfaces has introduced a deviation from the paper-based record (still existing). The arrival of hypertext user interfaces has proven to be of interest to fill the gap between the paper-based medical record and its electronic version. We think that further improvement can be accomplished by using a fully document-based system. We present the architecture, advantages and disadvantages of classical DBMS-based and Web/DBMS-based solutions. We also present a document-based solution and explain its advantages, which include communication, security, flexibility and genericity.

AI empowered context-aware smart system for medication adherence

Directory of Open Access Journals (Sweden)

Qiong Wu

2017-06-01

Full Text Available Purpose – Poor medication adherence leads to high hospital admission rate and heavy amount of health-care cost. To cope with this problem, various electronic pillboxes have been proposed to improve the medication adherence rate. However, most of the existing electronic pillboxes use time-based reminders which may often lead to ineffective reminding if the reminders are triggered at inopportune moments, e.g. user is sleeping or eating. Design/methodology/approach – In this paper, the authors propose an AI-empowered context-aware smart pillbox system. The pillbox system collects real-time sensor data from a smart home environment and analyzes the user’s contextual information through a computational abstract argumentation-based activity classifier. Findings – Based on user’s different contextual states, the smart pillbox will generate reminders at appropriate time and on appropriate devices. Originality/value – This paper presents a novel context-aware smart pillbox system that uses argumentation-based activity recognition and reminder generation.

MediSim: A Prototype VR System for Training Medical First Responders

Energy Technology Data Exchange (ETDEWEB)

Stansfield, S.; Shawver, D.; Sobel, A.

1997-12-31

This paper presents a prototype virtual reality (VR) system for training medical first responders. The initial application is to battlefield medicine and focuses on the training of medical corpsmen and other front-line personnel who might be called upon to provide emergency triage on the battlefield. The system is built upon Sandia`s multi-user, distributed VR platform and provides an interactive, immersive simulation capability. The user is represented by an Avatar and is able to manipulate his virtual instruments and carry out medical procedures. A dynamic casualty simulation provides realistic cues to the patient`s condition (e.g. changing blood pressure and pulse) and responds to the actions of the trainee (e.g. a change in the color of a patient`s skin may result from a check of the capillary refill rate). The current casualty simulation is of an injury resulting in a tension pneumothorax. This casualty model was developed by the University of Pennsylvania and integrated into the Sandia MediSim system.

Radiation monitoring system in medical facilities

International Nuclear Information System (INIS)

Matsuno, Kiyoshi

1981-01-01

(1) RI selective liquid effluent monitor is, in many cases, used at medical facilities to obtain data for density of radioactivity of six radionuclides. In comparison with the conventional gross measuring systems, over-evaluation is less, and the monitor is more practical. (2) Preventive monitor for loss of radium needle is a system which prevents missing of radium needle at a flush-toilet in radium treatment wards, and this monitor is capable of sensing a drop-off of radium needle of 0.5 mCi (minimum). (3) Short-lived positron gas measuring device belongs to a BABY CYCLOTRON installed in a hospital, and this device is used to measure density of radioactivity, radioactive impurity and chemical impurity of produced radioactive gas. (author)

Capacity Building in Open Medical Record System (OpenMRS) in ...

International Development Research Centre (IDRC) Digital Library (Canada)

Capacity Building in Open Medical Record System (OpenMRS) in Rwanda ... Partners in Health (PIH), an international nongovernmental organization, has demonstrated the usefulness of ... Journal articles ... will fund social science, population and public health, and health systems research relevant to the emerging crisis.

[Hospital clinical engineer orientation and function in the maintenance system of hospital medical equipment].

Science.gov (United States)

Li, Bin; Zheng, Yunxin; He, Dehua; Jiang, Ruiyao; Chen, Ying; Jing, Wei

2012-03-01

The quantity of medical equipment in hospital rise quickly recent year. It provides the comprehensive support to the clinical service. The maintenance of medical equipment becomes more important than before. It is necessary to study on the orientation and function of clinical engineer in medical equipment maintenance system. Refer to three grade health care system, the community doctors which is called General practitioner, play an important role as the gatekeeper of health care system to triage and cost control. The paper suggests that hospital clinical engineer should play similar role as the gatekeeper of medical equipment maintenance system which composed by hospital clinical engineer, manufacture engineer and third party engineer. The hospital clinical engineer should be responsible of guard a pass of medical equipment maintenance quality and cost control. As the gatekeeper, hospital clinical engineer should take the responsibility of "General engineer" and pay more attention to safety and health of medical equipment. The responsibility description and future transition? development of clinical engineer as "General Engineer" is discussed. More attention should be recommended to the team building of hospital clinical engineer as "General Engineer".

[Cooperation with the electronic medical record and accounting system of an actual dose of drug given by a radiology information system].

Science.gov (United States)

Yamamoto, Hideo; Yoneda, Tarou; Satou, Shuji; Ishikawa, Toru; Hara, Misako

2009-12-20

By input of the actual dose of a drug given into a radiology information system, the system converting with an accounting system into a cost of the drug from the actual dose in the electronic medical record was built. In the drug master, the first unit was set as the cost of the drug, and we set the second unit as the actual dose. The second unit in the radiology information system was received by the accounting system through electronic medical record. In the accounting system, the actual dose was changed into the cost of the drug using the dose of conversion to the first unit. The actual dose was recorded on a radiology information system and electronic medical record. The actual dose was indicated on the accounting system, and the cost for the drug was calculated. About the actual dose of drug, cooperation of the information in a radiology information system and electronic medical record were completed. It was possible to decide the volume of drug from the correct dose of drug at the previous inspection. If it is necessary for the patient to have another treatment of medicine, it is important to know the actual dose of drug given. Moreover, authenticity of electronic medical record based on a statute has also improved.

The "implicit" Ethics of a Systemic Approach to the Medical Praxis

Science.gov (United States)

Ricciuti, Alberto

The unstoppable acceleration of the scientific and technological development that is revolutionizing our socioeconomic systems in recent years has made the critical aspects and the inadequacy of medical epistemology more and more evident. Several elements have underlined the insufficiency of traditional ethical points of reference in Medicine, like the change of individual needs, the technical possibility of long-term management of heavy diseases, the change of the social and health systems caused by the interaction of different ethnic groups and cultures, several problems linked to the fair distribution of resources in regime of fiscal scarcity involving all the industrialized countries of our world. This brought to the necessity for Medicine to modify its coordinates, adjusting them on the person, and not on the disease. In order to reach this objective, the author strategically suggests Systemics as the epistemological guidance of the knowledge process, which can make the scientific method operate in an ethical and cultural horizon centered on the human being valorization, on the respect of his/her needs and the respect of his/her environment. A systemic approach of the medical thought can allow the re-orientation of the clinical look from a biological to a biographic one, the re-definition of the aim of the medical intervention as the restoration and support of self-organizing and self-regulating processes of the biological system, the achieving of a social and health expenditure's saving through a major appropriateness of prescription and an inherent preventive valence of medical interventions, the offer of new and larger horizons for the development of scientific research.

Implementation and validation of a new fixation system for stereotactic radiation therapy: An analysis of patient immobilization.

Science.gov (United States)

Lang, Stephanie; Linsenmeier, Claudia; Brown, Michelle L; Cavelaars, Frederique; Tini, Alessandra; Winter, Christopher; Krayenbuehl, Jerome

2015-01-01

Stereotactic radiation therapy is an established treatment technique for intracranial malignancies. We evaluated a new intracranial immobilization system with an emphasis on determining the intrafraction motion and the correlation of this motion with treatment time. Patients were immobilized using the trUpoint ARCH fixation system (CIVCO Medical Solutions). We collected data from 85 lesions in 73 patients treated between November 2011 and December 2013. Sixty-nine of 73 patients (95%) used the complete mask system; for the remaining 4 patients, the system had to be adapted. Patients were treated using volumetric modulated arc therapy stereotactic radiation therapy on a TrueBeam linear accelerator (Varian Medical Systems, Palo Alto, CA). Fraction doses of 2-8 Gy were applied in 4-30 fractions. Daily cone beam computed tomography imaging was performed before the treatment and was matched to the reference computed tomography using a 6-degrees-of-freedom automatching procedure. Additionally, posttreatment cone beam computed tomography scans were performed to assess intrafraction motion for 67 patients (375 fractions). The average 3-dimensional setup error was 2.1 ± 2.9 mm. The mean pitch and roll was -0.1 ± 0.7° and 0.2 ± 0.7°. A total of 98.0% of the pitch values and 98.9% of the roll values were immobilization system appears to be robust in terms of setup accuracy, intrafraction motion, and repositioning of the mask system. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

[Study on the reform and improvement of the medical device registration system in China].

Science.gov (United States)

Wang, Lanming

2012-11-01

Based on the theories of the Government Regulation and Administrative Licensure, aiming at the current situations of medical device registration system in China, some policy suggestions for future reform and improvement were provided as follows. (1) change the concepts of medical device registration administration. (2) perfect the regulations of medical device registration administration. (3) reform the medical device review organizational system. (4) Optimize the procedure of review and approval. (5) set up and maintain a professional team of review and approval staff. (6) reinforce the post-marketing supervision of medical devices. (7) foster and bring into play of the role of non-government organizations.

Reform in medical and health sciences educational system: a Delphi study of faculty members' views at Shiraz University of Medical Sciences.

Science.gov (United States)

Salehi, A; Harris, N; Lotfi, F; Hashemi, N; Kojouri, J; Amini, M

2014-04-03

Despite the strengths in the Iranian medical and health sciences educational system, areas in need of improvement have been noted. The purpose of this study was to understand the views of faculty members at Shiraz University of Medical Sciences about current and future needs for medical and health sciences education, with the goal of improving the quality of the educational system. The data were collected using a Delphi consensus method. Analysis of the findings identified the following key themes among the factors likely to contribute to medical and health sciences education and training: adding and/or increasing student numbers in higher degrees in preference to associate degrees; providing more interactive, student-centred teaching methods; improving the educational content with more practical and research-based courses tailored to society's needs; and an emphasis on outcome-based student evaluation techniques. These changes aim to respond to health trends in society and enhance the close relationship between medical education and the needs of the Iranian society.

A Novel Medical E-Nose Signal Analysis System

Directory of Open Access Journals (Sweden)

Lu Kou

2017-04-01

Full Text Available It has been proven that certain biomarkers in people’s breath have a relationship with diseases and blood glucose levels (BGLs. As a result, it is possible to detect diseases and predict BGLs by analysis of breath samples captured by e-noses. In this paper, a novel optimized medical e-nose system specified for disease diagnosis and BGL prediction is proposed. A large-scale breath dataset has been collected using the proposed system. Experiments have been organized on the collected dataset and the experimental results have shown that the proposed system can well solve the problems of existing systems. The methods have effectively improved the classification accuracy.

Teleradiology network system and computer-aided diagnosis workstation using the web medical image conference system with a new information security solution

Science.gov (United States)

Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Ohmatsu, Hironobu; Kaneko, Masahiro; Kakinuma, Ryutaru; Moriyama, Noriyuki

2011-03-01

We have developed the teleradiology network system with a new information security solution that provided with web medical image conference system. In the teleradiology network system, the security of information network is very important subjects. We are studying the secret sharing scheme as a method safely to store or to transmit the confidential medical information used with the teleradiology network system. The confidential medical information is exposed to the risk of the damage and intercept. Secret sharing scheme is a method of dividing the confidential medical information into two or more tallies. Individual medical information cannot be decoded by using one tally at all. Our method has the function of RAID. With RAID technology, if there is a failure in a single tally, there is redundant data already copied to other tally. Confidential information is preserved at an individual Data Center connected through internet because individual medical information cannot be decoded by using one tally at all. Therefore, even if one of the Data Centers is struck and information is damaged, the confidential medical information can be decoded by using the tallies preserved at the data center to which it escapes damage. We can safely share the screen of workstation to which the medical image of Data Center is displayed from two or more web conference terminals at the same time. Moreover, Real time biometric face authentication system is connected with Data Center. Real time biometric face authentication system analyzes the feature of the face image of which it takes a picture in 20 seconds with the camera and defends the safety of the medical information. We propose a new information transmission method and a new information storage method with a new information security solution.

Development of a medical academic degree system in China.

Science.gov (United States)

Wu, Lijuan; Wang, Youxin; Peng, Xiaoxia; Song, Manshu; Guo, Xiuhua; Nelson, Hugh; Wang, Wei

2014-01-01

The Chinese government launched a comprehensive healthcare reform to tackle challenges to health equities. Medical education will become the key for successful healthcare reform. We describe the current status of the Chinese medical degree system and its evolution over the last 80 years. Progress has been uneven, historically punctuated most dramatically by the Cultural Revolution. There is a great regional disparity. Doctors with limited tertiary education may be licensed to practice, whereas medical graduates with advanced doctorates may have limited clinical skills. There are undefined relationships between competing tertiary training streams, the academic professional degree, and the clinical residency training programme (RTP). The perceived quality of training in both streams varies widely across China. As the degrees of master or doctor of academic medicine is seen as instrumental in career advancement, including employability in urban hospitals, attainment of this degree is sought after, yet is often unrelated to a role in health care, or is seen as superior to clinical experience. Meanwhile, the practical experience gained in some prestigious academic institutions is deprecated by the RTP and must be repeated before accreditation for clinical practice. This complexity is confusing both for students seeking the most appropriate training, and also for clinics, hospitals and universities seeking to recruit the most appropriate applicants. The future education reforms might include: 1) a domestic system of 'credits' that gives weight to quality clinical experience vs. academic publications in career advancement, enhanced harmonisation between the competing streams of the professional degree and the RTP, and promotion of mobility of staff between areas of excellence and areas of need; 2) International - a mutual professional and academic recognition between China and other countries by reference to the Bologna Accord, setting up a system of easily comparable and

DESIGN AND DEVELOPMENT OF A REMOTE MEDICAL CONSULTATION SYSTEM

Directory of Open Access Journals (Sweden)

"A. Delrobaee

2006-05-01

Full Text Available Telemedicine is an indispensable tool in the hands of doctors to accelerate and facilitate the process of data interchange. To publicize and distribute the culture of utilizing this technology and providing the necessary equipment for this purpose and also to commence some useful activities in this field of science in Iran, the researchers group have designed and performed a telemedicine internet site with the goal of medical consultation. Software was designed and prepared, which is accessible to three groups of users with definite level of access for each one: normal users, doctors and site administrators. There are four main forums on this website with the following titles: medical consultation (Q&A, doctors’ special forum, scientific and research centers and also special disease groups, and the forum of graduates and medical students. Ultimately, we could achieve a new horizon to expand telemedicine activities in the field of medical consultation. A free web-based system was developed through the address of www.teleteb.com with the aim of remote medical consultation, developing the public health services and creating a powerful scientific and research link in the society of medicine.

XMedIA Communication System: An XML Driven Medical Image Processing and Archiving Environment

National Research Council Canada - National Science Library

Sakellaris, G

2001-01-01

... system meets the requirements for secure search, transaction, and presentation of medical information to the end users, whether patient or health care professional, Key features of the work include personalized access and efficient management of distributed medical knowledge, intercommunication of heterogeneous systems and presentation of information in a concise way, across different platforms.

An improved biometrics-based authentication scheme for telecare medical information systems.

Science.gov (United States)

Guo, Dianli; Wen, Qiaoyan; Li, Wenmin; Zhang, Hua; Jin, Zhengping

2015-03-01

Telecare medical information system (TMIS) offers healthcare delivery services and patients can acquire their desired medical services conveniently through public networks. The protection of patients' privacy and data confidentiality are significant. Very recently, Mishra et al. proposed a biometrics-based authentication scheme for telecare medical information system. Their scheme can protect user privacy and is believed to resist a range of network attacks. In this paper, we analyze Mishra et al.'s scheme and identify that their scheme is insecure to against known session key attack and impersonation attack. Thereby, we present a modified biometrics-based authentication scheme for TMIS to eliminate the aforementioned faults. Besides, we demonstrate the completeness of the proposed scheme through BAN-logic. Compared to the related schemes, our protocol can provide stronger security and it is more practical.

Medical Certification System -

Data.gov (United States)

Department of Transportation — Provides automated risk-based decision making capability in support of medical certification and clearances processing associated fees and supporting surveillance of...

Perspectives on the changing healthcare system: teaching systems-based practice to medical residents

Directory of Open Access Journals (Sweden)

Johanna Martinez

2013-09-01

Full Text Available Purpose: The Accreditation Council for Graduate Medical Education restructured its accreditation system to be based on educational outcomes in six core competencies. Systems-based practice is one of the six core competencies. The purpose of this report is to describe Weill Cornell Medical College's Internal Medicine Residency program curriculum for systems-based practice (SBP and its evaluation process. Methods: To examine potential outcomes of the POCHS curriculum, an evaluation was conducted, examining participants': (1 knowledge gain; (2 course ratings; and (3 qualitative feedback. Results: On average, there was a 19 percentage point increase in knowledge test scores for all three cohorts. The course was rated overall highly, receiving an average of 4.6 on a 1–5 scale. Lastly, the qualitative comments supported that the material is needed and valued. Conclusion: The course, entitled Perspectives on the Changing Healthcare System (POCHS and its evaluation process support that systems-based practice is crucial to residency education. The course is designed not only to educate residents about the current health care system but also to enable them to think critically about the risk and benefits of the changes. POCHS provides a framework for teaching and assessing this competency and can serve as a template for other residency programs looking to create or restructure their SBP curriculum.

MedEx: a medication information extraction system for clinical narratives

Science.gov (United States)

Stenner, Shane P; Doan, Son; Johnson, Kevin B; Waitman, Lemuel R; Denny, Joshua C

2010-01-01

Medication information is one of the most important types of clinical data in electronic medical records. It is critical for healthcare safety and quality, as well as for clinical research that uses electronic medical record data. However, medication data are often recorded in clinical notes as free-text. As such, they are not accessible to other computerized applications that rely on coded data. We describe a new natural language processing system (MedEx), which extracts medication information from clinical notes. MedEx was initially developed using discharge summaries. An evaluation using a data set of 50 discharge summaries showed it performed well on identifying not only drug names (F-measure 93.2%), but also signature information, such as strength, route, and frequency, with F-measures of 94.5%, 93.9%, and 96.0% respectively. We then applied MedEx unchanged to outpatient clinic visit notes. It performed similarly with F-measures over 90% on a set of 25 clinic visit notes. PMID:20064797

Evacuation support system for improved medical documentation and information flow in the field.

Science.gov (United States)

Walderhaug, Ståle; Meland, Per Håkon; Mikalsen, Marius; Sagen, Terje; Brevik, John Ivar

2008-02-01

Documentation of medical treatment and observation of patients during evacuation from the point of injury to definitive treatment is important both for optimizing patient treatment and managing the evacuation process. The current practice in military medical field documentation uses paper forms and voice communication. There are many shortcomings associated with this approach, especially with respect to information capture and sharing processes. Current research addresses the use of new technology for civilian ambulance-to-hospital communication. The research work presented in this article addresses information capture and sharing in extreme military conditions by evaluating a targeted computerized information system called EvacSys during a military exercise in northern Norway in December 2003. EvacSys was designed and implemented in close cooperation with military medical personnel in both Norway and the USA. The system was evaluated and compared to the traditional paper-based documentation method during a military exercise. The on-site evaluation was conducted in a military medical platoon in the Norwegian Armed Forces, using questionnaires, semi-structured interviews, observation and video recording to capture the users' system acceptance. A prototype software system running on a commercial off-the-shelf hardware platform was successfully developed. The evaluation of this system shows that the usability of digital information capturing and sharing are perceived to be at least as good as the traditional paper-based method. The medics found the new digital method to be more viable than the old one. No technical problems were encountered. Our research shows that it is feasible to utilize digital information systems for medical documentation in extreme outdoor environments. The usability concern is of utmost importance, and more research should be put into the design and alignment with existing workflow. Successful digitalization of information at the point of care

CLAIM (CLinical Accounting InforMation)--an XML-based data exchange standard for connecting electronic medical record systems to patient accounting systems.

Science.gov (United States)

Guo, Jinqiu; Takada, Akira; Tanaka, Koji; Sato, Junzo; Suzuki, Muneou; Takahashi, Kiwamu; Daimon, Hiroyuki; Suzuki, Toshiaki; Nakashima, Yusei; Araki, Kenji; Yoshihara, Hiroyuki

2005-08-01

With the evolving and diverse electronic medical record (EMR) systems, there appears to be an ever greater need to link EMR systems and patient accounting systems with a standardized data exchange format. To this end, the CLinical Accounting InforMation (CLAIM) data exchange standard was developed. CLAIM is subordinate to the Medical Markup Language (MML) standard, which allows the exchange of medical data among different medical institutions. CLAIM uses eXtensible Markup Language (XML) as a meta-language. The current version, 2.1, inherited the basic structure of MML 2.x and contains two modules including information related to registration, appointment, procedure and charging. CLAIM 2.1 was implemented successfully in Japan in 2001. Consequently, it was confirmed that CLAIM could be used as an effective data exchange format between EMR systems and patient accounting systems.

Risk management and measuring productivity with POAS--Point of Act System--a medical information system as ERP (Enterprise Resource Planning) for hospital management.

Science.gov (United States)

Akiyama, M

2007-01-01

The concept of our system is not only to manage material flows, but also to provide an integrated management resource, a means of correcting errors in medical treatment, and applications to EBM (evidence-based medicine) through the data mining of medical records. Prior to the development of this system, electronic processing systems in hospitals did a poor job of accurately grasping medical practice and medical material flows. With POAS (Point of Act System), hospital managers can solve the so-called, "man, money, material, and information" issues inherent in the costs of healthcare. The POAS system synchronizes with each department system, from finance and accounting, to pharmacy, to imaging, and allows information exchange. We can manage Man (Business Process), Material (Medical Materials and Medicine), Money (Expenditure for purchase and Receipt), and Information (Medical Records) completely by this system. Our analysis has shown that this system has a remarkable investment effect - saving over four million dollars per year - through cost savings in logistics and business process efficiencies. In addition, the quality of care has been improved dramatically while error rates have been reduced - nearly to zero in some cases.

A User-Centered Cooperative Information System for Medical Imaging Diagnosis.

Science.gov (United States)

Gomez, Enrique J.; Quiles, Jose A.; Sanz, Marcos F.; del Pozo, Francisco

1998-01-01

Presents a cooperative information system for remote medical imaging diagnosis. General computer-supported cooperative work (CSCW) problems addressed are definition of a procedure for the design of user-centered cooperative systems (conceptual level); and improvement of user feedback and optimization of the communication bandwidth in highly…

Virtual medical plant modeling based on L-system | Ding | African ...

African Journals Online (AJOL)

... aid of graphics and PlantVR, we implemented the plant shape and 3-D structure's reconstruction. Conclusion: Three-dimensional structure virtual plant growth model based on time- controlled L-system has been successfully established. Keywords: Drug R&D, toxicity, medical plants, fractals; L-system; quasi binary-trees.

78 FR 25304 - Siemens Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology), Including On...

Science.gov (United States)

2013-04-30

..., USA, Inc., Oncology Care Systems (Radiation Oncology), Including On-Site Leased Workers From Source... Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology), including on- site leased... of February 2013, Siemens Medical Solutions, USA, Inc., Oncology Care Systems (Radiation Oncology...

An MCNP-based model of a medical linear accelerator x-ray photon beam.

Science.gov (United States)

Ajaj, F A; Ghassal, N M

2003-09-01

The major components in the x-ray photon beam path of the treatment head of the VARIAN Clinac 2300 EX medical linear accelerator were modeled and simulated using the Monte Carlo N-Particle radiation transport computer code (MCNP). Simulated components include x-ray target, primary conical collimator, x-ray beam flattening filter and secondary collimators. X-ray photon energy spectra and angular distributions were calculated using the model. The x-ray beam emerging from the secondary collimators were scored by considering the total x-ray spectra from the target as the source of x-rays at the target position. The depth dose distribution and dose profiles at different depths and field sizes have been calculated at a nominal operating potential of 6 MV and found to be within acceptable limits. It is concluded that accurate specification of the component dimensions, composition and nominal accelerating potential gives a good assessment of the x-ray energy spectra.

New hospital payment systems: comparing medical strategies in The Netherlands, Germany and England.

Science.gov (United States)

van Essen, Anne Marije

2009-01-01

This paper seeks to identify different medical strategies adopted in relation to the new hospital payment systems in Germany, The Netherlands and England and analyse how the medical strategies have impacted on the emergence of these New Public Management policy tools between 2002 and 2007. A comparative approach is applied. In addition to secondary sources, the study uses publications in professional journals, official publications of the (national) physician organisations and a (non-random) expert questionnaire to obtain the views of the medical corporate bodies in the three countries. The results reveal differences in the medical strategies in the three countries that point towards the significance of institutional and interest configurations. The Dutch corporate medical body was most willing to solve the conflict, while the German and English corporate medical bodies seem to be keen to use a strategy of confrontation. The differences in medical strategies also impact on the ways in which hospital payment systems have emerged in the three countries. Further research is necessary to study the medical strategies in healthcare reforms from a broader perspective, for instance by including other countries. The paper gives insights into the interplay between the medical profession and the government in the context of new managerial governance practices in the hospital sector. It adds to the scholarly debates about the role of the medical profession in health policy-making.

[Design considerations for clinical data management in an integrated remote medical system].

Science.gov (United States)

Bautu, E; Bautu, A; Ciorap, R; Pomazan, V M; Petcu, L C

2009-01-01

In this paper, we present a proposal for the design of a telemedicine system. The system (called SIMPA) will be used for noninvasive monitoring of some vital parameters of patients with chronic diseases. The telemedicine system contains a fixed unit and some mobile units. The mobile unit contains various sensors used to gather data about vital biosignals, a transceiver and a medical processor. On the fixed unit side, the host transceiver must be compatible with the mobile transceiver. On the server side, an application analyzes and processes the data and further stores it in dedicated databases. The database support for the telemedicine application is ensured by open source technologies and already available communication infrastructures (GSM networks). The requirements for the application were thoroughly analyzed and the Entity-Relationship diagram of the system was designed and translated into relational model. SIMPA will be implemented using only free and open source technologies, which will ensure a low cost and improved extensibility and portability. We presented some design considerations for a low-cost telemedicine system. The system will help optimize medical decisions and will increase the quality of the medical act and lower the cost, to the ultimate benefit of the patient.

DXplain: a Web-based diagnostic decision support system for medical students.

Science.gov (United States)

London, S

1998-01-01

DXplain is a diagnostic decision support program, with a new World Wide Web interface, designed to help medical students and physicians formulate differential diagnoses based on clinical findings. It covers over 2000 diseases and 5000 clinical manifestations. DXplain suggests possible diagnoses, and provides brief descriptions of every disease in the database. Not all diseases are included, nor does DXplain take into account preexisting conditions or the chronological sequence of clinical manifestations. Despite these limitations, it is a useful educational tool, particularly for problem-based learning (PBL) cases and for students in clinical rotations, as it fills a niche not adequately covered by MEDLINE or medical texts. The system is relatively self-explanatory, requiring little or no end-user training. Medical libraries offering, or planning to offer, their users access to Web-based materials and resources may find this system a valuable addition to their electronic collections. Should it prove popular with the local users, provision of access may also establish or enhance the library's image as a partner in medical education.

Comparative Cost-Effectiveness Analysis of Three Different Automated Medication Systems Implemented in a Danish Hospital Setting.

Science.gov (United States)

Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

2018-02-01

Automated medication systems have been found to reduce errors in the medication process, but little is known about the cost-effectiveness of such systems. The objective of this study was to perform a model-based indirect cost-effectiveness comparison of three different, real-world automated medication systems compared with current standard practice. The considered automated medication systems were a patient-specific automated medication system (psAMS), a non-patient-specific automated medication system (npsAMS), and a complex automated medication system (cAMS). The economic evaluation used original effect and cost data from prospective, controlled, before-and-after studies of medication systems implemented at a Danish hematological ward and an acute medical unit. Effectiveness was described as the proportion of clinical and procedural error opportunities that were associated with one or more errors. An error was defined as a deviation from the electronic prescription, from standard hospital policy, or from written procedures. The cost assessment was based on 6-month standardization of observed cost data. The model-based comparative cost-effectiveness analyses were conducted with system-specific assumptions of the effect size and costs in scenarios with consumptions of 15,000, 30,000, and 45,000 doses per 6-month period. With 30,000 doses the cost-effectiveness model showed that the cost-effectiveness ratio expressed as the cost per avoided clinical error was €24 for the psAMS, €26 for the npsAMS, and €386 for the cAMS. Comparison of the cost-effectiveness of the three systems in relation to different valuations of an avoided error showed that the psAMS was the most cost-effective system regardless of error type or valuation. The model-based indirect comparison against the conventional practice showed that psAMS and npsAMS were more cost-effective than the cAMS alternative, and that psAMS was more cost-effective than npsAMS.

Real-Time Implementation of Medical Ultrasound Strain Imaging System

International Nuclear Information System (INIS)

Jeong, Mok Kun; Kwon, Sung Jae; Bae, Moo Ho

2008-01-01

Strain imaging in a medical ultrasound imaging system can differentiate the cancer or tumor in a lesion that is stiffer than the surrounding tissue. In this paper, a strain imaging technique using quasistatic compression is implemented that estimates the displacement between pre- and postcompression ultrasound echoes and obtains strain by differentiating it in the spatial direction. Displacements are computed from the phase difference of complex baseband signals obtained using their autocorrelation, and errors associated with converting the phase difference into time or distance are compensated for by taking into the center frequency variation. Also, to reduce the effect of operator's hand motion, the displacements of all scanlines are normalized with the result that satisfactory strain image quality has been obtained. These techniques have been incorporated into implementing a medical ultrasound strain imaging system that operates in real time.

Artificial intelligence and medical imaging. Expert systems and image analysis

International Nuclear Information System (INIS)

Wackenheim, A.; Zoellner, G.; Horviller, S.; Jacqmain, T.

1987-01-01

This paper gives an overview on the existing systems for automated image analysis and interpretation in medical imaging, especially in radiology. The example of ORFEVRE, the system for the analysis of CAT-scan images of the cervical triplet (c3-c5) by image analysis and subsequent expert-system is given and discussed in detail. Possible extensions are described [fr

Web-based Distributed Medical Information System for Chronic Viral Hepatitis

Science.gov (United States)

Yang, Ying; Qin, Tuan-fa; Jiang, Jian-ning; Lu, Hui; Ma, Zong-e.; Meng, Hong-chang

2008-11-01

To make a long-term dynamic monitoring to the chronically ill, especially patients of HBV A, we build a distributed Medical Information System for Chronic Viral Hepatitis (MISCHV). The Web-based system architecture and its function are described, and the extensive application and important role are also presented.

Medical Terminology of the Circulatory System. Medical Records. Instructional Unit for the Medical Transcriber.

Science.gov (United States)

Gosman, Minna L.

Developed as a result of an analysis of the task of transcribing as practiced in a health facility, this study guide was designed to teach the knowledge and skills required of a medical transcriber. The medical record department was identified as a major occupational area, and a task inventory for medical records was developed and used as a basis…

Medical Terminology of the Respiratory System. Medical Records. Instructional Unit for the Medical Transcriptionist.

Science.gov (United States)

Gosman, Minna L.

Following an analysis of the task of transcribing as practiced in a health facility, this study guide was designed to teach the knowledge and skills required of a medical transcriber. The medical record department was identified as a major occupational area, and a task inventory for medical records was developed and used as a basis for…

Medical Terminology of the Musculoskeletal System. Medical Records. Instructional Unit for the Medical Transcriber.

Science.gov (United States)

Gosman, Minna L.

Following an analysis of the task of transcribing as practiced in a health facility, this study guide was developed to teach the knowledge and skills required of a medical transcriber. The medical record department was identified as a major occupational area, and a task inventory for medical records was developed and used as a basis for a…

Final Report, Next-Generation Mega-Voltage Cargo-Imaging System for Cargo Conainer Inspection, March 2007

Energy Technology Data Exchange (ETDEWEB)

Dr. James Clayton, Ph.D., Varian Medical Systems-Security & Inspection Products; Dr. Emma Regentova, Ph.D, University of Nevada Las Vegas; Dr. Evangelos Yfantis, Ph.D., University of Nevada, Las Vegas

2007-03-27

The UNLV Research Foundation, as the primary award recipient, teamed with Varian Medical Systems-Security & Inspection Products and the University of Nevada Las Vegas (UNLV) for the purpose of conducting research and engineering related to a "next-generation" mega-voltage imaging (MVCI) system for inspection of cargo in large containers. The procurement and build-out of hardware for the MVCI project has been completed. The K-9 linear accelerator and an optimized X-ray detection system capable of efficiently detecting X-rays emitted from the accelerator after they have passed through the device is under test. The Office of Science financial assistance award has made possible the development of a system utilizing a technology which will have a profound positive impact on the security of U.S. seaports. The proposed project will ultimately result in critical research and development advances for the "next-generation" Linatron X-ray accelerator technology, thereby providing a safe, reliable and efficient fixed and mobile cargo inspection system, which will very significantly increase the fraction of cargo containers undergoing reliable inspection as the enter U.S. ports. Both NNSA/NA-22 and the Department of Homeland Security's Domestic Nuclear Detection Office are collaborating with UNLV and its team to make this technology available as soon as possible.

Final Report, Next-Generation Mega-Voltage Cargo-Imaging System for Cargo Container Inspection, March 2007

International Nuclear Information System (INIS)